{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T10:07:08Z","timestamp":1776766028620,"version":"3.51.2"},"reference-count":49,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,3,12]],"date-time":"2021-03-12T00:00:00Z","timestamp":1615507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Since its introduction in 1995, laparoscopic nephrectomy has emerged as the preferred surgical approach for living donor nephrectomy. Given the ubiquity of the surgical procedure and the need for favorable outcomes, as it is an elective operation on otherwise healthy individuals, it is imperative to ensure appropriate preoperative risk stratification and anticipate intraoperative challenges. The aim of the present study was to compare peri-and postoperative outcomes of living kidney donors (LD), who had undergone laparoscopic nephrectomy (LDN), with a control group of those who had undergone open nephrectomy (ODN). Health-related quality of life (QoL) was also assessed using the validated SF-36 questionnaire. Data from 252 LD from a single transplant center from March 2015 to December 2020 were analyzed retrospectively. In total, 117 donors in the LDN and 135 in the ODN groups were assessed. Demographics, type of transplantation, BMI, duration of surgery, length of hospital stay, peri- and postoperative complications, renal function at discharge and QoL were recorded and compared between the two groups using Stata 13.0 software. There was no difference in baseline characteristics, nor in the prevalence of peri-and postoperative complications, with a total complication rate of 16% (mostly minor, Clavien\u2013Dindo grade II) in both groups, while a different pattern of surgical complications was noticed between them. Duration of surgery was significantly longer in the ODN group (median 240 min vs. 160 min in LDN, p &lt; 0.01), warm ischemia time was longer in the LDN group (median 6 min vs.2 min in ODN, p &lt; 0.01) and length of hospital stay shorter in the LDN group (median 3 days vs. 7 days in ODN). Conversion rate from laparoscopic to open surgery was 2.5%. There was a drop in estimated glomerular filtration rate (eGFR) at discharge of 36 mL\/min in the LDN and 32 mL\/min in the ODN groups, respectively (p = 0.03). No death, readmission or reoperation were recorded. There was a significant difference in favor of LDN group for each one of the eight items of the questionnaire (SF1\u2013SF8). As for the two summary scores, while the total physical component summary (PCS) score was comparable between the two groups (57.87 in the LDN group and 57.07 in the ODN group), the mental component summary (MCS) score was significantly higher (62.14 vs. 45.22, p &lt; 0.001) in the LDN group. This study provides evidence that minimally invasive surgery can be performed safely, with very good short-term outcomes, providing several benefits for the living kidney donor, thereby contributing to expanding the living donor pool, which is essential, especially in countries with deceased-donor organ shortage.<\/jats:p>","DOI":"10.3390\/jcm10061195","type":"journal-article","created":{"date-parts":[[2021,3,12]],"date-time":"2021-03-12T11:56:55Z","timestamp":1615550215000},"page":"1195","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The Evolution of Living Donor Nephrectomy Program at A Hellenic Transplant Center. Laparoscopic vs. Open Donor Nephrectomy: Single-Center Experience"],"prefix":"10.3390","volume":"10","author":[{"given":"Spyridon","family":"Vernadakis","sequence":"first","affiliation":[{"name":"Kidney Transplantation Unit, Laiko General Hospital of Athens, 11527 Athina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Smaragdi","family":"Marinaki","sequence":"additional","affiliation":[{"name":"Nephrology and Kidney Transplantation Clinic, Laiko General Hospital of Athens, National and Kapodistrian University of Athens, 15772 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Darema","sequence":"additional","affiliation":[{"name":"Nephrology and Kidney Transplantation Clinic, Laiko General Hospital of Athens, National and Kapodistrian University of Athens, 15772 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioanna","family":"Soukouli","sequence":"additional","affiliation":[{"name":"Nephrology and Kidney Transplantation Clinic, Laiko General Hospital of Athens, National and Kapodistrian University of Athens, 15772 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3314-3329","authenticated-orcid":false,"given":"Ioannis El.","family":"Michelakis","sequence":"additional","affiliation":[{"name":"Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, 11526 Athens, Greece"},{"name":"Department of Internal Medicine, General Hospital of Athens \u201cKorgialenio-Benakio\u201d, 11526 