Correlation of pre-operative imaging characteristics with donor outcomes and operative difficulty in laparoscopic donor nephrectomy.

Abstract

This study aimed to understand the relationship of pre-operative measurements and risk factors on operative time and outcomes of laparoscopic donor nephrectomy. 242 kidney donors between 2010 and 2017 were identified. Patient's demographic, anthropomorphic and operative characteristics were abstracted from the electronic medical record. Glomerular filtration rates (GFR) were documented before surgery, within 24 hours, 6, 12 and 24 months after surgery. Standard radiological measures and kidney volumes, subcutaneous and perinephric fat thicknesses were assessed by three radiologists. Data were analyzed using standard statistical measures. There was significant correlation between cranio-caudal and latero-lateral diameters (p<0.0001) and kidney volume. The left kidney was transplanted in 92.6% of cases and the larger kidney in 69.2%. Kidney choice (smaller vs larger) had no statistically significant impact on the rate of change of donor kidney function over time adjusting for age, sex and race (p=0.61). Perinephric fat thickness (+4.08 min) and surgery after 2011 were significantly correlated with operative time (p≤0.01). In conclusion, cranio-caudal diameters can be used as a surrogate measure for volume in the majority of donors. Size may not be a decisive factor for long-term donor kidney function. Perinephric fat around the donor kidney should be reported to facilitate operative planning.

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Citation

Published Version (Please cite this version)

10.1111/ajt.15608

Publication Info

Schwartz, Fides R, Brian I Shaw, Reginald Lerebours, Federica Vernuccio, Francesca Rigiroli, Fernando Gonzalez, Sheng Luo, Aparna S Rege, et al. (2019). Correlation of pre-operative imaging characteristics with donor outcomes and operative difficulty in laparoscopic donor nephrectomy. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 10.1111/ajt.15608 Retrieved from https://hdl.handle.net/10161/19352.

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Scholars@Duke

Shaw

Brian Shaw

House Staff
Lerebours

Reginald (Gino) Lerebours

Biostatistician II

Education: Masters Degree, Biostatistics. Harvard University. 2017
Bachelors Degree, Statistics. North Carolina State University. 2015

Overview:  Gino currently collaborates with researchers, residents, and clinicians in the Departments of Surgery, Radiology and Infectious Diseases. His main research interests and experience are in statistical programming, data management, statistical modeling, statistical consulting and statistical education.

Luo

Sheng Luo

Professor of Biostatistics & Bioinformatics
Rege

Aparna Sharad Rege

Clinical Associate in the Department of Surgery
Marin

Daniele Marin

Associate Professor of Radiology

Liver Imaging
Dual Energy CT
CT Protocol Optimization
Dose Reduction Strategies for Abdominal CT Applications

Ravindra

Kadiyala Venkata Ravindra

Professor of Surgery

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