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#51
Living Donation in the News / Thirty-Year Trends in Perioper...
Last post by Clark - August 26, 2025, 11:06:46 AMhttps://jamanetwork.com/journals/jama/fullarticle/2822922
Thirty-Year Trends in Perioperative Mortality Risk for Living Kidney Donors Allan B. Massie, et al.
JAMA
2024;332;(12):1015-1017. doi:10.1001/jama.2024.14527
Living kidney donor candidates must be accurately informed of the risks of perioperative mortality. The best current estimate, 3.1 deaths within 90 days per 10 000 donations, comes from a study of donors from 1994 to 2009.1 Open donor nephrectomy, standard of care in the 1990s, has now been replaced almost completely by laparoscopic nephrectomy.2,3 Because of this transition, as well as improvements in donor selection, perioperative care, and surgical technique,4 prior estimates of perioperative mortality may not accurately represent current risk to donors. We performed a national registry study to characterize temporal trends in perioperative mortality in donors and risk factors associated with this event.
...
Discussion
Perioperative mortality after living donation declined substantially in the past decade compared with prior decades, to fewer than 1 event per 10 000 donations. Risk was higher for male donors and donors with a history of hypertension. Current guidelines5 for donor informed consent, based on 2009 data, should be updated to reflect this information.
Study limitations include that with only 36 perioperative deaths in 30 years, power to estimate relative risks is limited. Additionally, follow-up may be incomplete. However, OPTN requirements for donor follow-up have grown stricter, with 6-month follow-up required for donors since 2013; as such, missingness would bias toward lower mortality in earlier eras, the opposite of what the study found.
#52
Living Donation in the News / Second Time Around: Increased ...
Last post by Clark - August 26, 2025, 11:00:23 AMhttps://onlinelibrary.wiley.com/doi/abs/10.1111/ctr.70049
Second Time Around: Increased Rate of Living Donation From Repeat Organ Donors
Carolyn N. Sidoti, et al.
Clinical Transplantation
Volume39, Issue1
January 2025
https://doi.org/10.1111/ctr.70049
ABSTRACT
Introduction
Some living organ donors will decide to donate again at a later date. Evidence has indicated that this practice may have increased in recent years. We evaluated the incidence and outcomes of this practice to inform counseling of potential repeat donors.
Methods
Using SRTR data from 1994 to 2023, we identified 220 repeat living donors and their 415 recipients. We constructed donor comparison groups using weighting by the odds. We described clinical and lab results at 6 months, 1 year, and 2 years post-donation separately for kidney-second donors and liver-second donors. We compared all-cause graft failure for their recipients with those of comparison donors.
Results
The annual count of repeat living donors increased from 5 in 2018 to 25 in 2019 (p < 0.001). Of 220 donors, 159 were liver-second donors (72.3%) and 55 were kidney-second donors (25.0). The percentage of nondirected donations increased from 30.5% at first donation to 53.2% at second donation (p < 0.001). Liver-second donors had one death approximately 2.5 years post-donation. Seventeen were re-admitted and 20 experienced complications requiring an interventional procedure or re-operation. Among kidney-second donors, no deaths, re-admissions, or post-donation complications were reported. Post-donation outcomes in both groups were comparable when evaluated against organ-specific comparison donors. Recipients of repeat living donors experienced graft survival similar to recipients of comparison donors.
Conclusions
Repeat living donation may be a safe practice for carefully selected living donors in the short term; however, long term safety is unknown. Outcomes for recipients are similar to recipients of comparison donors.
Second Time Around: Increased Rate of Living Donation From Repeat Organ Donors
Carolyn N. Sidoti, et al.
Clinical Transplantation
Volume39, Issue1
January 2025
https://doi.org/10.1111/ctr.70049
ABSTRACT
Introduction
Some living organ donors will decide to donate again at a later date. Evidence has indicated that this practice may have increased in recent years. We evaluated the incidence and outcomes of this practice to inform counseling of potential repeat donors.
