Tailor-Made Live Kidney Donation
Nierdonatie bij leven op maat
This thesis describes several aspects of live kidney donation, such as surgical techniques, cost-effectivity, cosmetics en quality of life. Kidney transplantation offer several benefits when compared to dialysis. These benefits include better recipient and graft survival, better access to transplantation and pre-emptive transplantation. Eligibility criteria for live kidney donation have been extended in the last decade, leading to an increase in live donors and an increase in donors with mild comorbidities. This development requires continuous innovation evaluation of all aspects of live kidney donation, including selection, peroperative care, surgical techniques, outcome and long-term survival. There is high quality evidence suggesting that laparoscopic donor nephrectomy is to be preferred over open donor nephrectomy. This thesis describes two randomized controlled trials comparing hand-assisted retroperitoneoscopic donor nephrectomy with full laparoscopic donor nephrectomy. Furthermore, we assess the learning curves of both these techniques in a center with no experience and a center with abundant experience in endoscopic donor nephrectomy. The second part of the thesis focuses on post-operative outcome. It demonstrates the excellent cosmetic outcome after the procedure. Also, no difference in costs or cost-effectiveness was found between both earlier mentioned techniques. Quality of life after live donor nephrectomy is excellent. Furthermore, elderly donors tend to have higher quality of life scores after donation, and they also return to their baseline values earlier. Also, we try to identify factors that influence postoperative quality of life. In the final part we describe the ten-year follow-up on quality of life. The protocol of the LOVE-study is also presented. This study aims to assess the functional donor outcome on the long-term.
|Keywords||Transplantation, Live donors, Kidney, Surgery, Quality of life, Nephrectomy|
|Promotor||J.N.M. IJzermans (Jan)|
|Publisher||Erasmus University Rotterdam|
|Sponsor||Printing of this thesis has been financially supported by: Astellas Covidien Erasmus MC – afdeling Heelkunde Nederlandse Transplantatie Vereniging Olympus Takeda Applied Medical Chipsoft DuoMed Johnson &Johnson Medical Company Gilles Hondus Foundation Nierstichting Nederland|
Klop, K.W.J. (2014, July). Tailor-Made Live Kidney Donation. Erasmus University Rotterdam. Retrieved from http://hdl.handle.net/1765/51600