Original Paper Urol Int 2021;105:100–107 Laparoscopic Live Donor Nephrectomy: Experience of High-Volume Center with 2,477 Cases Sefa Alperen Ozturk a Yucel Yuksel b Halil Erbis b Ibrahim Aliosmanoglu b Mehmet Sarier c Ozlem Yayar d Havva Asuman Yavuz d Alper Demirbas b a Department of Urology, Suleyman Demirel University School of Medicine, Isparta, Turkey; b Department of General Surgery and Transplantation, Medical Park Hospital, Antalya, Turkey; c Department of Urology, Istinye University Medical Faculty, Istanbul, Turkey; d Department of Nephrology and Transplantation, Medical Park Hospital, Antalya, Turkey Received: July 14, 2020 Accepted: September 4, 2020 Published online: November 18, 2020 Sefa Alperen Ozturk Department of Urology, Süleyman Demirel University School of Medicine Cünür Isparta 32260 (Turkey) dr.sefa.alperen @gmail.com © 2020 S. Karger AG, Basel karger@karger.com www.karger.com/uin DOI: 10.1159/000511377 Keywords Laparoscopic live donor nephrectomy · Tips and tricks · Obesity · Warm ischemia time · Operation time · Multiple renal arteries Abstract Objective: Donors’ health and safety are mandatory in the living-donor kidney transplantation procedure. Laparoscop- ic live donor nephrectomy (LLDN) provides an increase in donor numbers with its benefits and becomes a standard of care. We aimed to explain the results, complication rates, tips, and tricks of the largest number of LLDN case series ever performed in the literature. Materials and Methods: Be- tween August 2012 and December 2019, 2,477 live donor case files were analyzed retrospectively. Age, gender, hospi- talization times, body mass index, warm ischemia times, op- eration times, numbers of arteries, side of the kidneys, and complications were noted. Results: 1,421 (57.4%) of 2,477 donors were female (p = 0.007). Operation times and warm ischemia times were found longer in right-sided LLDN and donors with multiple renal arteries (p = 0.046, <0.001, and <0.001, respectively). Obesity (BMI >30 kg/m 2 ) did not affect warm ischemia times while prolonging the operation times (p = 0.013). Hospitalization times and numbers of complica- tions were higher in obese donors. Conclusions: LLDN seems to be a reliable solution with fewer complications and high- er satisfaction rates. We hope to illuminate the way with tips and trick points for beginner transplant surgeons based on the experience obtained from 2,477 LLDN cases. © 2020 S. Karger AG, Basel Introduction Nowadays, kidney transplantation is the optimal treat- ment for end-stage renal disease (ESRD) patients [1]. The dead-end for the transplantation is lower numbers of the graft kidneys. After live donor nephrectomy starts being performed by surgeons, the pool of the graft has enlarged. There are several surgical procedures for harvesting the kidneys from live donors. At present, laparoscopic live donor nephrectomy (LLDN) is a standard surgical meth- od that was defined by Ratner et al. in 1995 [2]. LLDN encourages people to kidney donation [3]. Many transplantation centers use LLDN as a standard