February 2, 2009

Donor kidney removed via vagina

U.S. surgeons have successfully removed a healthy donor kidney through a small incision in the back of the donor's vagina.

Dr. Robert Montgomery, chief of the transplant division at Johns Hopkins University School of Medicine who led the team that performed the operation, said the transvaginal donor kidney extraction, performed last week on a 48-year-old woman from Lexington Park, Md., eliminated the need for a 5- to 6-inch abdominal incision and left only three pea-size scars on her abdomen, one of which is hidden in her navel.

Transvaginal kidney removals have been done previously to remove cancerous or non-functioning kidneys that endanger a patient's health, but not for healthy kidney donation, Montgomery said.

Because transplant donor nephrectomies are the most common kidney removal surgeries at about 6,000 a year in the United States -- this approach could have a tremendous impact on people's willingness to donate by offering more surgical options, Montgomery said.

Since the first laparoscopic donor nephrectomy was performed at Johns Hopkins in 1995, surgeons have been troubled by the need to make a relatively large incision in the patient's abdomen after completing the nephrectomy to extract the donor kidney, Montgomery said in a statement.

That incision is thought to significantly add to the patient's pain, hospitalization and convalescence -- removing the kidney through a natural opening should hasten the patient's recovery and provide a better cosmetic result.