Less-Invasive Procedure Brings More Kidney Donations
The surgeons also find that it is easier for patients to recruit donors with the laparoscopic technique. A third of the donors who underwent the new type of procedure were unrelated to the kidney recipients or were only distant relatives. Nearly four out of 10 donors traveled from out of state to donate.
The alternative to finding a living donor is to wait for a transplant from someone who has died.
"Living donor kidneys are better than cadaver kidneys because they last twice as long," says Johann Jonsson, MD, who reviewed the study for WebMD. The average cadaver kidney lasts six to eight years, he tells WebMD. Jonsson, director of the kidney transplant program at Inova Fairfax Hospital in Falls Church, Va., says doctors there are finding the same doubling of kidney donations as the University of Maryland.
"We're just at the beginning of the surge of either related or emotionally related donors, because the laparoscopy gives so many benefits we couldn't offer donors before," says Arieh Shalhav, MD, who also reviewed the study for WebMD. Shalhav is associate professor of urology at Indiana University School of Medicine, and a urologist at Methodist Hospital of Indiana in Indianapolis.
In the laparoscopic nephrectomy, surgeons make a 2 1/2-inch incision near the navel, along with four small holes through which instruments are inserted. The laparoscope, an instrument that houses a miniature camera that allows surgeons to see what they are doing on a video screen, is inserted through one of the holes. The surgical instruments are inserted through the others. The surgeons disconnect the kidney from the donor, wrap it in a plastic bag, and slide it out of the small incision. It is then transferred to the recipient.
Researchers also found that results of this laparoscopic surgery were slightly better than those of traditional surgery, with nearly 95% of the kidneys still functioning three years after they were implanted, compared to 91% with the traditional method.