Methods
Using SRTR data from 1994 to 2023, we identified 220 repeat living donors and their 415 recipients. We constructed donor comparison groups using weighting by the odds. We described clinical and lab results at 6 months, 1 year, and 2 years post-donation separately for kidney-second donors and liver-second donors. We compared all-cause graft failure for their recipients with those of comparison donors.
Results
The annual count of repeat living donors increased from 5 in 2018 to 25 in 2019 (p < 0.001). Of 220 donors, 159 were liver-second donors (72.3%) and 55 were kidney-second donors (25.0). The percentage of nondirected donations increased from 30.5% at first donation to 53.2% at second donation (p < 0.001). Liver-second donors had one death approximately 2.5 years post-donation. Seventeen were re-admitted and 20 experienced complications requiring an interventional procedure or re-operation. Among kidney-second donors, no deaths, re-admissions, or post-donation complications were reported. Post-donation outcomes in both groups were comparable when evaluated against organ-specific comparison donors. Recipients of repeat living donors experienced graft survival similar to recipients of comparison donors.
Conclusions
Repeat living donation may be a safe practice for carefully selected living donors in the short term; however, long term safety is unknown. Outcomes for recipients are similar to recipients of comparison donors.
#53
Living Donation in the News / Education Priorities and What ...
Last post by Clark - August 26, 2025, 10:54:58 AMhttps://journals.sagepub.com/doi/abs/10.1177/1526924820978599
Education Priorities and What Matters to Those Considering Living Kidney Donation
Kara Schick-Makaroff, et al.
Progress in Transplantation
Volume 31, Issue 1
https://doi.org/10.1177/1526924820978599
Abstract
Introduction:
Although informed consent content elements are prescribed in detailed regulatory guidance, many live kidney donors describe feeling underprepared and under informed. The goal of this pilot study was to explore the educational components needed to support an informed decision-making process for living kidney donors.
Methods/Approach:
A qualitative description design was conducted with thematic analysis of 5 focus groups with 2 cohorts: living kidney donor candidates (n = 11) and living kidney donors (n = 8).
Findings:
The educational components needed to engage in an informed decision-making process were: 1) contingent upon, and motivated by, personal circumstances; 2) supported through explanation of risks and benefits; 3) enhanced by understanding the overall donation experience; and 4) personalized by talking to another donor.
Discussion:
Tailoring education to meet the needs for fully informed decision-making is essential. Current education requirements, as defined by regulatory bodies, remain challenging to transplant teams attempting to ensure fully informed consent of living kidney donor candidates. Information on the emotional, financial, and overall life impact is needed, along with acknowledgement of relational ties driving donor motivations and the hoped-for recipient outcomes. Discussion of care practices, and access to peer mentoring may further strengthen the informed decision-making process.
Education Priorities and What Matters to Those Considering Living Kidney Donation
Kara Schick-Makaroff, et al.
Progress in Transplantation
Volume 31, Issue 1
https://doi.org/10.1177/1526924820978599
Abstract
Introduction:
Although informed consent content elements are prescribed in detailed regulatory guidance, many live kidney donors describe feeling underprepared and under informed. The goal of this pilot study was to explore the educational components needed to support an informed decision-making process for living kidney donors.
Methods/Approach:
A qualitative description design was conducted with thematic analysis of 5 focus groups with 2 cohorts: living kidney donor candidates (n = 11) and living kidney donors (n = 8).
Findings:
The educational components needed to engage in an informed decision-making process were: 1) contingent upon, and motivated by, personal circumstances; 2) supported through explanation of risks and benefits; 3) enhanced by understanding the overall donation experience; and 4) personalized by talking to another donor.
Discussion:
Tailoring education to meet the needs for fully informed decision-making is essential. Current education requirements, as defined by regulatory bodies, remain challenging to transplant teams attempting to ensure fully informed consent of living kidney donor candidates. Information on the emotional, financial, and overall life impact is needed, along with acknowledgement of relational ties driving donor motivations and the hoped-for recipient outcomes. Discussion of care practices, and access to peer mentoring may further strengthen the informed decision-making process.
#54
Living Donation in the News / Outcomes of living liver donor...
