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  • 1. Introduction
  • 2. Incision and Port Placement
  • 3. Left Colon Mobilization
  • 4. Left Kidney Exposure and Mobilization
  • 5. Left Renal Hilum Dissection
  • 6. Left Kidney Extraction
  • 7. Reperfusion of Kidney
  • 8. Closure
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Left Laparoscopic Donor Nephrectomy


Tatsuo Kawai, MD
Massachusetts General Hospital

Main Text


Chronic kidney disease (CKD) is characterized by a gradual decline in kidney function over a period of months to years. It affects 10% of the population worldwide, and millions die each year. Common causes include diabetes mellitus, hypertension, glomerulonephritis, and polycystic kidney disease. There are 5 stages of CKD depending on the level of kidney function as estimated based on the calculated glomerular filtration rate (GFR). Stage 1 is defined as kidney damage with normal or increased GFR (≥90 ml/min/1.73 m2); Stage 2 as a mild decrease in GFR (60-89 ml/min/1.73 m2); Stage 3 as a moderate decrease in GFR (30-59 ml/min/1.73 m2); Stage 4 as a severe decrease in GFR (15-29 ml/min/1.73 m2); Stage 5 as kidney failure with a severe decrease in GFR (<15 ml/min/1.73 m2). Kidney failure, or end stage renal disease, requires either a renal transplant to replace the failed kidneys or renal replacement therapy to filter and remove toxins from the blood through dialysis. A kidney transplant involves placing a healthy kidney into a person whose kidneys are no longer functioning. It is often the treatment of choice for patients with kidney failure compared with a lifetime on dialysis. This is due to better quality of life, lower risk of death, fewer dietary restrictions, and lower treatment costs. The procedure is classified as either deceased/cadaveric donor or living donor depending on whether or not the donor was alive at the time of harvesting the organ. Only one kidney is needed to replace two failed kidneys, making living donations an option. Here, we present a left laparoscopic living donor nephrectomy from a healthy female; the harvested kidney was later transplanted into a patient with kidney failure.

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