[Usefulness of cytokines as surgical aggression markers in the ischemia-reperfusion syndrome and post transplant renal function in an experimental model of laparoscopic vs. open renal autotransplantation].
OBJECTIVE
To analyze the modifications induced by laparoscopic and open nephrectomies in living donor transplantation on cytokines, to evaluate operative trauma of different surgical techniques and the influence on ischemia/reperfusion syndrome and renal function.


METHODS
Thirty pigs underwent left nephrectomy, 15 by laparoscopy and 15 by open approach in an experimental autotransplantation model.


RESULTS
Serum level of IL-2, IL-6, IL-10 and tumor necrosis factor (TNF) were lower during laparoscopic than open nephrectomy: 6.8 +/- 0.6 vs 13.9 +/- 1.1 pg/ml for IL-2, 46.2 +/- 2.3 vs 84.4 +/- 2.5 pg/ml for IL-6, 26.1 +/- 2.4 vs 92.8 +/- 12.6 pg/ml for IL-10, and 17.6 +/- 2.1 vs 38.5 +/- 4.8 pg/ml for TNF. There was no association between renal blood flow (RBF) and cytokines levels during nephrectomy: IL-2 (p = 0.498), IL-6 (p = 0.117), IL-10 (p = 0.081) y TNF (p = 0.644). However, there was correlation between IL-10 and the decrease of RBF after transplantation: (R2 0.48; p = 0.02). Initial serum creatinine levels were correlated with RBF and IL-2 levels during nephrectomy (R = 0.831, R2 = 0.691, p = 0.025), and postransplantation RBF (R = 0.784, R2 = 0.614, p < 0.0001). Seventh day creatinine levels were correlated with postransplantation RBF (R = 0.537, R2 = 0.289, p = 0.002) and IL-2 levels during nephrectomy (R = 0.685, R2 = 0.469, p = 0.015).


CONCLUSIONS
Cytokine levels were higher during the open approach than laparoscopic procedure. High levels of RBF during nephrectomy and transplantation improve early graft function while low levels of RBF and high levels ol IL-2 during nephrectomy induce delayed graft function.
Linares Quevedo
Ana Isabel
AI
Servicio de Urología 1, Hospital de Fuenlabrada, Fuenlabrada, Madrid, España. analinaresquevedo@hotmail.com
Burgos Revilla
Francisco Javier
FJ
Villafruela Sanz
Juan José
JJ
Zamora Romero
Javier
J
Pascual Santos
Julio
J
Marcén Letosa
Roberto
R
Cuevas Sánchez
Begoña
B
Sáenz Medina
Javier
J
Correa Gorospe
Carlos
C
D000818:Animals; D016207:Cytokines / Q000097:blood*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods*; D010535:Laparoscopy; D015427:Reperfusion Injury / Q000097:blood* / Q000209:etiology*; D013552:Swine
D016207:Cytokines