50547 Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor

Name of the Procedure:

Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor

• Common Name: Laparoscopic Donor Nephrectomy
• Technical Term: Laparoscopic Living Donor Nephrectomy with Cold Preservation

Summary

Laparoscopic donor nephrectomy is a minimally invasive surgical procedure where a kidney is removed from a living donor using laparoscopic techniques. The kidney is then preserved using cold preservation methods before being transplanted into a recipient.

Purpose

The procedure addresses end-stage renal disease or kidney failure in patients needing a kidney transplant. The goal is to procure a healthy kidney from a living donor to improve the recipient's quality of life and survival chances.

Indications

• A patient diagnosed with end-stage renal disease.
• A living donor willing and medically cleared to donate a kidney.
• Matching blood and tissue compatibility between donor and recipient.
• Donor in good overall health, with no contraindications for surgery.

Preparation

• Fasting for at least 8 hours before the procedure.
• Adjustments or discontinuation of certain medications as directed by the healthcare provider.
• Pre-surgical assessments including blood tests, imaging studies, and a thorough physical examination.
• Psychological and counseling sessions for both donor and recipient.

Procedure Description

1. Anesthesia: The patient (donor) is given general anesthesia.
2. Incisions: Small incisions are made in the abdomen for inserting laparoscopic instruments.
3. Laparoscope: A camera attached to a thin tube (laparoscope) is inserted to visualize internal organs.
4. Dissection: Surgeons carefully dissect the kidney while maintaining the integrity of surrounding structures.
5. Removal: The kidney is removed through one of the incisions.
6. Cold Preservation: The kidney is immediately placed in a cold preservation solution to maintain its viability until transplantation.

Duration

The procedure typically takes 2 to 4 hours.

Setting

The procedure is performed in a hospital's operating room.

Personnel

• Lead Surgeon specialized in laparoscopic and transplant surgery.
• Assisting Surgeons
• Anesthesiologist
• Surgical Nurses
• Operating Room Technicians

Risks and Complications

• Common: Pain, infection at incision sites, bleeding, reaction to anesthesia.
• Rare: Injury to surrounding organs, deep vein thrombosis (DVT), hernia at incision sites, kidney function issues in the donor.

Benefits

• Provides a life-saving kidney to the recipient with potentially shorter wait times compared to deceased donor kidneys.
• Typically results in better graft function and long-term outcomes for the recipient.
• Minimally invasive approach leads to reduced recovery time and smaller scars for the donor.

Recovery

• Immediate post-procedure care in a recovery room with monitoring for any complications.
• Pain management with medications as needed.
• Hospital stay of 2-4 days for the donor.
• Gradual return to normal activities, usually within 2-4 weeks.
• Follow-up appointments to monitor donor health and kidney function.

Alternatives

• Deceased donor kidney transplantation: No living donor required but possibly longer wait times and slightly lower success rates.
• Dialysis: An alternative to transplantation but requires ongoing treatment multiple times a week.
• Paired kidney exchange programs: Suitable if direct donor-recipient match is not possible.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel pain. Post-operatively, there might be discomfort and pain at incision sites, managed with medications. There is also emotional satisfaction often associated with successfully donating an organ to save another's life.