Extract

Introduction and rationale

Laparoscopic live donor nephrectomy is an operation that was designed specifically in an attempt to alleviate the profound shortage of kidneys for transplantation [1]. In the US, there is a growing disparity between the organ supply and demand. This has resulted in prolonged waiting times on the cadaveric renal transplant waiting list [2]. Commensurate with the increased waiting times has been an increase in the number of deaths of patients awaiting transplantation. Live kidney donors have remained an under-utilized source of transplantable organs.

Live donor renal transplantation offers several advantages over cadaveric transplantation. First, the long waiting times are eliminated. Second, there is a lower incidence of delayed function. Third, both patient and graft survival rates are significantly better with live donor transplantation [3]. Thus, not only are more organs made available, the need for repeat transplantation is reduced. Also, live donor renal transplantation is more cost effective than cadaveric donor transplantation [4]. However, despite these advantages, there exist significant disincentives to live kidney donation.

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