Alpha Omega Alpha Honor Medical Society

2011 Research Abstract

Do Antiandrogens Protect Against Pneumoperitoneum-Induced Renal Ischemia during Laparoscopic Surgery?

Investigator: Ingrid Wahjudi, Loma Linda University School of Medicine
Mentor: D. Duane Baldwin, Department of Urology, Loma Linda University School of Medicine

Introduction: Patients undergoing laparoscopic donor nephrectomy (LDN) are at risk for ischemia due to artificial pneumoperitoneum. Both testosterone (T) and dihydrotestosterone (DHT) have been shown to down-regulate the expression of heat-shock proteins (HSPs), which have a protective effect against ischemic damage.

Purpose: to assess if the absence of testosterone prior to laparoscopic surgery prevents ischemic damage during a laparoscopic donor nephrectomy (LDN).

Materials and Methods: The study was a prospective randomized controlled trial where 8 rats were divided into 2 groups. The treatment group (n=4) underwent a bilateral orchiectomy 1 week before undergoing laparoscopic nephrectomy to lower plasma levels of T to castrate levels. The control group (n=4) received a sham orchiectomy 1 week before undergoing laparoscopic nephrectomy. Venous blood samples were drawn and analyzed for creatinine, a hypoxia-induced marker. Blood analysis results were compared between the two groups to determine if there was a correlation between post-operative kidney function (creatinine), T levels, and the patient’s post-operative clinical course.

Results: Analysis of testosterone and creatinine levels in the experimental and control groups did not show that lower testosterone levels achieved by bilateral orchiectomies resulted in lower creatinine levels.

Conclusions: Reduced testosterone levels did not lower creatinine levels, a marker of renal ischemia caused by peritoneal insufflation. This study will be conducted again with a larger sample size and more sensitive markers because we believe the implications of this study have the potential to shed more light on the role of decreased levels of androgens in minimizing ischemia-related injuries from LDN. Based on these findings, we hope to gain an understanding of the basic science behind ischemia-related injury in the kidney as well as translate these findings into conventional clinical practice for patients undergoing LDN.

Updated on March 1, 2012.

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