Periarterial papaverine application improves intraoperative kidney function during laparoscopic donor nephrectomy.

Area of Science:

• Nephrology
• Surgical Innovation
• Transplantation Medicine

Background:

• Laparoscopic donor nephrectomy offers advantages over open surgery but may compromise graft quality due to reduced kidney perfusion.
• Elevated intra-abdominal pressure and renal angiospasm during laparoscopic procedures can impair renal blood flow.
• Investigating methods to improve renal perfusion is crucial for enhancing outcomes in laparoscopic kidney donation.

Purpose of the Study:

• To determine if periarterial papaverine application can enhance renal blood flow during laparoscopic donor nephrectomy.
• To assess the impact of papaverine on kidney function indicators like urine output and creatinine clearance.

Main Methods:

• Twelve male piglets underwent left laparoscopic donor nephrectomy.
• The treatment group (n=6) received papaverine hydrochloride around the renal artery before vessel preparation.
• Urine output and creatinine clearance were measured; free sodium excretion was assessed to rule out prerenal failure.

Main Results:

• Pigs treated with papaverine showed significantly higher mean urine output (0.052 ml/min/kg vs. 0.015 ml/min/kg, P=0.02).
• Creatinine clearance was also significantly improved in the papaverine group (2.22 ml/min/kg vs. 0.95 ml/min/kg, P=0.038).
• These findings indicate enhanced renal blood flow and function with papaverine administration.

Conclusions:

• Periarterial application of papaverine improves renal function during laparoscopic kidney harvest.
• Papaverine enhances renal blood flow, potentially improving graft quality in laparoscopic donor nephrectomy.
• This technique offers a promising method to mitigate perfusion-related complications in laparoscopic kidney donation.