Introduction: Safety of the donor is of paramount importance in transplant surgery, as there was no medical need of the surgery for the donor. Pakistan Kidney and Liver Institute and Research Center (PKLI)  was established in Lahore, Pakistan, in December 2017 and we review the perioperative outcome data of donor nephrectomy in our first 721 kidney transplants, performed at PKLI between July 2018 and Febuary 2024
Material and Methods: All the patients underwent Hand assisted donor nephrectomy using Gelport.. Variables such as gender, age, hepatitis B, hepatitis C, CMV status, stone in donor kidney, hospital stay, major and minor complications related to donor nephrectomy were searched in data base of PKLI. SPSS version 20 was utilized to compute statistical analysis. Continuous values were recorded as means and standard deviations while categorical values were represented as frequency and percentage values.
Results:  All 721 cases were included in the final analysis. There were 422 female (58%) and 299  male (42%) donors. Their mean age was 36.63 ± 9.76 years.Mean BMI was 25.68 ± 7.92 Kg/M2. Anti HCV  antibodies positive (38 patients, 5.2%), Hep C PCR zero copies in all,  HBV DNA zero copies in all and Donor CMV, (707 patients positive, 98%), were observed in the analysis. One hundred and twenty five donors (17.33%)  had history of previous surgical procedure including cesarian sections (52 = 7.21%) followed by appendicectomy (11=1.5%). Small Kidney stones were present in 14 (1.9%) of the donor kidneys. Post op complications included mainly fever in 23 (3.19%), transfusions in 4 (0.55%) patients, incisional hernia seen in 4 (0.55%) with acute obstruction in one patient, minor surgical site infection in 9 (01.24%) patients. Hospital stay was 2.2±0.55 days. Two cases were converted to open,  one due to  stapler failure and the other one due to short right renal vein. There was no donor mortality
Conclusions:  Hand assisted donor nephrectomy is a safe operation with minimal perioperative complications and short hospital stay. Presence of hand provides extra safety margin to the donor

Key words: kidney Donors, complications, hospital stay.