Last post by Clark - August 26, 2025, 10:52:02 AMhttps://onlinelibrary.wiley.com/doi/abs/10.1111/ctr.14394
Outcomes of living liver donor candidate evaluations in the Living Donor Collective pilot registry
Bertram L. Kasiske, et al.
Clinical Transplantation
Volume35, Issue9
September 2021
https://doi.org/10.1111/ctr.14394
Abstract
Background
To gather information on long-term outcomes after living donation, the Scientific Registry of Transplant Recipients (SRTR) conducted a pilot on the feasibility of establishing a comprehensive donor candidate registry.
Methods
A convenience sample of 6 US living liver donor programs evaluated 398 consecutive donor candidates in 2018, ending with the March 12, 2020, COVID-19 emergency.
Results
For 333/398 (83.7%), the donor or program decided whether to donate; 166/333 (49.8%) were approved, and 167/333 (50.2%) were not or opted out. Approval rates varied by program, from 27.0% to 63.3% (median, 46%; intraquartile range, 37.3–51.1%). Of those approved, 90.4% were white, 57.2% were women, 83.1% were < 50 years, and 85.5% had more than a high school education. Of 167 candidates, 131 (78.4%) were not approved or opted out because of: medical risk (10.7%); chronic liver disease risk (11.5%); psychosocial reasons (5.3%); candidate declined (6.1%); anatomical reasons increasing recipient risk (26.0%); recipient-related reasons (33.6%); finances (1.5%); or other (5.3%).
Conclusions
A comprehensive national registry is feasible and necessary to better understand candidate selection and long-term outcomes. As a result, the US Health Resources and Services Administration asked SRTR to expand the pilot to include all US living donor programs.
Outcomes of living liver donor candidate evaluations in the Living Donor Collective pilot registry
Bertram L. Kasiske, et al.
Clinical Transplantation
Volume35, Issue9
September 2021
https://doi.org/10.1111/ctr.14394
Abstract
Background
To gather information on long-term outcomes after living donation, the Scientific Registry of Transplant Recipients (SRTR) conducted a pilot on the feasibility of establishing a comprehensive donor candidate registry.
Methods
A convenience sample of 6 US living liver donor programs evaluated 398 consecutive donor candidates in 2018, ending with the March 12, 2020, COVID-19 emergency.
Results
For 333/398 (83.7%), the donor or program decided whether to donate; 166/333 (49.8%) were approved, and 167/333 (50.2%) were not or opted out. Approval rates varied by program, from 27.0% to 63.3% (median, 46%; intraquartile range, 37.3–51.1%). Of those approved, 90.4% were white, 57.2% were women, 83.1% were < 50 years, and 85.5% had more than a high school education. Of 167 candidates, 131 (78.4%) were not approved or opted out because of: medical risk (10.7%); chronic liver disease risk (11.5%); psychosocial reasons (5.3%); candidate declined (6.1%); anatomical reasons increasing recipient risk (26.0%); recipient-related reasons (33.6%); finances (1.5%); or other (5.3%).
Conclusions
A comprehensive national registry is feasible and necessary to better understand candidate selection and long-term outcomes. As a result, the US Health Resources and Services Administration asked SRTR to expand the pilot to include all US living donor programs.
#55
Living Donation in the News / Influence of surgical techniqu...
Last post by Clark - August 26, 2025, 10:48:42 AMhttps://onlinelibrary.wiley.com/doi/abs/10.1111/ctr.14703
Influence of surgical technique in donor hepatectomy on immediate and short-term living donor outcomes – A systematic review of the literature, meta-analysis, and expert panel recommendations
Yee L Cheah, et al.
Clinical Transplantation
Volume36, Issue10
October 2022
https://doi.org/10.1111/ctr.14703
Abstract
Background
There are currently no guidelines pertaining to ERAS pathways in living donor hepatectomy.
Objectives
The aim of this study was to identify whether surgical technique influences immediate and short-term outcomes after living liver donation surgery.
Data sources
Ovid MEDLINE, Embase, Scopus, Google Scholar, and Cochrane Central.
Methods
Systematic review and meta-analysis following PRISMA guidelines and recommendations using the GRADE approach derived from an international expert panel (CRD42021260707). Endpoints were mortality, overall complications, serious complications, bile eaks, pulmonary complications, estimated blood loss and length of stay.
