Effect of a Laparoscopic Donor Nephrectomy as an Intermediate Surgical Procedure on the Acute Phase Response in Healthy Living Kidney Donors Using Either Propofol or Sevoflurane Anaesthesia

Surgical trauma induces a complex inflammatory stress response, associated with postoperative morbidity. Patients’ physiological reserve, comorbidity, underlying disease and type of surgery will interrelate with the response. In addition, different anaesthetic agents are shown to have differential effects on this response. We explored the molecular effects of an intermediate surgical intervention together with the effect of either a propofol or sevoflurane based anaesthesia in a unique cohort of healthy living kidney donors (n=36, propofol 19, sevoflurane 17) undergoing laparoscopic donor nephrectomy by using proteomic profiling of blood plasma samples. Samples were taken before surgery, 2 and 24 hours after surgery. Quantitative analysis resulted in detection of 633 plasma proteins. A subset of 22 proteins showed significant (P<0.05) expression level changes between time points. Proteins with over two-fold change comprised a group of 8 upregulated targets known to be involved in the acute phase response (CRP, SAA1, SAA2, LBP), cellular proliferation (FGL1, A2GL) and anti-inflammation (AACT). These proteins were common in all living donors, except MAN1A1 and SAA2, which were upregulated only in propofol (MAN1A1) or sevoflurane (SAA2) treated individuals. To conclude, proteomic profiling identified upregulated proteins one day after laparoscopic donor nephrectomy involved in the acute phase response, immunogenicity and tissue remodeling.