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01.08.2011 | Original Article

No need for systemic heparinization during laparoscopic donor nephrectomy with short warm ischemia time

verfasst von: Frank Friedersdorff, Ingmar Wolff, Serdar Deger, Jan Roigas, John Buckendahl, Hannes Cash, Markus Giessing, Lutz Liefeldt, Kurt Miller, T. Florian Fuller

Erschienen in: World Journal of Urology | Ausgabe 4/2011

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Abstract

Purpose

Systemic heparin administration during laparoscopic donor nephrectomy (LDN) may prevent microvascular thrombus formation following warm ischemia. We herein present our experience with and without systemic heparinization during LDN.

Methods

We retrospectively reviewed donor complications and graft outcomes in 119 consecutive live donor kidney transplantations between January 2005 and December 2009. Systemic heparin was administered to the first 65 donors. LDN was carried out by 2 surgeons using a pure laparoscopic technique.

Results

Total operating time for LDN was significantly longer in the heparin group (202 vs. 157 min). The incidence of renal artery multiplicity was significantly higher in the heparin group. Mean warm ischemia time was 160 s, and mean hospital stay was 5 days with no differences between groups. Postoperative hemorrhage occurred in 3 donors with systemic heparinization and in 1 without heparinization. Two donors received blood transfusions, and 2 underwent laparoscopic reexploration. Three grafts were lost in the heparin group and 1 in the non-heparin group. Graft loss was due to early vascular thrombosis (n = 3) and due to acute rejection (n = 1). Overall, 1-year graft survival was 96.6%, and 1-year serum creatinine was 1.41 mg/dl (P = n. s. between groups).

Conclusions

Abandoning systemic donor heparinization in LDN with short warm ischemia has a low complication rate without adverse effects on short- and long-term graft outcomes.

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Titel: No need for systemic heparinization during laparoscopic donor nephrectomy with short warm ischemia time
verfasst von: Frank Friedersdorff
Ingmar Wolff
Serdar Deger
Jan Roigas
John Buckendahl
Hannes Cash
Markus Giessing
Lutz Liefeldt
Kurt Miller
T. Florian Fuller
Publikationsdatum: 01.08.2011
Verlag: Springer-Verlag
Erschienen in: World Journal of Urology / Ausgabe 4/2011
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-011-0704-1

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No need for systemic heparinization during laparoscopic donor nephrectomy with short warm ischemia time