Results
Of the 2410 screened articles, 21 articles were included for final analysis; three observational, 13 retrospective cohort, four prospective cohort studies, and one randomized trial. Overall complications were higher with right versus left hepatectomy (26.8% vs. 20.8%; OR 1.4, P = .010). Donors after left hepatectomy had shorter length of stay (MD 1.4 days) compared to right hepatectomy. There was no difference in outcomes after right donor hepatectomy with versus without middle hepatic vein. We had limited data on the influence of incision type and minimally invasive approaches on living donor outcomes, and no data on the effect of operative time on donor outcomes.
Conclusions
Left donor hepatectomy should be preferred over right hepatectomy, as it is related to improved donor short-term outcomes (QOE; Moderate | Grade of Recommendation; Strong). Right donor hepatectomy with or without MHV has equivalent outcomes (QOE; Moderate | Grade of Recommendation; Strong); no preference is recommended, decision should be based on program's experience and expertise. No difference in outcomes was observed related to incision type, minimally invasive vs. open (QOE; Low | Grade of Recommendation; Weak); no preference can be recommended.
Influence of surgical technique in donor hepatectomy on immediate and short-term living donor outcomes – A systematic review of the literature, meta-analysis, and expert panel recommendations
Yee L Cheah, et al.
Clinical Transplantation
Volume36, Issue10
October 2022
https://doi.org/10.1111/ctr.14703
Abstract
Background
There are currently no guidelines pertaining to ERAS pathways in living donor hepatectomy.
Objectives
The aim of this study was to identify whether surgical technique influences immediate and short-term outcomes after living liver donation surgery.
Data sources
Ovid MEDLINE, Embase, Scopus, Google Scholar, and Cochrane Central.
Methods
Systematic review and meta-analysis following PRISMA guidelines and recommendations using the GRADE approach derived from an international expert panel (CRD42021260707). Endpoints were mortality, overall complications, serious complications, bile eaks, pulmonary complications, estimated blood loss and length of stay.
Results
Of the 2410 screened articles, 21 articles were included for final analysis; three observational, 13 retrospective cohort, four prospective cohort studies, and one randomized trial. Overall complications were higher with right versus left hepatectomy (26.8% vs. 20.8%; OR 1.4, P = .010). Donors after left hepatectomy had shorter length of stay (MD 1.4 days) compared to right hepatectomy. There was no difference in outcomes after right donor hepatectomy with versus without middle hepatic vein. We had limited data on the influence of incision type and minimally invasive approaches on living donor outcomes, and no data on the effect of operative time on donor outcomes.
Conclusions
Left donor hepatectomy should be preferred over right hepatectomy, as it is related to improved donor short-term outcomes (QOE; Moderate | Grade of Recommendation; Strong). Right donor hepatectomy with or without MHV has equivalent outcomes (QOE; Moderate | Grade of Recommendation; Strong); no preference is recommended, decision should be based on program's experience and expertise. No difference in outcomes was observed related to incision type, minimally invasive vs. open (QOE; Low | Grade of Recommendation; Weak); no preference can be recommended.
#56
Living Donation in the News / Outcomes of Living Kidney Dono...
Last post by Clark - August 26, 2025, 10:45:04 AMhttps://journals.lww.com/transplantationdirect/fulltext/2021/05000/Outcomes_of_Living_Kidney_Donor_Candidate.1.aspx?context=LatestArticles
Outcomes of Living Kidney Donor Candidate Evaluations in the Living Donor Collective Pilot Registry
Kasiske, Bertram L. et al.
Transplantation Direct 7(5):p e689, May 2021. | DOI: 10.1097/TXD.0000000000001143
Abstract
Background.
Gaps in our knowledge of long-term outcomes affect decision making for potential living kidney donors.
Methods.
The Scientific Registry of Transplant Recipients was asked to determine the feasibility of a candidate registry.
Results.
