Anaesthesia and Peri-Operative Care for Laparoscopic Donor Nephrectomy
08 / 2004 - 05 / 2008
Recently, laparoscopic procedures occur much more frequently, mainly because of the reduced procedure-related morbidity. Advances in laparoscopic techniques have made procedures such as laparoscopic donor nephrectomy (LDN) possible. Increased intra-abdominal pressure during pneumoperitoneum (PP), however, is associated with increased mean arterial blood pressure and systemic vascular resistance, together with decreased stroke volume. In addition, impaired renal blood flow (RBF) and glomerular filtration rate, with oliguria and anuria, has been reported. One of the main concerns during LDN is preservation of renal function. Assessment of RBF during operation is not easily obtained; the anesthesiologist depends in normal practice on urine output and hemodynamic parameters. Ingrid Mertens zur Borg investigates the hemodynamic differences induced by CO2 - PP, what causes it, and its consequences for kidney function. Hopefully, her data will guide the anesthesiologist towards best management.