Background: The increasing number of living kidney donors in the last decade has led to the development of novel surgical techniques for live-donor nephrectomy. The aim of the present study was to evaluate the current status of the surgical approach in Europe. Methods: A survey was sent to 119 transplant centers in 12 European countries. Questions included the number of donors, the technique used, and the acceptance of donors with comorbidities. Results: Ninety-six centers (81%) replied. The number of living donors per center ranged from 0 to 124. Thirty-one institutions (32%) harvested kidneys using open techniques only. Six centers (6%) applied both endoscopic and open techniques; 59 centers (61%) performed endoscopic donor nephrectomy only. Lack of evidence that endoscopic techniques provide superior results was the main reason for still performing open donor nephrectomy. In seven centers, a lumbotomy is still performed. Seventy-two centers (75%) accept donors with a body mass index of more than 30 kg/m, the median upper limit in these centers was 35 kg/m (range, 31-40). Donors with an American Society of Anesthesiologists classification higher than 1 were accepted in 55% of the centers. Conclusions: Live kidney donation in general and minimally invasive donor nephrectomy in particular are more commonly applied in Northern and Western Europe. However, a classic lumbotomy is still performed in a minority of centers. Because minimally invasive techniques have been proven superior, more attention should be given to educational programs in this field to let many kidney donors benefit.

Kidney transplantation, Laparoscopic donor nephrectomy, Living donors, Open donor nephrectomy, Surgical technique, Survey,
Department of Surgery

Klop, K.W.J, Dols, L.F.C, Kok, N.F.M, Weimar, W, & IJzermans, J.N.M. (2012). Attitudes among surgeons towards live-donor nephrectomy: A european update. Transplantation (Vol. 94, pp. 263–268). doi:10.1097/TP.0b013e3182577501