Hand-assisted retroperitoneoscopic versus standard laparoscopic donor nephrectomy: HARP-trial

The HARP-trial is a multi-centre randomised controlled, single-blind trial. The study compares the hand-assisted retroperitoneoscopic approach with standard laparoscopic donor nephrectomy. The objective is to determine the best approach for live donor nephrectomy to optimise donor's safety and comfort while reducing donation related costs.This study will contribute to the evidence on any benefits of hand-assisted retroperitoneoscopic versus standard laparoscopic donor nephrectomy.Dutch Trial Register NTR1433Transplantation is the only treatment offering long-term benefit to patients with chronic kidney failure. As the number of patients suffering end stage renal disease (ESRD) increases, the recruitment of more kidney donors is important [1]. Live kidney donation is the most realistic option to reduce donor shortage on short- and long-term. Increasing the number of donors will decrease the number of patients on the waiting list and consequently reduce patient's mortality. Implementation of live donation offers the possibility to transplant before the kidney disease reaches the terminal phase, necessitating dialysis. Thus, this so called pre-emptive transplantation may prevent unnecessary surgical interventions to establish dialysis (including costs and mortality) and dialysis related complications. In the last decade the number of non-related live kidney donations is rising. Among these donors are family and friends of the recipient, and even anonymous donors; the ethical basis for live kidney donation is altering. The looser the connection between the donor and recipient is, the less clear the profit for the donor is.Live donor nephrectomy is performed on healthy individuals who do not receive direct therapeutic benefit of the procedure themselves. In order to guarantee safety for the donors, it is important to optimise the surgical approach. Recently we demonstrated the benefit of laparoscopic nephrectomy (LDN) to the donor. However, this method is characterised b