Laparoscopic live donor nephrectomy: Current practice and results of renal transplantation Sidney Kam-Hung Yip, 1 * Chi-Bon Leung, 2 Cheuk-Chun Szeto, 2 Nga-Yee Lam, 1 Chi-Kwok Chan, 1 Yuen-Fan Tong, 2 Chi-Fai Ng, 1 Bonnie Ching-Ha Kwan, 2 Kai-Ming Chow, 2 Eddie Shu-Yin Chan, 1 Simon See-Ming Hou, 1 Alex Wai-Yin Yu 2 and Philip Kam-Tao Li 2 Departments of 1 Surgery and 2 Medicine, Chinese University of Hong Kong, Hong Kong SAR. Objective: In 2009, 1659 patients with end-stage renal failure in Hong Kong were waiting for a renal transplant. The overall number of renal transplants carried out locally remains low, with an even lower number being live donor donations. Yet, live donor kidney transplantation yields results that are consistently superior to those of deceased donor kidney transplantation, and laparoscopic donor nephrectomy (LDN) is increasingly accepted worldwide as a safe and preferred surgical option. We aim to evaluate the outcome of LDN in our setting, and to compare with that of deceased donors in this retrospective review. Patients and Methods: A total of 12 patients received LDN over the study period of 2006–2009. Standard left transperitoneal LDN was carried out. Grafts including three with double vessels were prepared using the bench technique. The postoperative outcomes up to 1 year for both the donors and the recipients were studied. Contemporary results for the 47 deceased donor kidneys were studied and compared. Results: All donors had an eventful recovery. The operating time was 225.0  67.4 min. The hospital stay was 5.6  2.3 days. The recipient outcomes including hospital stay and creatinine levels at discharge and 1 year were 11 days, 121 umol/L and 116 umol/L, respectively. Specifically, no ureteric stricture or graft loss was noted at the 1-year follow up. Recipient complications included haematoma (1 patient), renal artery stenosis (1 patient) and redo of vascular anastomosis (1 patient). In contrast, the deceased donor graft recipients had a hospital stay of 11 days, and creatinine levels of 205 umol/L on discharge and 205 umol/L at 1year, respectively. The delayed graft function rates for the live donor and deceased donors group were 0% and 14.9%, whereas the 1-year graft survival rates were 100% and 87.2% respectively. Conclusion: The results showed that the donor morbidity rate was low, as reflected by the short hospital stay. Also, the overall parameters of recipients were good. In particular, no ureteric stricture was noted, and graft survival was 100% at 1 year. Living donor kidney transplant program using the laparoscopic technique is a viable option to improve the pool of kidneys for transplantation. Key words: Kidney transplant, donor nephrectomy, outcome, chronic renal failure. Renal transplantation has become a well-established therapy and represents the best therapeutic option for patients with end-stage renal disease. Live donor kidney transplantation yields results that are consis- tently superior to those of deceased donor kidney transplantation. To reduce the morbidity of donors, who are healthy individuals, laparoscopic donor nephrectomy (LDN) is increasingly accepted as a safe and preferred surgical option. 1–4 However, the overall number of renal transplants in Hong Kong remains low. From 2006 to 2009, 262 deceased donor renal transplants were carried out; in comparison, 30 live donor transplants were carried out during that period. Furthermore, amongst the patients who had a transplantation carried out in Hong Kong and had a functioning graft on 31 December 2009, 670 (65.5%) received deceased donor renal trans- plants, whereas just 353 (34.5%) received living donor renal transplants. 5 The feasibility of LDN was previ- ously evaluated in an experimental setting. 6 A clinical programme can be established despite the modest case volume. 7 We aim to evaluate the outcome of our *Author to whom all correspondence should be addressed. Email: sidneyyip@surgery.cuhk.edu.hk Received 27 May 2011; accepted 23 August 2011. Surgical Practice doi:10.1111/j.1744-1633.2011.00575.x Original Article © 2011 The Authors Surgical Practice © 2011 College of Surgeons of Hong Kong Surgical Practice (2012) 16, 17–21