Blood Transfusions in Laparoscopic Living Donor Nephrectomy: Single Center Experience from 500 Cases
Received 1 September 2019
Accepted for publication 19 December 2019
Published 15 January 2020 Volume 2020:12 Pages 1—5
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Jan Colli
Senohadi Boentoro, Irfan Wahyudi, Chaidir A Mochtar, Agus Rizal AH Hamid
Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto
Mangunkusumo Hospital, Jakarta, Indonesia
Correspondence: Irfan Wahyudi Email firstname.lastname@example.org
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: transfusion rate, laparoscopic living donor nephrectomy, renal transplantation
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