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Periarterial application of papaverine during laparoscopic donor nephrectomy improves early graft function after kidney transplantation in pigs

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Abstract

Background: Laparoscopic donor nephrectomy (LDN) increases incentives to donation by subjects who might refuse an open operation. However, the incidence of delayed graft function is higher after LDN than after open operation. This may be caused by the reduction of renal perfusion as a result of the raised intraabdominal pressure and mechanically induced renal angiospasm during the operation. We conducted experiments to find out whether the application of papaverine around the renal artery during LDN could improve early graft function after transplantation. Methods: Renal function was studied in 10 male pigs (weight ~25 kg). The left kidney was harvested laparoscopically (intraabdominal pressure 8 mmHg). Five animals were randomly selected to have perivascular application of 50 mg papaverine (treatment group) before preparation of the vessels. In controls no papaverine was used. After LDN and open right nephrectomy the left kidney was autotransplanted. The main outcome measures were volume of urine produced and creatinine clearance during the first 20 h after the transplant. Results: The groups were comparable in respect of body weight, hemodynamic values, amount of infusions, warm and cold ischemia time, and duration of anastomosis. Urine output and creatinine clearance were significantly higher in pigs treated with papaverine than in controls. Conclusions: Papaverine substantially improved early graft function in pigs when applied around the renal artery during LDN. Whether this is applicable to procurement of human kidneys remains to be evaluated.

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References

  1. AT Ali WD Montgomery WP Santamore PA Spence (1997) ArticleTitlePreventing gastroepiploic artery spasm: papaverine vs. calcium channel blockade. J Surg Res 71 41–48 Occurrence Handle10.1006/jsre.1997.5138 Occurrence Handle1:CAS:528:DyaK2sXls1Oqtbw%3D Occurrence Handle9271276

    Article  CAS  PubMed  Google Scholar 

  2. B Arquilla R Gupta J Gernshiemer M Fischer (2000) ArticleTitleAcute arterial spasm in an extremity caused by inadvertent intra-arterial injection successfully treated in the emergency department. J Emerg Med 19 139–143 Occurrence Handle10.1016/S0736-4679(00)00200-6 Occurrence Handle1:STN:280:DC%2BD3cvjslOhtQ%3D%3D Occurrence Handle10903461

    Article  CAS  PubMed  Google Scholar 

  3. LJ Cisek RM Gobet CA Peters (1998) ArticleTitlePneumoperitoneum produces reversible renal dysfuntion in animals with normal and chronically reduced renal function. J Endourol 12 95–100 Occurrence Handle1:STN:280:DyaK1c3mvVCnuw%3D%3D Occurrence Handle9607433

    CAS  PubMed  Google Scholar 

  4. JF Flowers S Jacobs E Cho A Morton WF Rosenberger D Evans AL Imbembo ST Bartlett (1997) ArticleTitleComparison of open and laparoscopic live donor nephrectomy. Ann Surg 226 483–489 Occurrence Handle1:STN:280:DyaK1c%2Fht1Srsw%3D%3D Occurrence Handle9351716

    CAS  PubMed  Google Scholar 

  5. H Hausmann J Photiadis R Hatzer (1996) ArticleTitleBlood flow in the internal mammary artery after the administrate of papaverine during coronary artery bypass grafting. Tex Heart Inst J 23 279–283 Occurrence Handle1:STN:280:ByiC38znvFU%3D Occurrence Handle8969027

    CAS  PubMed  Google Scholar 

  6. A Koffron C Herman O Gross M Ferrario D Kaufman M Abecassis J Fryer F Stuart J Leventhal (2001) ArticleTitleLaparoscopic donor nephrectomy: analysis of donor and recipient outcomes. Transplant Proc 33 1111 Occurrence Handle10.1016/S0041-1345(00)02437-4 Occurrence Handle1:STN:280:DC%2BD3M7mvVOmsg%3D%3D Occurrence Handle11267213