Ten living kidney donor programs evaluated 2107 consecutive kidney donor candidates; 2099 of 2107 (99.6%) completed evaluations, 1578 of 2099 (75.2%) had a decision, and 790 of 1578 (50.1%) were approved to donate as of March 12, 2020. By logistic regression, candidates most likely to be approved were married or had attended college or technical school; those least likely to be approved had ≥1 of the following characteristics: Black race, history of cigarette smoking, and higher blood pressure, higher triglycerides, or higher urine albumin-to-creatinine ratios. Reasons for 617 candidates not being approved included medical issues other than chronic kidney disease risk (25.3%), chronic kidney disease risk (18.5%), candidate withdrawal (15.2%), recipient reason (13.6%), anatomical risk to the recipient (10.3%), noneconomic psychosocial (10.3%), economic (0.5%), and other reasons (6.4%).
Conclusions.
These results suggest that a comprehensive living donor registry is both feasible and necessary to assess long-term outcomes that may inform decision making for future living donor candidates. There may be socioeconomic barriers to donation that require more granular identification so that active measures can address inequities. Some candidates who did not donate may be suitable controls for discerning the appropriateness of acceptance decisions and the long-term outcomes attributable to donation. We anticipate that these issues will be better identified with modifications to the data collection and expansion of the registry to all centers over the next several years.
Outcomes of Living Kidney Donor Candidate Evaluations in the Living Donor Collective Pilot Registry
Kasiske, Bertram L. et al.
Transplantation Direct 7(5):p e689, May 2021. | DOI: 10.1097/TXD.0000000000001143
Abstract
Background.
Gaps in our knowledge of long-term outcomes affect decision making for potential living kidney donors.
Methods.
The Scientific Registry of Transplant Recipients was asked to determine the feasibility of a candidate registry.
Results.
Ten living kidney donor programs evaluated 2107 consecutive kidney donor candidates; 2099 of 2107 (99.6%) completed evaluations, 1578 of 2099 (75.2%) had a decision, and 790 of 1578 (50.1%) were approved to donate as of March 12, 2020. By logistic regression, candidates most likely to be approved were married or had attended college or technical school; those least likely to be approved had ≥1 of the following characteristics: Black race, history of cigarette smoking, and higher blood pressure, higher triglycerides, or higher urine albumin-to-creatinine ratios. Reasons for 617 candidates not being approved included medical issues other than chronic kidney disease risk (25.3%), chronic kidney disease risk (18.5%), candidate withdrawal (15.2%), recipient reason (13.6%), anatomical risk to the recipient (10.3%), noneconomic psychosocial (10.3%), economic (0.5%), and other reasons (6.4%).
Conclusions.
These results suggest that a comprehensive living donor registry is both feasible and necessary to assess long-term outcomes that may inform decision making for future living donor candidates. There may be socioeconomic barriers to donation that require more granular identification so that active measures can address inequities. Some candidates who did not donate may be suitable controls for discerning the appropriateness of acceptance decisions and the long-term outcomes attributable to donation. We anticipate that these issues will be better identified with modifications to the data collection and expansion of the registry to all centers over the next several years.
#57
Living Donation in the News / Psychosocial Evaluation of Liv...
Last post by Clark - August 26, 2025, 10:39:59 AMhttps://journals.lww.com/transplantjournal/abstract/2024/11000/psychosocial_evaluation_of_living_kidney_donors__a.21.aspx
Psychosocial Evaluation of Living Kidney Donors: A Survey of Current Practices in the United States
Clifton, Erin PhD1; et al.
Transplantation 108(11):p e382-e389, November 2024. | DOI: 10.1097/TP.0000000000005095
Abstract
Background.
Best practices in psychosocial evaluation and care of living donor candidates and donors are not well established.
Methods.
We surveyed 195 living kidney donor (LKD) transplant centers in United States from October 2021 to April 2022 querying (1) composition of psychosocial teams, (2) evaluation processes including clinical tools and domains assessed, (3) selection criteria, and (4) psychosocial follow-up post-donation.
Results.
