This study aims to review the current evidence on the Mayo Adhesive Probability (MAP) score and its association with surgical outcomes in laparoscopic donor nephrectomy (LDN). We hypothesize that the MAP score correlates with worse surgical outcomes in LDN, similar to its role in partial nephrectomy for renal cell carcinoma.

A systematic review and meta-analysis were conducted using the PICO framework. Literature searches were performed in PubMed, Wiley Online Library, Embase, Clinical Key, and Scopus. Study selection followed PRISMA guidelines and predefined eligibility criteria. Forest plots were used for quantitative synthesis, and the Newcastle-Ottawa Scale was applied for risk of bias assessment.

Five cohort studies met the inclusion criteria, comprising a total of 1,060 LDN patients. All studies were rated as good quality. Meta-analysis revealed a pooled mean difference in operation time of 6.28 minutes (95% CI: 3.49–9.08; p < 0.0001) between MAP 0 and MAP ≥1 groups, with moderate heterogeneity (I² = 43%). These findings indicate that a higher MAP score is significantly associated with longer operative times in LDN.

MAP score is a significant predictor of longer operation time in LDN. However, the limited number of studies and surgical outcome data highlight the need for further high-quality research, including randomized controlled trials, to validate and expand on these findings.