Living donor nephrectomy has been developed and
promoted as a method to address the shortfall in kidneys available for transplantation. The classical method to procure a kidney from a living donor is the open donor nephrectomy performed through a flank lumbotomy incision. However, this classical method has negative short- and long-term side effects for the donor. These disincentives are a drawback for possible donors to donate a kidney. Therefore, transplant surgeons were stimulated to develop new and less invasive techniques. In this review several new open and laparoscopic techniques are described. Compared with open donor nephrectomy, laparoscopic donor nephrectomy has shown superior results in terms of postoperative pain, cosmetics, convalescence, and return to normal daily activities. No significant differences exist between the two approaches in terms of complication rates, cost-effectiveness and graft function. Nowadays, laparoscopic donor nephrectomy has become the preferred method for procuring kidney grafts of living donors in many centres.