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首页> 外文期刊>Surgical Endoscopy >Short-term impact of carbon dioxide, helium, and gasless laparoscopic donor nephrectomy on renal function and histomorphology in donor and recipient.
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Short-term impact of carbon dioxide, helium, and gasless laparoscopic donor nephrectomy on renal function and histomorphology in donor and recipient.

机译：二氧化碳，氦气和无气腹腔镜供体肾切除术对供体和受体肾功能和组织形态的短期影响。

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BACKGROUND: Laparoscopic donor nephrectomy has the potential to increase the number of living kidney donations by reducing donor morbidity. However, studies have shown that raised intraabdominal pressure can result in transient renal dysfunction. Therefore, laparoscopically procured kidneys might be at higher risk for suffering a period of ischemia during pneumoperitoneum. The objective of this study was to investigate the short-term impact of pneumoperitoneum used for laparoscopic donor nephrectomy on renal function and histomorphology in donor and recipient. METHODS: EXPERIMENT 1: KIDNEY DONOR: Initially, 36 brown Norway (BN) rats were randomized for three procedures: 2 h of carbon dioxide (CO2) insufflation (8 mmHg), 2 h of helium insufflation (8 mmHg), and 2 h of gasless technique (0 mmHg). After this, a unilateral nephrectomy was performed in all the animals. EXPERIMENT 2: RECIPIENT: Subsequently, 36 donor BN rats were subjected to a similar insufflation protocol, but after nephrectomy, a syngeneic kidney transplantation (BN-BN) was performed. Urine and blood samples were collected on postoperative days 1, 3, 7, and 14 for determination of renal function. Subsequently, donor and recipient kidneys were removed for histomorphologic and immunohistochemical analysis. RESULTS: In both donors and recipients, no significant changes in serum creatinine, proteinuria, or glomular filtration were detected between the CO2, the helium, and the gasless control groups. In both experiments, histologic analysis of Kidney specimens did not show any deleterious effects from abdominal gas insufflation. Although kidney grafts exposed to CO2 showed significantly higher numbers of CD45+ leukocytes 3 days after transplantation, immunohistochemical analysis did not show significant differences in number of infiltrating cells (CD4, CD8, ED1, OX6, OX62) between the two insufflation groups and the gasless control subjects. CONCLUSIONS: Abdominal gas insufflation does not have an adverse effect on the renal function of the kidney donor 1 week after laparoscopic donor nephrectomy. No differences in renal function or histomorphology were detected between syngeneic kidney grafts exposed to pneumoperitoneum and gasless control subjects.
机译：背景：腹腔镜供体肾切除术有可能通过减少供体发病率来增加活体肾脏捐献的数量。但是，研究表明，腹腔内压力升高会导致短暂的肾功能不全。因此，腹腔镜手术肾脏可能在气腹期间遭受局部缺血的风险更高。这项研究的目的是调查用于腹腔镜供体肾切除术的气腹对肾功能和供体和受体组织形态的短期影响。方法：实验1：肾脏捐赠者：最初，将36只挪威棕色（BN）大鼠随机分为以下三个步骤：二氧化碳（CO2）注入2 h（8 mmHg），氦气注入2 h（8 mmHg）和2 h无气技术（0 mmHg）。之后，对所有动物进行单侧肾切除术。实验2：收件人：随后，对36只BN供体大鼠进行了类似的注入方案，但在肾切除术后，进行了同种肾脏移植（BN-BN）。术后第1、3、7和14天收集尿液和血液样本以测定肾功能。随后，取出供者和接受者的肾脏以进行组织形态学和免疫组织化学分析。结果：在供体和受体中，在二氧化碳，氦气和无气体对照组之间，血清肌酐，蛋白尿或肾小球滤过均无明显变化。在两个实验中，肾脏标本的组织学分析均未显示腹腔气体吹入有任何有害作用。尽管暴露于CO2的肾脏移植物在移植后3天显示出明显更高的CD45 +白细胞数量，但免疫组化分析并未显示两个吹入组和无气对照组之间的浸润细胞（CD4，CD8，ED1，OX6，OX62）数量有显着差异科目。结论：腹腔镜供体肾切除术后1周，腹腔气体吹入对肾脏供体的肾脏功能没有不利影响。在暴露于气腹的同种肾脏移植物和无气体对照受试者之间，未检测到肾功能或组织形态的差异。

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