We received 161 responses from 104 programs, representing 53% of active LKD programs and 67% of LKD transplant volume in 2019. Most respondents (63%) were social workers/independent living donor advocates. Over 90% of respondents indicated donor candidates with known mental health or substance use disorders were initially evaluated by the psychosocial team. Validated psychometric or transplant-specific tools were rarely utilized but domains assessed were consistent. Active suicidality, self-harm, and psychosis were considered absolute contraindications in >90% of programs. Active depression was absolute contraindication in 50% of programs; active anxiety disorder was excluded 27%. Conditions not contraindicated to donation include those in remission: anxiety (56%), depression (53%), and posttraumatic stress disorder (41%). There was acceptance of donor candidates using alcohol, tobacco, or cannabis recreationally, but not if pattern met criteria for active use disorder. Seventy-one percent of programs conducted post-donation psychosocial assessment and use local resources to support donors.
Conclusions.
There was variation in acceptance of donor candidates with mental health or substance use disorders. Although most programs conducted psychosocial screening post-donation, support is not standardized and unclear if adequate. Future studies are needed for consensus building among transplant centers to form guidelines for donor evaluation, acceptance, and support.
Psychosocial Evaluation of Living Kidney Donors: A Survey of Current Practices in the United States
Clifton, Erin PhD1; et al.
Transplantation 108(11):p e382-e389, November 2024. | DOI: 10.1097/TP.0000000000005095
Abstract
Background.
Best practices in psychosocial evaluation and care of living donor candidates and donors are not well established.
Methods.
We surveyed 195 living kidney donor (LKD) transplant centers in United States from October 2021 to April 2022 querying (1) composition of psychosocial teams, (2) evaluation processes including clinical tools and domains assessed, (3) selection criteria, and (4) psychosocial follow-up post-donation.
Results.
We received 161 responses from 104 programs, representing 53% of active LKD programs and 67% of LKD transplant volume in 2019. Most respondents (63%) were social workers/independent living donor advocates. Over 90% of respondents indicated donor candidates with known mental health or substance use disorders were initially evaluated by the psychosocial team. Validated psychometric or transplant-specific tools were rarely utilized but domains assessed were consistent. Active suicidality, self-harm, and psychosis were considered absolute contraindications in >90% of programs. Active depression was absolute contraindication in 50% of programs; active anxiety disorder was excluded 27%. Conditions not contraindicated to donation include those in remission: anxiety (56%), depression (53%), and posttraumatic stress disorder (41%). There was acceptance of donor candidates using alcohol, tobacco, or cannabis recreationally, but not if pattern met criteria for active use disorder. Seventy-one percent of programs conducted post-donation psychosocial assessment and use local resources to support donors.
Conclusions.
There was variation in acceptance of donor candidates with mental health or substance use disorders. Although most programs conducted psychosocial screening post-donation, support is not standardized and unclear if adequate. Future studies are needed for consensus building among transplant centers to form guidelines for donor evaluation, acceptance, and support.
#58
Living Donation in the News / The Psychosocial Evaluation of...
Last post by Clark - August 26, 2025, 10:36:47 AMhttps://journals.lww.com/transplantjournal/fulltext/2024/11000/the_psychosocial_evaluation_of_living_kidney.6.aspx
The Psychosocial Evaluation of Living Kidney Donation: Time for Standardization in Practice
Levan, Macey L. JD, PhD1; LaPointe Rudow, Dianne ANP-BC, DNP, FAAN2
Transplantation 108(11):p e342-e343, November 2024. | DOI: 10.1097/TP.0000000000005084
INTRODUCTION
The transplant community has an opportunity to improve clinical follow-up and data collection opportunities, to implement standardized psychometrics instruments in the living kidney donor evaluation process and optimize psychosocial team structures. Clifton et al1 was an American Society of Transplantation Living Donor Community of Practice Mental Health Working Group product. Their survey reached 53% of active US living donor programs with the intent of understanding composition of psychosocial teams evaluating donor candidates, what the evaluation process entailed, and postdonation psychosocial follow-up. Although policy has been established for more than a decade, there is much transplant hospital variation in living donor evaluation screening mechanisms, acceptance practices, and support offered.
...
