[Comparative analysis of renal graft function after open vs. laparoscopic nephrectomy: experimental model].

Area of Science:

• Nephrology
• Surgical Innovation
• Transplantation Science

Background:

• Living donor renal transplantation offers superior patient and graft survival compared to cadaveric donors.
• It is a vital alternative given the persistent shortage of donor organs.

Purpose of the Study:

• To compare the effects of ischemia-reperfusion and functional outcomes of renal grafts obtained via open versus laparoscopic nephrectomy.
• This comparative analysis was conducted using a porcine model for renal autotransplantation.

Main Methods:

• Thirty pigs underwent left kidney nephrectomy, with 15 utilizing laparoscopy and 15 employing open surgery.
• Renal blood flow (RBF) was measured using an electromagnetic probe, and serum creatinine levels were monitored post-transplant.

Main Results:

• Laparoscopic retrieval resulted in significantly lower average RBF post-unclamping compared to open surgery (p < 0.001).
• The laparoscopic group exhibited a more pronounced RBF reduction within the first 5 minutes post-unclamping (p < 0.001).
• Post-transplant creatinine levels were higher in the laparoscopic group during the first week, indicating poorer renal function recovery.

Conclusions:

• Renal grafts retrieved via laparoscopy demonstrate a more pronounced ischemia-reperfusion syndrome.
• Laparoscopic donor nephrectomy is associated with a significant deterioration in early renal graft function compared to open surgery.