Attitudes among surgeons towards live-donor nephrectomy: a European update.
| Autor: | Klop KW; Division of Transplant Surgery, Department of Surgery, Erasmus Medical Center, Erasmus University Rotterdam, the Netherlands., Dols LF, Kok NF, Weimar W, Ijzermans JN |
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| Jazyk: | angličtina |
| Zdroj: | Transplantation [Transplantation] 2012 Aug 15; Vol. 94 (3), pp. 263-8. |
| DOI: | 10.1097/TP.0b013e3182577501 |
| Abstrakt: | Background: The increasing number of living kidney donors in the last decade has led to the development of novel surgical techniques for live-donor nephrectomy. The aim of the present study was to evaluate the current status of the surgical approach in Europe. Methods: A survey was sent to 119 transplant centers in 12 European countries. Questions included the number of donors, the technique used, and the acceptance of donors with comorbidities. Results: Ninety-six centers (81%) replied. The number of living donors per center ranged from 0 to 124. Thirty-one institutions (32%) harvested kidneys using open techniques only. Six centers (6%) applied both endoscopic and open techniques; 59 centers (61%) performed endoscopic donor nephrectomy only. Lack of evidence that endoscopic techniques provide superior results was the main reason for still performing open donor nephrectomy. In seven centers, a lumbotomy is still performed. Seventy-two centers (75%) accept donors with a body mass index of more than 30 kg/m, the median upper limit in these centers was 35 kg/m (range, 31-40). Donors with an American Society of Anesthesiologists classification higher than 1 were accepted in 55% of the centers. Conclusions: Live kidney donation in general and minimally invasive donor nephrectomy in particular are more commonly applied in Northern and Western Europe. However, a classic lumbotomy is still performed in a minority of centers. Because minimally invasive techniques have been proven superior, more attention should be given to educational programs in this field to let many kidney donors benefit. |
| Databáze: | MEDLINE |
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