Skip to main content
Top
Published in: Surgical Endoscopy 7/2006

01-07-2006

Effect of prolonged warm ischemia and pneumoperitoneum on renal function in a rat syngeneic kidney transplantation model

Authors: M. Y. Lind, E. J. Hazebroek, I. M. Bajema, F. Bonthuis, W. C. J. Hop, R. W. F. de Bruin, J. N. M. Ijzermans

Published in: Surgical Endoscopy | Issue 7/2006

Login to get access

Abstract

Background

Laparoscopic donor nephrectomy is associated with several advantages for the donor. However, graft function may be impaired due to use of pneumoperitoneum and prolonged warm ischemia. This study investigated the impact of pneumoperitoneum and prolonged warm ischemia on long-term graft function in a syngeneic rat renal transplant model.

Methods

A total of 27 Brown Norway rats were randomized for transplantation of kidneys after three different procedures: no insufflation and no warm ischemia (group 1), no insufflation with 20 min of warm ischemia (group 2), and CO2 insufflation and 20 min of warm ischemia (group 3). Glomerular filtration rate (GRF), serum creatinine, urine volume, urine creatinine, and proteinuria were determined monthly for 1 year. One year after transplantation, the grafts were removed for histomorphologic analysis.

Results

No significant differences in GRF, serum creatinine, urine volume, and proteinuria were found among the three groups. Histologic analysis also showed no differences between the groups.