The Psychosocial Evaluation of Living Kidney Donation: Time for Standardization in Practice
Levan, Macey L. JD, PhD1; LaPointe Rudow, Dianne ANP-BC, DNP, FAAN2
Transplantation 108(11):p e342-e343, November 2024. | DOI: 10.1097/TP.0000000000005084
INTRODUCTION
The transplant community has an opportunity to improve clinical follow-up and data collection opportunities, to implement standardized psychometrics instruments in the living kidney donor evaluation process and optimize psychosocial team structures. Clifton et al1 was an American Society of Transplantation Living Donor Community of Practice Mental Health Working Group product. Their survey reached 53% of active US living donor programs with the intent of understanding composition of psychosocial teams evaluating donor candidates, what the evaluation process entailed, and postdonation psychosocial follow-up. Although policy has been established for more than a decade, there is much transplant hospital variation in living donor evaluation screening mechanisms, acceptance practices, and support offered.
...
#59
Living Donation in the News / Comparison of Single-Port Robo...
Last post by Clark - August 26, 2025, 10:33:35 AMhttps://www.liebertpub.com/doi/abs/10.1089/end.2023.0364
Comparison of Single-Port Robotic Donor Nephrectomy and Laparoscopic Donor Nephrectomy
Michael A. Palese, et al.
Journal of EndourologyVol. 38, No. 2
https://doi.org/10.1089/end.2023.036
Abstract
Purpose: To compare the intra- and postoperative outcomes of single-port robotic donor nephrectomies (SP RDNs) and laparoscopic donor nephrectomies (LDNs).
Materials and Methods: We retrospectively reviewed our institutional database for patients who received LDN or SP RDN between September 2020 and December 2022. Donor baseline characteristics, intraoperative outcomes, postoperative outcomes, and recipient renal function were extracted and compared between LDN and SP RDN. SP RDN learning curve analysis based on operative time and graft extraction time was performed using cumulative sum analysis.
Results: One hundred forty-four patients underwent LDN and 32 patients underwent SP RDN. LDN and SP RDN had similar operative times (LDN: 190.3 ± 28.0 minutes, SP RDN: 194.5 ± 35.1 minutes, p = 0.3253). SP RDN patients had significantly greater extraction times (LDN: 83.2 ± 40.3 seconds, SP RDN: 204.1 ± 52.2 seconds, p < 0.0001) and warm ischemia times (LDN: 145.1 ± 61.7 seconds, SP RDN: 275.4 ± 65.6 seconds, p < 0.0001). There were no differences in patient subjective pain scores, inpatient opioid usage, or Clavien–Dindo II+ complications. Short- and medium-term postoperative donor and recipient renal function were also similar between the groups. SP RDN graft extraction time and total operative time learning curves were achieved at case 27 and 13, respectively.
Conclusion: SP RDN is a safe and feasible alternative to LDN that minimizes postoperative abdominal incisional scars and has a short learning curve. Future randomized prospective clinical trials are needed to confirm the findings of this study and to identify other potential benefits and drawbacks of SP RDNs.
Comparison of Single-Port Robotic Donor Nephrectomy and Laparoscopic Donor Nephrectomy
Michael A. Palese, et al.
Journal of EndourologyVol. 38, No. 2
https://doi.org/10.1089/end.2023.036
Abstract
Purpose: To compare the intra- and postoperative outcomes of single-port robotic donor nephrectomies (SP RDNs) and laparoscopic donor nephrectomies (LDNs).
Materials and Methods: We retrospectively reviewed our institutional database for patients who received LDN or SP RDN between September 2020 and December 2022. Donor baseline characteristics, intraoperative outcomes, postoperative outcomes, and recipient renal function were extracted and compared between LDN and SP RDN. SP RDN learning curve analysis based on operative time and graft extraction time was performed using cumulative sum analysis.
