Anterior vertical mini-incision versus retroperitoneoscopic nephrectomy in living kidney donation: A prospective study on donors' quality of life and clinical outcome

BACKGROUND: A fundamental goal in living kidney donation (LKD) is to maximize donor safety while minimizing postoperative impairments. We evaluated clinical outcome and health-related quality of life (QOL) comparing anterior vertical mini-incision donor nephrectomy (MIDN) and retroperitoneoscopic donor nephrectomy (RPDN).

METHODS: 38 MIDN and 45 RPDN donors were analyzed. In a subsample (n=18 MIDN; n=32 RPDN), QOL was prospectively assessed with the WHOQOL-Bref questionnaire before and 3 months after LKD.

RESULTS: Skin-to-skin time (169 vs. 116 min, p<0.001) and hospital stay (6.6 vs. 4.9 days, p<0.001) were significantly shorter in RPDN. 26% MIDN patients and 13% RPDN patients developed postoperative complications (p=0.14). While in MIDN the QOL domains physical health (p=0.03) and psychological (p=0.03) and the overall QOL facet (p=0.003) were significantly lower 3 months post LKD compared to baseline, there were no significant QOL decreases in RPDN. However, no significant postoperative QOL differences were found between groups. RPDN donors retrospectively reported significantly less postoperative pain (p=0.007) and physical strain (p=0.05) caused by LKD than MIDN donors.

CONCLUSIONS: It may be possible to further reduce the surgical burden of LKD by introducing RPDN. Postoperative QOL was not significantly different between groups, but the QOL decrease appeared to be less pronounced in RPDN. This article is protected by copyright. All rights reserved.