    Article  CAS  PubMed  Google Scholar 

  7. F Lindberg D Bergqvist M Björck I Rasmussen (2003) ArticleTitleRenal hemodynamics during carbon dioxide pneumoperitoneum. An experimental study in pigs. Surg Endosc 16 480–484

    Google Scholar 

  8. ET London HS Ho AMC Neuhaus BM Wolfe SM Rudich RV Perez (2000) ArticleTitleEffect of intravascular volume expansion on renal function during prolonged CO2 pneumoperitoneum. Ann Surg 231 195–201 Occurrence Handle10.1097/00000658-200002000-00007 Occurrence Handle1:STN:280:DC%2BD3c7jslSktw%3D%3D Occurrence Handle10674610

    Article  CAS  PubMed  Google Scholar 

  9. EM McDougall TG Monk JS Wolf Jr M Hicks RV Clayman S Gardner PA Humphrey T Sharp K Martin (1996) ArticleTitleThe effect of prolonged pneumoperitoneum on renal function in an animal model. J Am Coll Surg 182 317–328 Occurrence Handle1:STN:280:BymC1MrmvFQ%3D Occurrence Handle8605555

    CAS  PubMed  Google Scholar 

  10. Y Miki K Iwase W Kamiike E Taniguchi K Sakaguchi J Sumimura H Matsuda I Nagai (1997) ArticleTitleLaparoscopic cholecystectomy and time-course changes in renal function. The effect of the retraction method on renal function. Surg Endosc 11 838–841 Occurrence Handle10.1007/s004649900466 Occurrence Handle1:STN:280:ByiH3M7ntFY%3D Occurrence Handle9266647

    Article  CAS  PubMed  Google Scholar 

  11. RA Montgomery LR Kavoussi LM Su V Sinkov C Cohen WR Maley JF Burdick J Markowitz LE Ratner (2001) ArticleTitleImproved recipient results after 5 years of performing laparoscopic donor nephrectomy. Transplant Proc 33 1108–1110 Occurrence Handle10.1016/S0041-1345(00)02436-2 Occurrence Handle1:STN:280:DC%2BD3M7mvVOnuw%3D%3D Occurrence Handle11267212

    Article  CAS  PubMed  Google Scholar 

  12. JM Nogueira CB Cangro JC Fink E Schweitzer A Wiland DK Klassen J Gardner J Flowers S Jacobs E Cho B Philosophe ST Bartlett MR Weir (1999) ArticleTitleA comparison of recipient renal outcomes with laparoscopic versus open live donor nephrectomy. Transplantation 67 722–728 Occurrence Handle10.1097/00007890-199903150-00014 Occurrence Handle1:STN:280:DyaK1M7psVWqsQ%3D%3D Occurrence Handle10096529

    Article  CAS  PubMed  Google Scholar 

  13. O Ostraat H Lonnroth M Olausson I Blohme (2000) ArticleTitleExperience with laparoscopic donor nephrectomy at a European transplant centre. Transpl Int 13 S253–S254

    Google Scholar 

  14. B Philosophe PC Kuo EJ Schweitzer AC Farney JW Lim LB Johnson S Jacobs JL Flowers ES Cho ST Bartlett (1999) ArticleTitleLaparoscopic versus open donor nephrectomy. Transplantation 68 497–502 Occurrence Handle1:STN:280:DyaK1MvgvVarsQ%3D%3D Occurrence Handle10480406

    CAS  PubMed  Google Scholar 

  15. LE Ratner LJ Ciseck RG Moore FG Cigarroa HS Kaufman LR Kavoussi (1995) ArticleTitleLaparoscopic live donor nephrectomy. Transplantation 60 1047–1049 Occurrence Handle1:STN:280:BymD28jotVc%3D Occurrence Handle7491680

