Left or right kidney in hand-assisted donor nephrectomy? A randomized controlled trial

Background. There is an ongoing discussion in living renal transplantation whether the right or the left donor nephrectomy is to be preferred if both kidneys are equal, due to the lack of prospective studies. Methods. A prospective single-center randomized trial was conducted from April 2002 to September 2006, in which 60 eligible consecutive donors were randomized to either left-sided or right-sided hand-assisted laparoscopic donor nephrectomy (HALDN). Primary endpoint was operation time. Secondary endpoints were donor morbidity, warm ischemia time, delayed graft function, urological complications, quality of life, and graft survival. Results. Median operating time for left-sided HALDN (180 min) was significantly longer compared with right-sided HALDN (150 min; P=0.021). There were no conversions in both groups. There were no major intra- or postoperative complications. One-year graft survival rate was 96% in the left group versus 93% in the right group (P=0.625, log rank). Conclusions. Operating time of HALDN of the right kidney is significantly shorter than HALDN of the left kidney. No differences were detected in complication rates and graft survival between left and right-sided donor nephrectomy.