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chrysoula","family":"Beletsioti","sequence":"additional","affiliation":[{"name":"Department of Health Economics, School of Medicine, General Hospital of Nikaia \u201cAgios Panteleimon\u201d, National and Kapodistrian University of Athens, 18454 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios","family":"Zavvos","sequence":"additional","affiliation":[{"name":"Kidney Transplantation Unit, Laiko General Hospital of Athens, 11527 Athina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioannis","family":"Bokos","sequence":"additional","affiliation":[{"name":"Kidney Transplantation Unit, Laiko General Hospital of Athens, 11527 Athina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioannis N.","family":"Boletis","sequence":"additional","affiliation":[{"name":"Nephrology and Kidney Transplantation Clinic, Laiko General Hospital of Athens, National and Kapodistrian University of Athens, 15772 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1056\/NEJM199912023412303","article-title":"Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant","volume":"341","author":"Wolfe","year":"1999","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1146\/annurev.med.51.1.393","article-title":"Kidney transplantation from living unrelated donors","volume":"51","author":"Cecka","year":"2000","journal-title":"Annu. Rev. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1860","DOI":"10.1016\/j.juro.2007.07.008","article-title":"Open versus laparoscopic live donor nephrectomy: A focus on the safety of donors and the need for a donor registry","volume":"178","author":"Shokeir","year":"2007","journal-title":"J. Urol."},{"key":"ref_4","first-page":"1047","article-title":"Laparoscopic live donor nephrectomy","volume":"60","author":"Ratner","year":"1995","journal-title":"Transplantation"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Wilson, C.H., Sanni, A., Rix, D.A., and Soomro, N.A. (2011). Laparoscopic versus open nephrectomy for live kidney donors. Cochrane Database Syst. Rev.","DOI":"10.1002\/14651858.CD006124.pub2"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2563","DOI":"10.1093\/ndt\/gfl207","article-title":"Open and laparoscopic living donor nephrectomy in Switzerland: A retrospective assessment of clinical outcomes and the motivation to donate","volume":"21","author":"Dahm","year":"2006","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_7","unstructured":"Breda, A., Budde, K., Figueiredo, A., Lledo\u2019 Garcia, E., Olsburgh, J., and Regele, H. (2021, January 30). European Association of Urology (EAU) Guidelines on Kidney Transplantation. Version 2020. Available online: http:\/\/uroweb.org\/guideline\/renal-transplantation\/."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"588215","DOI":"10.3389\/fsurg.2020.588215","article-title":"Robot-Assisted Laparoscopic Living Donor Nephrectomy: The University of Florence Technique","volume":"7","author":"Serni","year":"2020","journal-title":"Front. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.ijsu.2020.12.011","article-title":"Learning curves of minimally invasive donor nephrectomy in a high-volume center: A cohort study of 1895 consecutive living donors","volume":"86","author":"Takagi","year":"2021","journal-title":"Int. J. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Spaggiari, M., Garcia-Roca, R., Tulla, K.A., Okoye, O.T., Di Bella, C., Oberholzer, J., Jeon, H., Tzvetanov, I.G., and Benedetti, E. (2020). Robotic Assisted Living Donor Nephrectomies: A Safe Alternative to Laparoscopic Technique for Kidney Transplant Donation. Ann. Surg.","DOI":"10.1097\/SLA.0000000000004247"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","article-title":"Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey","volume":"240","author":"Dindo","year":"2004","journal-title":"Ann. Surg."},{"key":"ref_12","unstructured":"Ware, J.E., Snow, K.K., Kosinski, M., Gandek, B., and New England Medical Center (1997). SF-36 Health Survey: Manual and Interpretation Guide, The Health Institute, New England Medical Center."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1007\/s11136-004-6014-y","article-title":"Validating and norming of the Greek SF-36 Health Survey","volume":"14","author":"Pappa","year":"2005","journal-title":"Qual. Life Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2003","DOI":"10.1016\/S0140-6736(14)62484-3","article-title":"Living kidney donation: Outcomes, ethics, and uncertainty","volume":"385","author":"Reese","year":"2015","journal-title":"Lancet"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1111\/j.1432-2277.2009.01027.x","article-title":"Live donor nephrectomy: A review of evidence for surgical techniques","volume":"23","author":"Dols","year":"2010","journal-title":"Transpl. Int."