[Living donor nephrectomy: The French guidelines from CTAFU]

Abstract

Objective: To propose surgical recommendations for living donor nephrectomy.

Method: Following a systematic approach, a review of the literature (Medline) was conducted by the CTAFU regarding functional and anatomical assessment of kidney donors, including which side the kidney should be harvested from. Distinct surgical techniques and approaches were evaluated. References were considered with a predefined process to propose recommendations with the corresponding levels of evidence.

Results: The recommendations clarify the legal and regulatory framework for kidney donation in France. A rigorous assessment of the donor is one of the essential prerequisites for donor safety. The impact of nephrectomy on kidney function needs to be anticipated. In case of modal vascularization of both kidneys without a relative difference in function or urologic abnormality, removal of the left kidney is the preferred choice to favor a longer vein. Mini-invasive approaches for nephrectomy provide faster donor recovery, less donor pain and shorter hospital stay than open surgery.

Conclusion: These French recommendations must contribute to improving surgical management of candidates for kidney donation.

Keywords: Donneur vivant; Laparoscopie; Living donor nephrectomy; Minimally invasive surgery; Néphrectomie; Renal transplantation; Transplantation rénale.