Less May Be More in Kidney Donation

Single port nephrectomy for living kidney donors led to higher satisfaction

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) To donate a kidney is a giant act of generosity. Living kidney donors must go through a serious surgery and recovery, which is not easy for everyone. One type of kidney removal surgery may make donors happier.

Researchers found that living donors who had a kidney removed through a single opening in the belly button had less scarring and higher satisfaction than donors who went through a multi-opening kidney removal surgery.

"Consider becoming a kidney donor."

Single-port donor nephrectomy - also called laparoendoscopic singe-site (LESS) surgery - is a newer surgery for kidney removal in which the kidney is taken out through the belly button. The surgery practically leaves no scar. Once the opening heals, it is hidden within the belly button.

Rolf Barth, M.D., of the University of Maryland School of Medicine, and colleagues found that kidney donors who went through the belly button surgery were more satisfied with their cosmetic outcome and the overall donation process.

In addition, donors who went through the single-opening surgery did not have as much trouble bending, kneeling or stooping after surgery, compared to those who went through the multi-opening surgery.

Both types of surgery are equally safe.

"Everything we do in organ transplantation is based on the generosity of organ donors," said Dr. Barth.

"If we as surgeons can safely improve the donation process for our living donors by perfecting less-invasive surgical options, we should embrace these new approaches," he said.

Over 92,000 people in the U.S. are on the waiting list for a kidney transplant. Living donations can help these patients get a new kidney sooner and avoid the risks of dialysis or worsening kidney disease.

"The waiting list for a kidney continues to grow every day, while the number of donated organs remains flat," said Laurie Reece, Operations Director at the Alliance for Paired Donation.

"Twelve or more people die every day because they don't get a transplant in time. In some states, the wait for a deceased donor's kidney is seven or eight years! So clearly, living donation is a critical area, especially since living donor kidneys last, on average, 16.5 years as opposed to about half that for a deceased donor kidney," said Reece, who was not involved in the study.

For their study, Dr. Barth and colleagues compared the outcomes of 135 single-opening donors and 100 multi-opening donors. In addition, another group of 100 single-opening and 100 multi-opening donors filled out two questionnaires.

The results showed that the single-opening surgery, or LESS surgery, did not increase risks or complications, compared to multi-opening surgery. What's more, donors who underwent LESS surgery were more satisfied with their decision to donate.

"For a living kidney donor who leaves the operating room with no health benefit from the surgical procedure and only a small band-aid over the [belly button], LESS may be more," said Dr. Barth.

"I think living donors derive their satisfaction by helping someone else live a better life, not the type of surgery they have," said Reece.

"But at the end of the day, we must do everything we can to enhance the safety of living donors - not just their satisfaction. If this procedure can make the procedure more safe, then I hope it becomes as commonplace as laparoscopic kidney removal," she said.

"If we could make the living donor procedure safer - or at least a little less painful and with a smaller incision - I think more people would consider living donation," she said.

The University of Maryland Medical Center - where Dr. Barth is employed - uses LESS surgery as their standard of care for living donors.

This study was published September 10 in the Annals of Surgery

Reviewed by: 
Review Date: 
September 16, 2012
Last Updated:
September 28, 2012