Beneficial effects of a new fluid regime on kidney function of donor and recipient during laparoscopic v open donor nephrectomy.
OBJECTIVE
Laparoscopic donor nephrectomy (LDN) has been associated with delayed graft function compared with open donor nephrectomy (ODN). We have recently shown that the adverse effect of pneumoperitoneum (PP) on hemodynamics could be prevented by a new fluid regime. The aim of this study was to test the effect of this fluid regime on the kidney function of the donor and recipient after LDN and ODN.


METHODS
We prospectively collected data of 51 donors undergoing ODN and 59 donors undergoing LDN as well as data from the corresponding recipients. All donors and recipients were treated with a standardized anesthesia and fluid regime. This fluid regime consisted of preoperative overnight hydration together with a bolus of colloid administered before induction of anesthesia and before introduction of PP. Follow-up was 2 years.


RESULTS
Baseline characteristics of the two groups were comparable. Hemodynamics and urine output until nephrectomy were comparable between both groups. Donor kidney function did not differ after ODN and LDN. Estimated glomerular filtration rate, graft survival, and recipient survival did not differ between open and laparoscopically procured transplants. No adverse effects of the novel fluid regime (eg, pulmonary edema or additional oxygen supply) were observed in the donors.


CONCLUSIONS
In contrast to our earlier findings, the kidney function of the donor and recipient is comparable between ODN and LDN after introduction of a new fluid regime.
Mertens zur Borg
Ingrid R A M
IR
Department of Anesthesiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
Kok
Niels F M
NF
Lambrou
Georgo
G
Jonsson
David
D
Alwayn
Ian P J
IP
Tran
Khe T C
KT
Weimar
Willem
W
Ijzermans
Jan N M
JN
Gommers
Diederik
D
D000328:Adult; D000368:Aged; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006085:Graft Survival; D006801:Humans; D007668:Kidney / Q000502:physiology*; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000502:physiology*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011446:Prospective Studies; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome; D014563:Urodynamics / Q000502:physiology