Antidiuretic Hormone Release During Laparoscopic Donor Nephrectomy
| Autor: | Diederik Gommers, H. Jaap Bonjer, Robert de Vos tot Nederveen Cappel, Teun van Gelder, Eric J. Hazebroek, Jan N. M. IJzermans, Willem Weimar, Ewout W. Steyerberg |
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| Rok vydání: | 2002 |
| Předmět: |
Adult
Male Insufflation medicine.medical_specialty Vasopressins medicine.medical_treatment Renal function Nephrectomy Pneumoperitoneum Living Donors medicine Humans Kidney business.industry Middle Aged medicine.disease Kidney Transplantation Surgery medicine.anatomical_structure Renal blood flow Female Laparoscopy business Pneumoperitoneum Artificial Hormone Antidiuretic |
| Zdroj: | Archives of Surgery. 137:600-605 |
| ISSN: | 0004-0010 |
| Popis: | During laparoscopic procedures, increased intra-abdominal pressure may cause transient renal dysfunction due to impaired renal blood flow and induction of neurohormones. However, the relationship between antidiuretic hormone (ADH) secretion and increased intra-abdominal pressure is poorly understood.Laparoscopic donor nephrectomy (LDN) is associated with an increase in plasma ADH concentration, which influences renal function in both the donor and transplanted graft.To evaluate plasma ADH levels during LDN and to correlate ADH levels with graft function.In 30 patients who underwent LDN, plasma ADH levels were collected before insufflation, during surgery, after desufflation, and 24 hours after the procedure. In 6 patients who had open donor nephrectomy, blood samples were obtained as controls. Furthermore, graft function, operative characteristics, and clinical outcome were compared.University hospital.In the LDN group, mean ADH levels during pneumoperitoneum and 30 minutes postinsufflation were significantly higher compared with preinsufflation values (P.001). Twenty-four hours after LDN, mean ADH levels had returned to normal values. There were no significant differences in ADH levels in the open donor nephrectomy group. No significant differences in either intraoperative diuresis, blood pressure readings, or postoperative graft function were documented among the 2 groups.In this study, LDN was associated with an increase in plasma ADH that appeared to be related to increased intra-abdominal pressure. We conclude that the increased ADH concentrations during LDN are not associated with clinically significant changes in either the kidney donor or the transplanted graft. |
| Databáze: | OpenAIRE |
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