Abstract

LINARES QUEVEDO, A.I. et al. Comparative analysis of renal graft function after open vs laparoscopic nephrectomy: experimental model. Actas Urol Esp [online]. 2008, vol.32, n.1, pp.140-151. ISSN 0210-4806.

Introduction: 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. Goals: 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. Material and 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 1^st 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.

Keywords : Renal transplantation; Open nefrectomy; Laparoscopic nefrectomy.

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