Results: One hundred forty-four patients underwent LDN and 32 patients underwent SP RDN. LDN and SP RDN had similar operative times (LDN: 190.3 ± 28.0 minutes, SP RDN: 194.5 ± 35.1 minutes, p = 0.3253). SP RDN patients had significantly greater extraction times (LDN: 83.2 ± 40.3 seconds, SP RDN: 204.1 ± 52.2 seconds, p < 0.0001) and warm ischemia times (LDN: 145.1 ± 61.7 seconds, SP RDN: 275.4 ± 65.6 seconds, p < 0.0001). There were no differences in patient subjective pain scores, inpatient opioid usage, or Clavien–Dindo II+ complications. Short- and medium-term postoperative donor and recipient renal function were also similar between the groups. SP RDN graft extraction time and total operative time learning curves were achieved at case 27 and 13, respectively.
Conclusion: SP RDN is a safe and feasible alternative to LDN that minimizes postoperative abdominal incisional scars and has a short learning curve. Future randomized prospective clinical trials are needed to confirm the findings of this study and to identify other potential benefits and drawbacks of SP RDNs.
#60
Living Donation in the News / Standardizing Patient Educatio...
Last post by Clark - August 26, 2025, 10:28:17 AMhttps://digscholarship.unco.edu/capstones/149/
https://digscholarship.unco.edu/cgi/viewcontent.cgi?article=1228&context=capstones
Standardizing Patient Education for Living Kidney Donors
Diana Thompson
ABSTRACT
Published Doctor of Nursing Practice scholarly research project, University of Northern Colorado, 2025.
Living kidney donation occurs when a person voluntarily donates a functioning kidney to another individual in need. The kidney donation process is lengthy, complex, and can be overwhelming for many potential donors. A gap was identified in the patient education process at the project site as evidenced by frequent postoperative questions and concerns expressed by living donors and their caregivers. A literature review suggested this was a national problem, yet a standardized education process for living kidney donors has yet to be developed. The purpose of this scholarly project was to develop a standardized process for living kidney donor education comprised of a checklist of teaching materials and topics for the healthcare team and an established education delivery timeline prior to surgery. This DNP scholarly project aimed to answer the following research question:
Q1 How can an evidence-based, expert-informed, and standardized patient education process and timeline be developed for integration into an existing living kidney donor program?
As guided by the plan do study act model, survey data were collected from 16 transplant team members directly involved in living donor education at the project site. The survey findings revealed that although the required topics were being covered during donor evaluation, there were inconsistencies about which team member was providing the education and at which point during the process each topic should be addressed. The survey results were synthesized with best practices from the literature and regulatory requirements to develop a checklist and timeline aimed at standardizing donor education and strengthening team communication. A pilot plan was iv proposed for implementing and evaluating the checklist and timeline in the future. The project findings have implications for how and when critical information is communicated to potential living kidney donors using a team-based approach.
https://digscholarship.unco.edu/cgi/viewcontent.cgi?article=1228&context=capstones
Standardizing Patient Education for Living Kidney Donors
Diana Thompson
ABSTRACT
Published Doctor of Nursing Practice scholarly research project, University of Northern Colorado, 2025.
Living kidney donation occurs when a person voluntarily donates a functioning kidney to another individual in need. The kidney donation process is lengthy, complex, and can be overwhelming for many potential donors. A gap was identified in the patient education process at the project site as evidenced by frequent postoperative questions and concerns expressed by living donors and their caregivers. A literature review suggested this was a national problem, yet a standardized education process for living kidney donors has yet to be developed. The purpose of this scholarly project was to develop a standardized process for living kidney donor education comprised of a checklist of teaching materials and topics for the healthcare team and an established education delivery timeline prior to surgery. This DNP scholarly project aimed to answer the following research question:
Q1 How can an evidence-based, expert-informed, and standardized patient education process and timeline be developed for integration into an existing living kidney donor program?
As guided by the plan do study act model, survey data were collected from 16 transplant team members directly involved in living donor education at the project site. The survey findings revealed that although the required topics were being covered during donor evaluation, there were inconsistencies about which team member was providing the education and at which point during the process each topic should be addressed. The survey results were synthesized with best practices from the literature and regulatory requirements to develop a checklist and timeline aimed at standardizing donor education and strengthening team communication. A pilot plan was iv proposed for implementing and evaluating the checklist and timeline in the future. The project findings have implications for how and when critical information is communicated to potential living kidney donors using a team-based approach.