    CAS  PubMed  Google Scholar 

  16. LE Ratner LR Kavoussi M Sroka J Hiller R Weber PG Schulam R Montgomery (1997) ArticleTitleLaparoscopic assisted live donor nephrectomy—a comparison with the open approach. Transplantation 63 229–233 Occurrence Handle1:STN:280:ByiC2s3itlw%3D Occurrence Handle9020322

    CAS  PubMed  Google Scholar 

  17. HA Razvi D Fields JC Vargas ED Vaughan A Vukasin RE Sosa (1996) ArticleTitleOliguria during laparoscopic surgery: evidence for direct renal parenchymal compression as an etiologic factor. J Endourol 10 1–4 Occurrence Handle1:STN:280:BymH3s%2FlvFI%3D Occurrence Handle8833721

    CAS  PubMed  Google Scholar 

  18. AB Vardiman TA Kopitnik PD Purdy HH Batjer DS Samson (1995) ArticleTitleTreatment of traumatic arterial vasospasm with intraarterial papaverine infusion. Am J Neuroradiol 16 319–321 Occurrence Handle1:STN:280:ByqB2czhtlw%3D Occurrence Handle7726078

    CAS  PubMed  Google Scholar 

  19. JS Wolf Jr RM Merion AB Leichtman DA Campbell Jr JC Magee JD Punch JG Turcotte JW Konnak (2001) ArticleTitleRandomized controlled trial of hand-assisted laparoscopic versus open surgical live donor nephrectomy. Transplantation 72 284–290 Occurrence Handle1:STN:280:DC%2BD3MvktFWisQ%3D%3D Occurrence Handle11477354

    CAS  PubMed  Google Scholar 

  20. J Zacherl M Stangl H Feussner M Shibakita S Bock W Erhardt JR Siewert (2002) ArticleTitlePeriarterial papaverine application improves intraoperative kidney function during laparoscopic donor nephrectomy. J Surg Res 103 268–271 Occurrence Handle10.1006/jsre.2002.6363 Occurrence Handle1:CAS:528:DC%2BD38XitlGntL8%3D Occurrence Handle11922744

    Article  CAS  PubMed  Google Scholar 

  21. J Zacherl E Thein M Stangl H Feussner S Bock W Erhardt JR Siewert (2003) ArticleTitleInfluence of periarterial papaverine application on intraoperative renal blood flow and function during laparoscopic donor nephrectomy in pigs. Surg Endosc 17 . Occurrence Handle10.1007/s00464-002-8835-5

    Article  Google Scholar 

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Acknowledgements

We thank the nursing staff of the “Institut für Experimentelle Onkologie und Therapieforschung” for their cooperation and the MITI (Minimal Invasive Technology Institute) team for financial aid and logistic support.

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Authors and Affiliations

  1. Chirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaningerstraße 22, 81675 Munich, Germany

    J. Zacherl, H. Feussner, J. R. Siewert & M. Stangl

  2. Institut für Experimentelle Onkologie und Therapieforschung, Klinikum rechts der Isar, Technische Universität München, Ismaningerstraße 22, 81675 Munich, Germany

    S. Bock & W. Erhardt

  3. Universitätsklinik für Chirurgie, Klinische Abteilung f. Allgemeinchirurgie, Allgemeines Krankenhaus Wien, Universität Wien, Währinger Gürtel 18-20, 1090 Vienna, Austria

    J. Zacherl

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  1. J. Zacherl
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  2. S. Bock
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  3. H. Feussner
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  5. J. R. Siewert
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  6. M. Stangl
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Correspondence to J. Zacherl.

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Zacherl, J., Bock, S., Feussner, H. et al. Periarterial application of papaverine during laparoscopic donor nephrectomy improves early graft function after kidney transplantation in pigs. Surg Endosc 18, 417–420 (2004). https://doi.org/10.1007/s00464-003-8912-4

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  • DOI: https://doi.org/10.1007/s00464-003-8912-4

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