Enhanced Recovery after Implementation of Surgery Protocol in Living Kidney Donors: The ISMETT Experience

Transplant Proc. 2019 Nov;51(9):2910-2913. doi: 10.1016/j.transproceed.2019.04.089. Epub 2019 Oct 9.

Abstract

Introduction: Laparoscopic living donor nephrectomy (LLDN) has become the standard procedure for living kidney transplantation. Enhanced recovery after surgery (ERAS) is a multimodal perioperative management aimed at facilitating rapid patient recovery after major surgery by modifying the response to stress induced by exposure to surgery. This association can further reduce hospital stay, surgical stress, and perioperative morbidity of living kidney donors.

Material and methods: In this retrospective analysis conducted at our institute, we compared the first 21 patients who underwent LLDN enrolled with the ERAS protocol with 55 patients who underwent LLDN with the fast-track protocol in the 5 years prior to ERAS protocol implementation.

Results: We evaluated 76 consecutive patients. After ERAS protocol implementation, elderly living donors had a shorter hospital stay and a faster return to normal life compared with the same age group of patients in the previous period. There were no major differences in median postoperative hospital stay and no meaningful differences in the percentage of complications after surgery and hospital readmissions.

Conclusions: The introduction of the ERAS protocol for patients undergoing LLDN compared with the traditional protocol led to a reduction in postoperative hospitalization in elder donors, without determining a raise in the number of hospital complications and readmissions.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Kidney Transplantation*
  • Laparoscopy / adverse effects
  • Laparoscopy / methods
  • Length of Stay / statistics & numerical data
  • Living Donors*
  • Male
  • Middle Aged
  • Nephrectomy / methods*
  • Patient Readmission / statistics & numerical data
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Recovery of Function*
  • Retrospective Studies
  • Tissue and Organ Harvesting / adverse effects
  • Tissue and Organ Harvesting / methods*