Blood transfusions in laparoscopic living donor nephrectomy: Single center experience from 500 cases

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Abstract

Introduction: Laparoscopic surgery has been acknowledged to reduce the morbidity rate thus improving patient safety. During the LLDN, the most frequent complication is renal vessels injuries, which often requires a blood transfusion. Besides the need for a blood transfusion, major bleeding caused by renal vessels injuries requires open conversion and repair. Thus, this study would like to descript and analyze the need for blood transfusion in laparoscopic living donor nephrectomy surgery in our center. Methods: We performed a retrospective cohort study in the Department of Urology at Cipto Mangunkusumo National Hospital. The records of all kidney transplantation donor patients who underwent LLDN procedures carried out at our institution from November 2011 to October 2017 were reviewed. Data including donor age, preoperative hemoglobin level, postoperative hemoglobin level, intraoperative bleeding, number of artery(ies), number of vein(s), donor side, conversion to open surgery, surgery duration, and donor BMI were collected and analyzed. These data were further correlated with the transfusion rate. Results: There were 500 patients underwent laparoscopic living donor nephrectomy procedure at our institution. All of the patients had LLDN with a transperitoneal approach. The difference in blood transfusion rate proportion between male patients with 0.9% compared to 0.6% in female patients was not significant (p=0.782). There is no significant difference in blood transfusion rate proportion regarding renal side (p=0.494), number of artery (p=0.362), age (p=0.978), BMI (p=0.569), and preoperative hemoglobin (p=0.766). Median estimated blood loss in patients who received intraoperative blood transfusion was significantly much greater than in patients who did not receive a blood transfusion (p<0.001). Conclusion: Based on this study, we suggest that in our institution, preoperative blood products are not necessarily needed. The surgeon’s learning curve and technique play a significant role in preventing intraoperative complications and blood loss.

Original languageEnglish
Pages (from-to)1-5
Number of pages5
JournalResearch and Reports in Urology
Volume12
DOIs
Publication statusPublished - 1 Jan 2020

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Living Donors
Nephrectomy
Blood Transfusion
Tissue Donors
Hemoglobins
Kidney
Arteries
Hemorrhage
Conversion to Open Surgery
Learning Curve
Intraoperative Complications
Wounds and Injuries
Urology
Patient Safety
Kidney Transplantation
Laparoscopy
Veins
Cohort Studies
Retrospective Studies
Morbidity

Keywords

  • Laparoscopic living donor nephrectomy
  • Renal transplantation
  • Transfusion rate

Cite this

@article{a829a3d9f60c420e99dea2f03b7900bd,
title = "Blood transfusions in laparoscopic living donor nephrectomy: Single center experience from 500 cases",
abstract = "Introduction: Laparoscopic surgery has been acknowledged to reduce the morbidity rate thus improving patient safety. During the LLDN, the most frequent complication is renal vessels injuries, which often requires a blood transfusion. Besides the need for a blood transfusion, major bleeding caused by renal vessels injuries requires open conversion and repair. Thus, this study would like to descript and analyze the need for blood transfusion in laparoscopic living donor nephrectomy surgery in our center. Methods: We performed a retrospective cohort study in the Department of Urology at Cipto Mangunkusumo National Hospital. The records of all kidney transplantation donor patients who underwent LLDN procedures carried out at our institution from November 2011 to October 2017 were reviewed. Data including donor age, preoperative hemoglobin level, postoperative hemoglobin level, intraoperative bleeding, number of artery(ies), number of vein(s), donor side, conversion to open surgery, surgery duration, and donor BMI were collected and analyzed. These data were further correlated with the transfusion rate. Results: There were 500 patients underwent laparoscopic living donor nephrectomy procedure at our institution. All of the patients had LLDN with a transperitoneal approach. The difference in blood transfusion rate proportion between male patients with 0.9{\%} compared to 0.6{\%} in female patients was not significant (p=0.782). There is no significant difference in blood transfusion rate proportion regarding renal side (p=0.494), number of artery (p=0.362), age (p=0.978), BMI (p=0.569), and preoperative hemoglobin (p=0.766). Median estimated blood loss in patients who received intraoperative blood transfusion was significantly much greater than in patients who did not receive a blood transfusion (p<0.001). Conclusion: Based on this study, we suggest that in our institution, preoperative blood products are not necessarily needed. The surgeon’s learning curve and technique play a significant role in preventing intraoperative complications and blood loss.",
keywords = "Laparoscopic living donor nephrectomy, Renal transplantation, Transfusion rate",
author = "Senohadi Boentoro and Irfan Wahyudi and Mochtar, {Chaidir A.} and Hamid, {Agus Rizal A.H.}",
year = "2020",
month = "1",
day = "1",
doi = "10.2147/RRU.S229431",
language = "English",
volume = "12",
pages = "1--5",
journal = "Research and Reports in Urology",
issn = "1179-1551",
publisher = "Dove Medical Press Limited",

