Laparoskopische Lebendspender-Nephrektomie und Autotransplantation nach perivaskulär injiziertem Papaverin - Experimentelle Studie am Schwein

LAPAROSCOPIC LIVE DONOR NEPHRECTOMY AND AUTOTRANSPLANTATION AFTER PERIVASCULAR PAPAVERINE APPLICATION - EXPERIMENTAL STUDY IN PIGS The aim of this study is to evaluate whether renal function and blood perfusion can be enhanced by periarterial application of papaverine during laparoscopic donor nephrectomy in pigs. The study is subdivided in two parts. In part one, intraoperative urine output and creatinine-clearance are measured to investigate the influence of perivascular papaverine on renal function during the laparoscopic procedure. In part two of the study, blood perfusion of both kidneys during laparoscopic left donor nephrectomy is determined using fluorescent-labeled microspheres to analyse the vasodilatative effect of papaverine. In a subgroup of animals the donor nephrectomy is followed by autotransplantation and initial renal function is measured for a period of 24 hours after papaverine administration and laparoscopic nephrectomy. Histopathological examination of random samples is performed to evaluate structural damage following nephrectomy and autotransplantation. This study is carried out to refer to the actual clinical situation. After perivascular administration of papaverine an increase of renal function during laparoscopic nephrectomy can be achieved. Compared to controls urine output and creatinine-clearance is significantly improved after local papaverine application. In part two of the study measurement of renal blood flow shows enhanced renal perfusion after application of the vasodilatator in the treatment group. After autotransplantation the papaverine group exhibits an improved initial renal function. Enhanced creatinine-clearance has to be varified by further experiments. Histopathological signs of tissue damages of various extend can be found in all samples. The results presented are interpreted as follows: local periarterial application of papaverine increases renal blood flow during laparoscopic donor nephrectomy. Therefore renal function seems to be augmented. In controls decreased organ perfusion seems to lead to impaired renal function. In consequence the presented study demonstrates a significant better graft function in the treatment group. This method might have the potential to significantly improve graft quality after laparoscopic live donor nephrectomy in human patients.

Level thesis:degree_level

thesis.doctoral

Grantor dc:publisher

Ludwig-Maximilians-Universität

Year

2003

Author dc:creator

• Bock, Stefanie Christina

Repository record source_url

https://edoc.ub.uni-muenchen.de/1469/

OAI identifier oai:identifier

oai:edoc.ub.uni-muenchen.de:1469