Early Controversies Pneumoperitoneum

With good intraoperative hydration of the donor (5-6 L), initial concerns for renal dysfunction due to increased pressure from pneumoperitoneum have not been realized (69-71). In addition to aggressive hydration, the donors are given 25 g of intravenous mannitol, which provides an osmotic diuresis and has antioxidant properties. Clinically, all renal transplant centers attempt aggressive hydration of the donor prior to and during the nephrectomy, with some services even aiming for 4000 to 6000 mL of intravenous fluids prior to and during the procedure (25).

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