[Immune response during laparoscopic and open living donor nephrectomy. An experimental pig model].
BACKGROUND
It's been demonstrated laparoscopic access determines a lower surgical stress, by measurement of several markers as different interleuquines (IL) or C-reactive protein (CRP). Endothelin 1 (ET-1) is a powerful vasoconstrictor produced in renal endothelium scarcely studied in laparoscopy. The objective of this study is to analyze immune response during laparoscopic and open donor nephrectomy, in a porcine experimental model by means of measuring IL-2, 10, tumoral necrosis factor alpha (TNFalpha), CRP and ET-1.


METHODS
Twenty pigs underwent left nephrectomy, 10 by laparoscopy and 10 by open approach in an experimental model. Both groups were monitorized IL-2, 10, TNF alpha, ET-1 at basal, immediately post surgery, first, third, fifth and seventh days after procedure.


RESULTS
The comparative analysis between groups demonstrated a significant increase in levels of CRP (1.44+/-0.88 vs 1.32+/-0.14 mg/dl, p=0.046), TNF alpha (131.14+/-41.37 vs 57.19+/-23.71 pg/ml, p>0.001) and ET-1 (0.91+/-0.49 vs 0.56+/-0.5 fmol/ml, p=0.001) of open nephrectomy group, as a higher levels of IL-2 in laparoscopic group.


CONCLUSIONS
Open donor nephrectomy determines a higher immune response than laparoscopic approach. The importance of this fact over the ischemia-reperfusion syndrome or the immediate function of graft is not clearly established.
Servicio de Urología Hospital de Fuenlabrada, Madrid. javiersaenzmedina@yahoo.es
J
J
Sáenz Medina
M S
MS
Asuero de Lis
J
J
Villafruela Sanz
C
C
Correa Gorospe
B
B
Cuevas
J
J
Galindo Alvarez
A
A
Páez Borda
A I
AI
Linares Quevedo
R
R
Marcén Letosa
J
J
Pascual Santos
F J
FJ
Burgos Revilla
D000818:Animals; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D019332:Endothelin-1 / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D007376:Interleukin-2 / Q000097:blood; D007668:Kidney / Q000276:immunology; D010535:Laparoscopy; D009392:Nephrectomy / Q000379:methods*; D013552:Swine; D014019:Tissue Donors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D015415:Biomarkers; D019332:Endothelin-1; D007376:Interleukin-2; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D002097:C-Reactive Protein