Lind M Y, Hazebroek E J, Bajema I M, Bonthuis F, Hop W C J, de Bruin R W F, Ijzermans J N M
Department of Surgery, Erasmus MC, Dr. Molewaterplein 40, 3015, GD Rotterdam, The Netherlands.
Surg Endosc. 2006 Jul;20(7):1113-8. doi: 10.1007/s00464-005-0050-8. Epub 2006 May 13.
Laparoscopic donor nephrectomy is associated with several advantages for the donor. However, graft function may be impaired due to use of pneumoperitoneum and prolonged warm ischemia. This study investigated the impact of pneumoperitoneum and prolonged warm ischemia on long-term graft function in a syngeneic rat renal transplant model.
A total of 27 Brown Norway rats were randomized for transplantation of kidneys after three different procedures: no insufflation and no warm ischemia (group 1), no insufflation with 20 min of warm ischemia (group 2), and CO2 insufflation and 20 min of warm ischemia (group 3). Glomerular filtration rate (GRF), serum creatinine, urine volume, urine creatinine, and proteinuria were determined monthly for 1 year. One year after transplantation, the grafts were removed for histomorphologic analysis.
No significant differences in GRF, serum creatinine, urine volume, and proteinuria were found among the three groups. Histologic analysis also showed no differences between the groups.
Warm ischemia in combination with CO2 pneumoperitoneum, as used in laparoscopic donor nephrectomy, does not result in a negative effect on long-term graft function.
腹腔镜供肾切除术对供体有诸多优势。然而，气腹的使用和长时间的热缺血可能会损害移植肾功能。本研究在同基因大鼠肾移植模型中，探究了气腹和长时间热缺血对长期移植肾功能的影响。
总共27只棕色挪威大鼠被随机分为三组，分别接受三种不同手术操作后的肾脏移植：无气腹且无热缺血（第1组）、无气腹但有20分钟热缺血（第2组）、二氧化碳气腹且有20分钟热缺血（第3组）。在1年的时间里，每月测定肾小球滤过率（GRF）、血清肌酐、尿量、尿肌酐和蛋白尿。移植1年后，取出移植物进行组织形态学分析。
三组之间在GRF,血清肌酐、尿量和蛋白尿方面未发现显著差异。组织学分析也显示各组之间无差异。
腹腔镜供肾切除术中使用的热缺血与二氧化碳气腹联合使用，对长期移植肾功能不会产生负面影响。