}

TY - JOUR

T1 - Blood transfusions in laparoscopic living donor nephrectomy

T2 - Single center experience from 500 cases

AU - Boentoro, Senohadi

AU - Wahyudi, Irfan

AU - Mochtar, Chaidir A.

AU - Hamid, Agus Rizal A.H.

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Introduction: Laparoscopic surgery has been acknowledged to reduce the morbidity rate thus improving patient safety. During the LLDN, the most frequent complication is renal vessels injuries, which often requires a blood transfusion. Besides the need for a blood transfusion, major bleeding caused by renal vessels injuries requires open conversion and repair. Thus, this study would like to descript and analyze the need for blood transfusion in laparoscopic living donor nephrectomy surgery in our center. Methods: We performed a retrospective cohort study in the Department of Urology at Cipto Mangunkusumo National Hospital. The records of all kidney transplantation donor patients who underwent LLDN procedures carried out at our institution from November 2011 to October 2017 were reviewed. Data including donor age, preoperative hemoglobin level, postoperative hemoglobin level, intraoperative bleeding, number of artery(ies), number of vein(s), donor side, conversion to open surgery, surgery duration, and donor BMI were collected and analyzed. These data were further correlated with the transfusion rate. Results: There were 500 patients underwent laparoscopic living donor nephrectomy procedure at our institution. All of the patients had LLDN with a transperitoneal approach. The difference in blood transfusion rate proportion between male patients with 0.9% compared to 0.6% in female patients was not significant (p=0.782). There is no significant difference in blood transfusion rate proportion regarding renal side (p=0.494), number of artery (p=0.362), age (p=0.978), BMI (p=0.569), and preoperative hemoglobin (p=0.766). Median estimated blood loss in patients who received intraoperative blood transfusion was significantly much greater than in patients who did not receive a blood transfusion (p<0.001). Conclusion: Based on this study, we suggest that in our institution, preoperative blood products are not necessarily needed. The surgeon’s learning curve and technique play a significant role in preventing intraoperative complications and blood loss.

AB - Introduction: Laparoscopic surgery has been acknowledged to reduce the morbidity rate thus improving patient safety. During the LLDN, the most frequent complication is renal vessels injuries, which often requires a blood transfusion. Besides the need for a blood transfusion, major bleeding caused by renal vessels injuries requires open conversion and repair. Thus, this study would like to descript and analyze the need for blood transfusion in laparoscopic living donor nephrectomy surgery in our center. Methods: We performed a retrospective cohort study in the Department of Urology at Cipto Mangunkusumo National Hospital. The records of all kidney transplantation donor patients who underwent LLDN procedures carried out at our institution from November 2011 to October 2017 were reviewed. Data including donor age, preoperative hemoglobin level, postoperative hemoglobin level, intraoperative bleeding, number of artery(ies), number of vein(s), donor side, conversion to open surgery, surgery duration, and donor BMI were collected and analyzed. These data were further correlated with the transfusion rate. Results: There were 500 patients underwent laparoscopic living donor nephrectomy procedure at our institution. All of the patients had LLDN with a transperitoneal approach. The difference in blood transfusion rate proportion between male patients with 0.9% compared to 0.6% in female patients was not significant (p=0.782). There is no significant difference in blood transfusion rate proportion regarding renal side (p=0.494), number of artery (p=0.362), age (p=0.978), BMI (p=0.569), and preoperative hemoglobin (p=0.766). Median estimated blood loss in patients who received intraoperative blood transfusion was significantly much greater than in patients who did not receive a blood transfusion (p<0.001). Conclusion: Based on this study, we suggest that in our institution, preoperative blood products are not necessarily needed. The surgeon’s learning curve and technique play a significant role in preventing intraoperative complications and blood loss.

KW - Laparoscopic living donor nephrectomy

KW - Renal transplantation

KW - Transfusion rate

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U2 - 10.2147/RRU.S229431

DO - 10.2147/RRU.S229431

M3 - Article

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JO - Research and Reports in Urology

JF - Research and Reports in Urology

SN - 1179-1551

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