title: Antidiuretic hormone release during laparoscopic donor nephrectomy.
abstract: BACKGROUND
  During laparoscopic procedures, increased intra-abdominal pressure may cause transient renal dysfunction due to impaired renal blood flow and induction of neurohormones. However, the relationship between antidiuretic hormone (ADH) secretion and increased intra-abdominal pressure is poorly understood.
  
  
  OBJECTIVE
  Laparoscopic donor nephrectomy (LDN) is associated with an increase in plasma ADH concentration, which influences renal function in both the donor and transplanted graft.
  
  
  OBJECTIVE
  To evaluate plasma ADH levels during LDN and to correlate ADH levels with graft function.
  
  
  METHODS
  In 30 patients who underwent LDN, plasma ADH levels were collected before insufflation, during surgery, after desufflation, and 24 hours after the procedure. In 6 patients who had open donor nephrectomy, blood samples were obtained as controls. Furthermore, graft function, operative characteristics, and clinical outcome were compared.
  
  
  METHODS
  University hospital.
  
  
  RESULTS
  In the LDN group, mean ADH levels during pneumoperitoneum and 30 minutes postinsufflation were significantly higher compared with preinsufflation values (P<.001). Twenty-four hours after LDN, mean ADH levels had returned to normal values. There were no significant differences in ADH levels in the open donor nephrectomy group. No significant differences in either intraoperative diuresis, blood pressure readings, or postoperative graft function were documented among the 2 groups.
  
  
  CONCLUSIONS
  In this study, LDN was associated with an increase in plasma ADH that appeared to be related to increased intra-abdominal pressure. We conclude that the increased ADH concentrations during LDN are not associated with clinically significant changes in either the kidney donor or the transplanted graft.
authors: Department of Surgery, Erasmus Medical Center, Rotterdam, Dr Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
authors: Eric J
authors: EJ
authors: Hazebroek
authors: Robert
authors: R
authors: de Vos tot Nederveen Cappel
authors: Diederik
authors: D
authors: Gommers
authors: Teun
authors: T
authors: van Gelder
authors: Willem
authors: W
authors: Weimar
authors: Ewout W
authors: EW
authors: Steyerberg
authors: H Jaap
authors: HJ
authors: Bonjer
authors: Jan N M
authors: JN
authors: IJzermans
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D010535:Laparoscopy; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods; D011028:Pneumoperitoneum, Artificial; D014667:Vasopressins / Q000097:blood* / Q000378:metabolism
chemical_list: D014667:Vasopressins