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2264","DOI":"10.1097\/TP.0000000000001327","article-title":"Perioperative Events and Complications in Minimally Invasive Live Donor Nephrectomy: A Systematic Review and Meta-Analysis","volume":"100","author":"Kortram","year":"2016","journal-title":"Transplantation"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1097\/SLA.0b013e318153fd13","article-title":"Laparoscopic versus open live donor nephrectomy in renal transplantation: A meta-analysis","volume":"247","author":"Nanidis","year":"2008","journal-title":"Ann. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1111\/j.1464-410X.2005.05415.x","article-title":"Comparison of laparoscopic and open donor nephrectomy: A randomized controlled trial","volume":"95","author":"Simforoosh","year":"2005","journal-title":"BJU Int."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"45","DOI":"10.5527\/wjn.v6.i1.45","article-title":"Laparoscopic vs open donor nephrectomy: Lessons learnt from single academic center experience","volume":"6","author":"Tsoulfas","year":"2017","journal-title":"World J. Nephrol."},{"key":"ref_20","first-page":"5993","article-title":"Long-term outcomes of laparoscopic versus open donor nephrectomy for kidney transplantation: A meta-analysis","volume":"12","author":"Wang","year":"2020","journal-title":"Am. J. Transl. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1111\/j.1464-410X.2012.11058.x","article-title":"Techniques in laparoscopic donor nephrectomy","volume":"110","author":"Banga","year":"2012","journal-title":"BJU Int."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1007\/s00423-007-0192-3","article-title":"Current concepts in transplant surgery: Laparoscopic living donor of the kidney","volume":"392","author":"Paul","year":"2007","journal-title":"Langenbeck\u2019s Arch. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.transproceed.2006.10.006","article-title":"Laparoscopic donor nephrectomy: Effects of learning curve on surgical outcomes","volume":"39","author":"Martin","year":"2007","journal-title":"Transplant. Proc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1038\/nrcardio.2015.5","article-title":"Anti-inflammatory therapies for atherosclerosis","volume":"12","author":"Back","year":"2015","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1097\/TP.0000000000001251","article-title":"Evolution of Living Donor Nephrectomy at a Single Center: Long-term Outcomes With 4 Different Techniques in Greater Than 4000 Donors Over 50 Years","volume":"100","author":"Serrano","year":"2016","journal-title":"Transplantation"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Garcia-Ochoa, C., Feldman, L.S., Nguan, C., Monroy-Cuadros, M., Arnold, J., Boudville, N., Cuerden, M., Dipchand, C., Eng, M., and Gill, J. (2019). Perioperative Complications During Living Donor Nephrectomy: Results From a Multicenter Cohort Study. Can. J. Kidney Health Dis., 6.","DOI":"10.1177\/2054358119857718"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1097\/TP.0b013e3182577501","article-title":"Attitudes among surgeons towards live-donor nephrectomy: A European update","volume":"94","author":"Klop","year":"2012","journal-title":"Transplantation"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1053\/j.ackd.2012.04.010","article-title":"Living donor practices in the United States","volume":"19","author":"Mandelbrot","year":"2012","journal-title":"Adv. Chronic Kidney Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"137","DOI":"10.5500\/wjt.v5.i3.137","article-title":"Weight trends in United States living kidney donors: Analysis of the UNOS database","volume":"5","author":"Sachdeva","year":"2015","journal-title":"World J. Transplant."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"297","DOI":"10.12659\/AOT.896687","article-title":"Obese Kidney Donors in the Laparoscopic Living Nephrectomy Era: How Safe?","volume":"21","author":"Marcelino","year":"2016","journal-title":"Ann. Transplant."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"S56","DOI":"10.1038\/ijo.2008.87","article-title":"BMI-related errors in the measurement of obesity","volume":"32","author":"Rothman","year":"2008","journal-title":"Int. J. Obes."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2269","DOI":"10.1089\/end.2008.9725","article-title":"Laparoscopic donor nephrectomy: Effect of perirenal fat upon donor operative time","volume":"22","author":"Anderson","year":"2008","journal-title":"J. Endourol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1016\/j.jcmg.2014.07.017","article-title":"Visceral adiposity and the risk of metabolic syndrome across body mass index: The MESA Study","volume":"7","author":"Shah","year":"2014","journal-title":"Jacc. Cardiovasc. Imaging"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1038\/ki.2014.118","article-title":"Shifting paradigms in eligibility criteria for live kidney donation: A systematic review","volume":"87","author":"Ahmadi","year":"2015","journal-title":"Kidney Int."