Laparoscopic living-donor nephrectomy.

BACKGROUND In order to increase the number of renal donors, laparoscopic live-donor nephrectomy (LLDN) was first performed 8 years ago. Today, LLDN is a routine procedure in many centres worldwide. We reviewed the literature with regard to extend the use of this method, the feasibility and safety for donor, graft and recipient. Laparoscopic and open-donor nephrectomy are compared, and the impact of LLDN on donors' willingness is evaluated. METHODS Literature search (PubMed, DIMDI, Medline) for the period from 1995 to 2003. RESULTS More than 200 centres worldwide perform LLDN. It is a feasible and safe surgical procedure. For the donor, LLDN has numerous advantages, while graft and recipient outcome are the same as with the open approach. The learning curve on the way to performing this operation safely is long, and surgeons planning to integrate LLDN into their programme must be trained thoroughly. There are some indications that with LLDN the number of donors willing to donate a kidney can be increased. CONCLUSIONS LLDN is widely used and will spread further. It is of the utmost importance to undergo thorough laparoscopic training in general urology prior to performing this procedure.