Anterior vertical mini‐incision vs. retroperitoneoscopic nephrectomy in living kidney donation: a prospective study on donors' quality of life and clinical outcome

Background A fundamental goal in living kidney donation ( LKD ) is to maximize donor safety while minimizing post‐operative impairments. We evaluated clinical outcome and health‐related quality of life ( QOL ) comparing anterior vertical mini‐incision donor nephrectomy ( MIDN ) and retroperitoneoscopic donor nephrectomy ( RPDN ). Methods Thirty‐eight MIDN and 45 RPDN donors were analyzed. In a subsample (n = 18 MIDN ; n = 32 RPDN ), QOL was prospectively assessed with the WHOQOL ‐Bref questionnaire before and three months after LKD . Results Skin‐to‐skin time (169 vs. 116 min, p < 0.001) and hospital stay (6.6 vs. 4.9 d, p < 0.001) were significantly shorter in RPDN . In total, 26% of MIDN patients and 13% of RPDN patients developed post‐operative complications (p = 0.14). While in MIDN the QOL domains physical health (p = 0.03) and psychological (p = 0.03) and the overall QOL facet (p = 0.003) were significantly lower three months post‐ LKD compared to baseline, there were no significant QOL decreases in RPDN . However, no significant post‐operative QOL differences were found between groups. RPDN donors retrospectively reported significantly less post‐operative pain (p = 0.007) and physical strain (p = 0.05) caused by LKD than MIDN donors. Conclusions It may be possible to further reduce the surgical burden of LKD by introducing RPDN . Post‐operative QOL was not significantly different between groups, but the QOL decrease appeared to be less pronounced in RPDN .