Conclusion

Warm ischemia in combination with CO2 pneumoperitoneum, as used in laparoscopic donor nephrectomy, does not result in a negative effect on long-term graft function.
Literature
1.
go back to reference Akbulut G, Serteser M, Polat C, Koken T, Aktepe F, Yilmaz S, Gokce C, Gokce O (2002) Changes in tissue-oxidative stress markers in an experimental model of laparoscopic donor nephrectomy. Transplantation 74: 1768–1772CrossRefPubMed Akbulut G, Serteser M, Polat C, Koken T, Aktepe F, Yilmaz S, Gokce C, Gokce O (2002) Changes in tissue-oxidative stress markers in an experimental model of laparoscopic donor nephrectomy. Transplantation 74: 1768–1772CrossRefPubMed
2.
go back to reference Altintas F, Tunali Y, Bozkurt P, Kaya G, Uygun N, Aricioglu F, Hacibekiroglu M (2001) An experimental study on the relationship of intra-abdominal pressure and renal ischemia. Middle East J Anesthesiol 16: 55–66PubMed Altintas F, Tunali Y, Bozkurt P, Kaya G, Uygun N, Aricioglu F, Hacibekiroglu M (2001) An experimental study on the relationship of intra-abdominal pressure and renal ischemia. Middle East J Anesthesiol 16: 55–66PubMed
4.
go back to reference Brennan TV, Freise CE, Fuller TF, Bostrom A, Tomlanovich SJ, Feng S (2004) Early graft function after living donor kidney transplantation predicts rejection but not outcomes. Am J Transplant 4: 971–979CrossRefPubMed Brennan TV, Freise CE, Fuller TF, Bostrom A, Tomlanovich SJ, Feng S (2004) Early graft function after living donor kidney transplantation predicts rejection but not outcomes. Am J Transplant 4: 971–979CrossRefPubMed
5.
go back to reference Cruzado JM, Torras J, Riera M, et al (2000) Influence of nephron mass in development of chronic renal failure after prolonged warm renal ischemia. Am J Physiol Renal Physiol 279: F259–F269PubMed Cruzado JM, Torras J, Riera M, et al (2000) Influence of nephron mass in development of chronic renal failure after prolonged warm renal ischemia. Am J Physiol Renal Physiol 279: F259–F269PubMed
6.
go back to reference Fisher B, Lee S (1965) Microvascular surgical techniques in research with special reference to renal transplantation in the rat. Surgery 58: 904 Fisher B, Lee S (1965) Microvascular surgical techniques in research with special reference to renal transplantation in the rat. Surgery 58: 904
7.
go back to reference Flowers JL, Jacobs S, Cho E, Morton A, Rosenberger WF, Evans D, Imbembo AL, Bartlett ST (1997) Comparison of open and laparoscopic live donor nephrectomy. Ann Surg 226: 483–489PubMedCrossRef Flowers JL, Jacobs S, Cho E, Morton A, Rosenberger WF, Evans D, Imbembo AL, Bartlett ST (1997) Comparison of open and laparoscopic live donor nephrectomy. Ann Surg 226: 483–489PubMedCrossRef
8.
go back to reference Lewis GR, Brook NR, Walker JR, Bains JC, Veitch PS, Nicholson ML (2004) A comparison of traditional open, minimal-incision donor nephrectomy and laparoscopic donor nephrectomy. Transpl Int 17: 589–595PubMedCrossRef Lewis GR, Brook NR, Walker JR, Bains JC, Veitch PS, Nicholson ML (2004) A comparison of traditional open, minimal-incision donor nephrectomy and laparoscopic donor nephrectomy. Transpl Int 17: 589–595PubMedCrossRef
9.
go back to reference London ET, Ho HS, Neuhaus AM, Wolfe BM, Rudich SM, Perez RV (2000) Effect of intravascular volume expansion on renal function during prolonged CO2 pneumoperitoneum. Ann Surg 231: 195–201CrossRefPubMed London ET, Ho HS, Neuhaus AM, Wolfe BM, Rudich SM, Perez RV (2000) Effect of intravascular volume expansion on renal function during prolonged CO2 pneumoperitoneum. Ann Surg 231: 195–201CrossRefPubMed
10.
go back to reference Nogueira JM, Cangro CB, Fink JC, et al (1999) A comparison of recipient renal outcomes with laparoscopic versus open live donor nephrectomy. Transplantation 67: 722–728CrossRefPubMed Nogueira JM, Cangro CB, Fink JC, et al (1999) A comparison of recipient renal outcomes with laparoscopic versus open live donor nephrectomy. Transplantation 67: 722–728CrossRefPubMed
11.
go back to reference Hazebroek EJ, de Bruin RW, Bouvy ND, Marquet RL, Bonthuis F, Bajema IM, Hayes DP, Ijzermans JN, Bonjer HJ (2003) Long term impact of pneumoperitoneum used for laparoscopic donor nephrectomy on renal function and histomorphology in donor and recipient rats. Ann Surg 237: 351–357CrossRefPubMed Hazebroek EJ, de Bruin RW, Bouvy ND, Marquet RL, Bonthuis F, Bajema IM, Hayes DP, Ijzermans JN, Bonjer HJ (2003) Long term impact of pneumoperitoneum used for laparoscopic donor nephrectomy on renal function and histomorphology in donor and recipient rats. Ann Surg 237: 351–357CrossRefPubMed
12.
go back to reference Hazebroek EJ, de Bruin RW, Bouvy ND, van Duikeren S, Bonthuis F, Marquet RL, Bajema IM, Hayes DP, Ijzermans JN, Bonjer HJ (2002) Short-term impact of carbon dioxide, helium, and gasless laparoscopic donor nephrectomy on renal function and histomorphology in donor and recipient. Surg Endosc 16: 245–251PubMedCrossRef Hazebroek EJ, de Bruin RW, Bouvy ND, van Duikeren S, Bonthuis F, Marquet RL, Bajema IM, Hayes DP, Ijzermans JN, Bonjer HJ (2002) Short-term impact of carbon dioxide, helium, and gasless laparoscopic donor nephrectomy on renal function and histomorphology in donor and recipient. Surg Endosc 16: 245–251PubMedCrossRef
13.
go back to reference Hazebroek EJ, Gommers D, Schreve MA, van Gelder T, Roodnat JI, Weimar W, Bonjer HJ, Ijzermans JN (2002) Impact of intraoperative donor management on short-term renal function after laparoscopic donor nephrectomy. Ann Surg 236: 127–132CrossRefPubMed Hazebroek EJ, Gommers D, Schreve MA, van Gelder T, Roodnat JI, Weimar W, Bonjer HJ, Ijzermans JN (2002) Impact of intraoperative donor management on short-term renal function after laparoscopic donor nephrectomy. Ann Surg 236: 127–132CrossRefPubMed
