Donor Nephrectomy

A donor nephrectomy is a surgical procedure to remove a healthy kidney from a living donor for transplantation into a recipient with end-stage renal disease (ESRD). The goal of the procedure is to provide a functioning kidney to the recipient, allowing them to regain normal kidney function and discontinue dialysis.

Types of Donor Nephrectomy

There are two main types of donor nephrectomy:

• Open Donor Nephrectomy: This is a traditional surgical approach where a single incision (usually 6-8 inches long) is made in the abdomen to access and remove the kidney.
• Laparoscopic Donor Nephrectomy: This is a minimally invasive surgical approach where several small incisions (usually 0.5-1 inch long) are made in the abdomen, and a laparoscope (a thin tube with a camera and light) is used to visualize and remove the kidney.

Surgical Procedure

The donor nephrectomy procedure typically involves the following steps:

1. The donor is given general anesthesia to ensure they are comfortable and pain-free during the procedure.
2. The surgeon makes an incision (or several small incisions) in the abdomen to access the kidney.
3. The kidney is carefully dissected from surrounding tissues, and the blood vessels and ureter are identified and ligated (tied off).
4. The kidney is then removed through the incision, and the donor's remaining kidney is left intact to continue functioning normally.

Benefits and Risks

The benefits of donor nephrectomy include:

• Providing a life-saving transplant to a recipient with ESRD
• Allowing the recipient to regain normal kidney function and discontinue dialysis
• Improving the quality of life for both the donor and the recipient

The risks associated with donor nephrectomy include:

• Bleeding or hemorrhage during or after surgery
• Infection or abscess formation at the surgical site
• Adverse reactions to anesthesia
• Potential long-term risks, such as hypertension or proteinuria (excess protein in the urine), although these are rare

Post-Operative Care and Recovery

After the procedure, the donor typically spends several days in the hospital for monitoring and recovery. The donor will need to:

• Rest and avoid strenuous activities for several weeks
• Take pain medication as directed by their healthcare provider
• Follow a healthy diet and lifestyle to promote healing and overall health
• Attend follow-up appointments with their healthcare provider to monitor their recovery and kidney function

Donor Selection and Evaluation

Potential donors undergo a thorough evaluation process, which includes:

• Medical history and physical examination
• Laboratory tests (e.g., blood work, urinalysis)
• Imaging studies (e.g., CT scan, ultrasound)
• Psychological evaluation to assess the donor's motivations and emotional well-being

The goal of this evaluation is to ensure that the donor is healthy enough for surgery and that the donated kidney will be suitable for transplantation.