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Correspondence and Brief Communications
December 1, 2007

Reduced Renal and Hepatic Perfusion Caused by Pos-itive-Pressure Pneumoperitoneum: Impact on Donor Kidneys

Arch Surg. 2007;142(12):1225. doi:10.1001/archsurg.142.12.1225-a

We read this article1 with interest; it describes an important problem. We have a few thoughts about this study: the controls were baseline studies from patients undergoing laparoscopy. Whether these baseline readings were recorded prior to or after the onset of positive-pressure pneumoperitoneum (PPP) is important, but it was not mentioned. We think that baseline studies from open surgery could have provided the extent of sympathetic activity, humoral factors, etc, in altering hepatic and renal microcirculation.

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