Small Incision Kidney Transplantation with Living Related Donors

INTRODUCTION: Due to improvements in technique and the use of mechanical devices, small incision kidney transplantation (SI-KT) with living related donors was developed in our institution to reduce post-operative pain and improve cosmesis. In this study, we describe this approach specifically in regard to Japanese patients, and compare it with ordinary incision kidney transplantation (OI-KT). PATIENTS AND METHODS: We performed SI-KT on 13 patients between August 2012 and March 2020. A 6 to 9 cm Gibson’s incision was made to approach the iliac fossa where the graft was placed. An historical OI-KT group was selected to match the SI-KT group in regard to age, gender, BMI, donor and recipient characteristics. Factors affecting the operation and management of the patient were compared between the SI-KT and OI-KT groups. RESULTS: The average skin incision was 7.6cm and 13.2cm in the SI-KT and OI-KT groups, respectively. The operating time, estimated blood loss, graft weight, and recipient body mass index (BMI) were comparable in both groups. The average length of both veins and arteries in the SI-KT group were significantly longer. There were no statistical differences in the use of analgesics. No functional differences or complications were observed in the two groups. CONCLUSIONS: Although the length of the skin incision depends in part on recipient BMI and the size of the graft kidney, SI-KT from living donor can be performed successfully. In this study, there were no differences comparing OI-KT and SI-KT, but the amount of analgesics used tended to be less, and the satisfaction of the recipients tended to be higher in the SI-KT group.departmental bulletin pape