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<p>To evaluate the surgical outcomes, technical nuances, perioperative complication management, mid- to long-term follow-up outcomes in terms of graft function and patient survival of robot-assisted kidney transplantation (RAKT), including experiences with deceased donor and paediatric transplants. This single-centre study prospectively and retrospectively analyzed 92 patients undergoing RAKT between August 2021 and December 2024. The cohort includes adult and paediatric recipients, with both living and deceased donors. One among them is a paediatric cadaveric en-bloc dual kidney donor transplant. Patients with high anaesthetic risk, significant atherosclerotic iliac vessels, and a past history of multiple abdominal surgeries were excluded from the study. Data on ischaemia times, anastomosis durations, operative time, haemoglobin drop, serum creatinine, estimated GFR, delayed graft function, and complications were collected. Median follow-up duration was 21&#xa0;months. The mean warm ischaemia time was 3.6 ± 1.8&#xa0;min, cold ischaemia time 48.4 ± 12.4&#xa0;min, and total operative time 258.6 ± 46.4&#xa0;min. Prompt diuresis occurred in 88 patients; three had delayed graft function (one live donor and two deceased donors), and one graft loss was noted. Perioperative complications included graft bleeding, paralytic ileus, lymphoceles, and graft vascular kinking, with all managed successfully. Paediatric and deceased donor RAKTs demonstrated favourable outcomes. Serum creatinine at 1&#xa0;year averaged 1.2 ± 0.8&#xa0;mg/dL for adult live donor transplants; graft survival at 2&#xa0;years was 98.9%. RAKT is a safe and effective alternative to open kidney transplantation when performed by experienced surgeons. The study extends RAKT indications to deceased donor, paediatric, and complex cases, emphasizing management of uncommon complications, learning curve considerations, and cost analysis. RAKT represents a promising minimally invasive kidney transplant option.</p>

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Robotic assisted kidney transplantation and its nuances: experience of a high-volume tertiary care centre

  • 期刊论文

  • 发表日期：

    2025年10月13日

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  • Supreeth Nagaraju,
  • Mohan Keshavamurthy,
  • Suraj Jayadeva Reddy,
  • Karthik Rao,
  • Karibasavaraja Neelagar

摘要

To evaluate the surgical outcomes, technical nuances, perioperative complication management, mid- to long-term follow-up outcomes in terms of graft function and patient survival of robot-assisted kidney transplantation (RAKT), including experiences with deceased donor and paediatric transplants. This single-centre study prospectively and retrospectively analyzed 92 patients undergoing RAKT between August 2021 and December 2024. The cohort includes adult and paediatric recipients, with both living and deceased donors. One among them is a paediatric cadaveric en-bloc dual kidney donor transplant. Patients with high anaesthetic risk, significant atherosclerotic iliac vessels, and a past history of multiple abdominal surgeries were excluded from the study. Data on ischaemia times, anastomosis durations, operative time, haemoglobin drop, serum creatinine, estimated GFR, delayed graft function, and complications were collected. Median follow-up duration was 21 months. The mean warm ischaemia time was 3.6 ± 1.8 min, cold ischaemia time 48.4 ± 12.4 min, and total operative time 258.6 ± 46.4 min. Prompt diuresis occurred in 88 patients; three had delayed graft function (one live donor and two deceased donors), and one graft loss was noted. Perioperative complications included graft bleeding, paralytic ileus, lymphoceles, and graft vascular kinking, with all managed successfully. Paediatric and deceased donor RAKTs demonstrated favourable outcomes. Serum creatinine at 1 year averaged 1.2 ± 0.8 mg/dL for adult live donor transplants; graft survival at 2 years was 98.9%. RAKT is a safe and effective alternative to open kidney transplantation when performed by experienced surgeons. The study extends RAKT indications to deceased donor, paediatric, and complex cases, emphasizing management of uncommon complications, learning curve considerations, and cost analysis. RAKT represents a promising minimally invasive kidney transplant option.