14.
go back to reference Jablonski P, Howden BO, Rae DA, Birrell CS, Marshall VC, Tange J (1983) An experimental model for assessment of renal recovery from warm ischemia. Transplantation 35: 198–204PubMedCrossRef Jablonski P, Howden BO, Rae DA, Birrell CS, Marshall VC, Tange J (1983) An experimental model for assessment of renal recovery from warm ischemia. Transplantation 35: 198–204PubMedCrossRef
15.
go back to reference Kirsch AJ, Hensle TW, Chang DT, Kayton ML, Olsson CA, Sawczuk IS (1994). Renal effects of CO2 insufflation: oliguria and acute renal dysfunction in a rat pneumoperitoneum model. Urology 43: 453–459CrossRefPubMed Kirsch AJ, Hensle TW, Chang DT, Kayton ML, Olsson CA, Sawczuk IS (1994). Renal effects of CO2 insufflation: oliguria and acute renal dysfunction in a rat pneumoperitoneum model. Urology 43: 453–459CrossRefPubMed
16.
go back to reference McDougall EM, Monk TG, Wolf JS Jr, Hicks M, Clayman RV, Gardner S, Humphrey PA, Sharp T, Martin K (1996) The effect of prolonged pneumoperitoneum on renal function in an animal model. J Am Coll Surg 182: 317–328PubMed McDougall EM, Monk TG, Wolf JS Jr, Hicks M, Clayman RV, Gardner S, Humphrey PA, Sharp T, Martin K (1996) The effect of prolonged pneumoperitoneum on renal function in an animal model. J Am Coll Surg 182: 317–328PubMed
17.
go back to reference Odland MD, Ney AL, Jacobs DM, Larkin JA, Steffens EK, Kraatz JJ, Rodriguez JL (1999) Initial experience with laparoscopic live donor nephrectomy. Surgery 126: 603–606PubMed Odland MD, Ney AL, Jacobs DM, Larkin JA, Steffens EK, Kraatz JJ, Rodriguez JL (1999) Initial experience with laparoscopic live donor nephrectomy. Surgery 126: 603–606PubMed
18.
go back to reference Ratner LE, Kavoussi LR, Schulam PG, Bender JS, Magnuson TH, Montgomery R (1997) Comparison of laparoscopic live donor nephrectomy versus the standard open approach. Transplant Proc 29: 138–139PubMedCrossRef Ratner LE, Kavoussi LR, Schulam PG, Bender JS, Magnuson TH, Montgomery R (1997) Comparison of laparoscopic live donor nephrectomy versus the standard open approach. Transplant Proc 29: 138–139PubMedCrossRef
19.
go back to reference Ratner LE, Kavoussi LR, Sroka M, Hiller J, Weber R, Schulam PG, Montgomery R (1997) Laparoscopic assisted live donor nephrectomy—a comparison with the open approach. Transplantation 63: 229–233PubMedCrossRef Ratner LE, Kavoussi LR, Sroka M, Hiller J, Weber R, Schulam PG, Montgomery R (1997) Laparoscopic assisted live donor nephrectomy—a comparison with the open approach. Transplantation 63: 229–233PubMedCrossRef
20.
go back to reference Ratner LE, Montgomery RA, Maley WR, et al (2000) Laparoscopic live donor nephrectomy: the recipient. Transplantation 69: 2319–2323PubMedCrossRef Ratner LE, Montgomery RA, Maley WR, et al (2000) Laparoscopic live donor nephrectomy: the recipient. Transplantation 69: 2319–2323PubMedCrossRef
21.
go back to reference Sasaki TM, Finelli F, Bugarin E, Fowlkes D, Trollinger J, Barhyte DY, Light JA (2000) Is laparoscopic donor nephrectomy the new criterion standard? Arch Surg 135: 943–947PubMedCrossRef Sasaki TM, Finelli F, Bugarin E, Fowlkes D, Trollinger J, Barhyte DY, Light JA (2000) Is laparoscopic donor nephrectomy the new criterion standard? Arch Surg 135: 943–947PubMedCrossRef
22.
go back to reference Schafer M, Sagesser H, Reichen J, Krahenbuhl L (2001) Alterations in hemodynamics and hepatic and splanchnic circulation during laparoscopy in rats. Surg Endosc 15: 1197–1201PubMedCrossRef Schafer M, Sagesser H, Reichen J, Krahenbuhl L (2001) Alterations in hemodynamics and hepatic and splanchnic circulation during laparoscopy in rats. Surg Endosc 15: 1197–1201PubMedCrossRef
23.
go back to reference Troppmann C, Ormond DB, Perez RV (2003) Laparoscopic (vs open) live donor nephrectomy: a UNOS database analysis of early graft function and survival. Am J Transpl 3: 1295–1301CrossRef Troppmann C, Ormond DB, Perez RV (2003) Laparoscopic (vs open) live donor nephrectomy: a UNOS database analysis of early graft function and survival. Am J Transpl 3: 1295–1301CrossRef
24.
go back to reference Watanabe N, Kamei S, Ohkubo A, Yamanaka M, Ohsawa S, Makino K, Tokuda K (1986) Urinary protein as measured with a pyrogallol red–molybdate complex, manually and in a Hitachi 726 automated analyzer. Clin Chem 32: 1551–1554PubMed Watanabe N, Kamei S, Ohkubo A, Yamanaka M, Ohsawa S, Makino K, Tokuda K (1986) Urinary protein as measured with a pyrogallol red–molybdate complex, manually and in a Hitachi 726 automated analyzer. Clin Chem 32: 1551–1554PubMed
25.
go back to reference Wilson CH, Bhatti AA, Rix DA, Soomro NA (2005) Comparison of laparoscopic and open donor nephrectomy: UK experience. BJU Int 95: 131–135PubMedCrossRef Wilson CH, Bhatti AA, Rix DA, Soomro NA (2005) Comparison of laparoscopic and open donor nephrectomy: UK experience. BJU Int 95: 131–135PubMedCrossRef
Metadata
Title
Effect of prolonged warm ischemia and pneumoperitoneum on renal function in a rat syngeneic kidney transplantation model
Authors
M. Y. Lind
E. J. Hazebroek
I. M. Bajema
F. Bonthuis
W. C. J. Hop
R. W. F. de Bruin
J. N. M. Ijzermans
Publication date
01-07-2006
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 7/2006
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-005-0050-8

Other articles of this Issue 7/2006

Surgical Endoscopy 7/2006 Go to the issue