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1016\/j.transproceed.2004.12.209","article-title":"Warm ischemic time during laparoscopic live donor nephrectomy: Effects on graft function","volume":"37","author":"Soulsby","year":"2005","journal-title":"Transplant. Proc."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.kint.2020.03.034","article-title":"Changes in kidney function follow living donor nephrectomy","volume":"98","author":"Lam","year":"2020","journal-title":"Kidney Int."},{"key":"ref_37","unstructured":"Simmons, R.G., Klei, S.D., and Simmons, R.L. (1997). Gift of Life: The Social and Psychological Impact of Organ Transplantation, John Wiley & Sons."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1097\/00007890-199903150-00013","article-title":"Long-term follow-up of living kidney donors: Quality of life after donation","volume":"67","author":"Johnson","year":"1999","journal-title":"Transplantation"},{"key":"ref_39","first-page":"2067","article-title":"Kidney donors don\u2019t regret: Follow-up of 370 donors in Stockholm since 1964","volume":"69","author":"Brink","year":"2000","journal-title":"Transplantation"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1097\/01.TP.0000133307.00604.86","article-title":"Quality of life of living kidney donors in Germany: A survey with the Validated Short Form-36 and Giessen Subjective Complaints List-24 questionnaires","volume":"78","author":"Giessing","year":"2004","journal-title":"Transplantation"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1111\/j.1600-6143.2010.03424.x","article-title":"The long-term quality of life of living kidney donors: A multicenter cohort study","volume":"11","author":"Clemens","year":"2011","journal-title":"Am. J. Transplant."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2018","DOI":"10.1097\/01.ju.0000067975.59772.b6","article-title":"Quality of life, pain and return to normal activities following laparoscopic donor nephrectomy versus open mini-incision donor nephrectomy","volume":"169","author":"Perry","year":"2003","journal-title":"J. Urol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1111\/j.1399-0012.2004.00308.x","article-title":"Laparoscopic donor nephrectomy vs. open live donor nephrectomy: A quality of life and functional study","volume":"19","author":"Buell","year":"2005","journal-title":"Clin. Transplant."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1097\/01.tp.0000268071.63977.42","article-title":"Quality of life after randomization to laparoscopic versus open living donor nephrectomy: Long-term follow-up","volume":"84","author":"Andersen","year":"2007","journal-title":"Transplantation"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1016\/S0090-4295(02)01865-4","article-title":"Quality of life of living kidney donors: The short-form 36-item health questionnaire survey","volume":"60","author":"Isotani","year":"2002","journal-title":"Urology"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Lafranca, J.A., Spoon, E.Q.W., van de Wetering, J., Jnm, I.J., and Dor, F. (2017). Attitudes among transplant professionals regarding shifting paradigms in eligibility criteria for live kidney donation. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0181846"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1111\/tri.12012","article-title":"Living organ donation practices in Europe\u2014Results from an online survey","volume":"26","author":"Lennerling","year":"2013","journal-title":"Transpl. Int."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1111\/ctr.12219","article-title":"Impact of donor and recipient age difference on long-term allograft survival after living donor renal transplantation: Analysis of 478 cases","volume":"27","author":"Kostakis","year":"2013","journal-title":"Clin. Transplant."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1783","DOI":"10.1097\/TP.0000000000001770","article-title":"Summary of Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors","volume":"101","author":"Lentine","year":"2017","journal-title":"Transplantation"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/6\/1195\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:35:00Z","timestamp":1760160900000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/6\/1195"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,12]]},"references-count":49,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,3]]}},"alternative-id":["jcm10061195"],"URL":"https:\/\/doi.org\/10.3390\/jcm10061195","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,12]]}}}