Abstract

SAENZ MEDINA, J. et al. Immune response during laparoscopic and open living donor nephrectomy: An experimental pig model. Actas Urol Esp [online]. 2008, vol.32, n.4, pp.435-442. ISSN 0210-4806.

Introduction: 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 α (TNFα), 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 α 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 α (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.

Keywords : Laparoscopy; Nephrectomy; Immune response.

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