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85ml. The mean post-operative hospital stay was 2 (1–3) days. All donors demonstrated rapid recovery with no major intraor post-operative complications. The donor recovery and post-operative period was uneventful. Patientcontrolled analgesia and oral acetaminophen were used infrequently for pain relief in the first and the following two post-operative days, respectively. The mean serum creatinine on admission was 95.5 16.4 (71–130) and 124 22.4 (86–166) mmol/l at the time of discharge from the hospital. All donors are subjected to follow-up after 2 weeks and then at 3, 6 and 12 months and subsequently on a yearly basis. The relationship between donors and recipients was first degree in eight, second degree in one and unrelated in three. All transplanted kidneys had immediate function except two. One was lost because of hyperacute non-HLA-related rejection. The second graft was lost because of arterial thrombosis on the fifth post-operative day. The second lost graft was transplanted in a recipient with spina bifida, ileal conduit (used for transplant ureter implantation), history of recurrent deep vein thromobosis and leg amputation because of arterial thrombosis. However, no coagulopathy was demonstrated. The corner stone in live donor nephrectomy is to keep morbidity to a minimum. The HAR nephrectomy was proved to offer a high degree of safety and a short hospital stay [1]. It is characterized by low risk of bleeding, visceral injury, bowel obstruction and internal hernia. The HAR procedure facilitates better control of the surgical field through combining the tactile feedback with the two-dimensional video screen picture [1,4]. Our donors represent a variety of vascular anomalies that were considered contraindications of laparoscopic live donor nephrectomies, especially the retroperitoneoscopic approach. However, we successfully extended the use of this approach to this group of donors. Four of the donors had two renal arteries. One of the donors represented a case of rare venous anomaly (double IVC), which has an incidence rate of 0.5–3% [5]. This type of vascular anomaly presents an operative difficulty due to shortness of the left renal vein and crossing of the left IVC division anterior to the left renal artery which is normally shorter than the right side and needs to be divided behind the left IVC division. With comprehensive pre-operative assessment, laparoscopic techniques can be used safely for living kidney donors with anatomical anomalies. Removal of vascular anomalies as one of the relative contraindications of laparoscopic donor nephrectomy may increase the number of living donor kidney transplants, as it has the attraction of cosmetic outcome, low post-operative morbidity and economic disincentives for potential donors. Since the introduction of this technique, we have an increased number of potential living donors and we are on target to double the number of living donor transplants at our centre.

Nephrotic syndrome as a manifestation of Toxocara canis infection