0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Correspondence and Brief Communications |

Living-Donor Nephrectomies: Laparoscopy and Open Techniques

Lloyd E. Ratner, MD; Robert A. Montgomery, MD, PhD; Louis R. Kavoussi, MD
Arch Surg. 1998;133(11):1253. doi:.
Text Size: A A A
Published online

Extract

In the paper "Two Hundred One Consecutive Living-Donor Nephrectomies," Shaffer et al1 present their experience with living-donor nephrectomies performed through a standard flank approach. The authors should be congratulated for the excellent results in their series. The low complication rate achieved with the open operation should be viewed as the standard by which all other operative techniques are judged.

Complication rate, however, is not synonymous with morbidity. From the patients' standpoint, pain, time out of work, and inability to perform routine responsibilities, all constitute morbidity. In their series, Shaffer et al do not report the duration or severity of postoperative pain or the length of time until patients return to full activities or employment. Prolonged recuperative time, pain, and cosmetic results can all serve as disincentives to live kidney donation. Our series have shown that when the open flank approach is used, return to full activities and employment average (±SD) 6.2±3.2 and 6.3±3.3 weeks, respectively, and 8±4 weeks for patients with physically demanding jobs.2 This creates significant logistical and financial disincentives. Donors often must forego more than 10% of their annual income and pay out-of-pocket expenses for travel, housing, and child care. It is unknown how many additional live-kidney donors would have come forward over the study period, and how many recipients would have benefitted from living-donor transplantations if some of these disincentives to live donation had been removed.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();