[Comparative analysis of renal graft function after open vs. laparoscopic nephrectomy: experimental model].
BACKGROUND
Living donor renal transplant reports a higher patient and graft survival in comparison to cadaver donor and represents a good alternative facing the current lack of organs for transplant.


OBJECTIVE
To analyze comparatively in an experimental model (pig) the influence of ischemia-reperfusion and functional outcome of renal graft retrieved by open Vs laparoscopic nephrectomy.


METHODS
30 lab pigs were nephrectomized (left kidney): 15 by laparoscopy and 15 by open surgery, as living donors, in a model of renal autotransplant. Renal blood flow (RBF) was measured by means of an electromagnetic probe and creatinine levels during the first week after the implant.


RESULTS
Comparative analysis of RBF during the immediate 60 min after unclamping showed a significant reduction of average RBF in laparoscopic group in comparison to open group (p < 0.001), with a more evident reduction of RBF in the laparoscopic group during the 5-min period after unclamping (p < 0.001) and a progressive recuperation of RBF during the 1st hour, slowest in laparoscopic group. Creatinine levels in the first week after the transplant decreased progressively from 1.3 to 0.8 mgrs/dl in the open group and from 2 to 1.1 mg/dl in laparoscopic group (p < 0.001).


CONCLUSIONS
Renal grafts retrieved by laparoscopy presents a more evident ischemia-reperfusion syndrome shown by a lower average RBF after unclamping and a significant deterioration of renal function during the first week after transplant.
Linares Quevedo
A I
AI
Servicio de Urologia, Hospital de Fuenlabrada, Madrid. analinaresquevedo@hotmail.com
Burgos Revilla
F J
FJ
Villafruela Sanz
J J
JJ
Zamora Romero
J
J
Pascual Santos
J
J
Marcén Letosa
R
R
Cuevas Sánchez
B
B
Correa Gorospe
C
C
D000818:Animals; D016030:Kidney Transplantation / Q000502:physiology*; D010535:Laparoscopy; D023421:Models, Animal; D009392:Nephrectomy / Q000379:methods*; D013552:Swine