Robotic Versus Open Kidney Transplantation from Deceased Donors

Background: While robot-assisted kidney transplantation (RAKT) from living donors has been shown to achieve favourable outcomes, there is a lack of evidence on the safety and efficacy of RAKT as compared with the gold standard open kidney transplantation (OKT) in the setting of deceased donors, who...

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Autores: Campi, Riccardo|||0000-0001-5237-0888, Pecoraro, Alessio|||0000-0002-0667-1468, Li Marzi, Vincenzo|||0000-0002-6328-7980, Tuccio, Agostino, Giancane, Saverio, Peris, Adriano, Cirami, Calogero Lino, Breda, Alberto|||0000-0002-7842-9048, Vignolini, Graziano, Serni, Sergio
Tipo de documento: artigo
Data de publicação:2022
País:España
Recursos:Universitat Autònoma de Barcelona
Repositório:Dipòsit Digital de Documents de la UAB
Idioma:inglês
OAI Identifier:oai:ddd.uab.cat:277662
Acesso em linha:https://ddd.uab.cat/record/277662
https://dx.doi.org/urn:doi:10.1016/j.euros.2022.03.007
Access Level:Acceso aberto
Palavra-chave:Complications
Deceased donor
Kidney
Renal function
Robotic
Transplant
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network_name_str España
repository_id_str
dc.title.none.fl_str_mv Robotic Versus Open Kidney Transplantation from Deceased Donors
A Prospective Observational Study
title Robotic Versus Open Kidney Transplantation from Deceased Donors
spellingShingle Robotic Versus Open Kidney Transplantation from Deceased Donors
Campi, Riccardo|||0000-0001-5237-0888
Complications
Deceased donor
Kidney
Renal function
Robotic
Transplant
title_short Robotic Versus Open Kidney Transplantation from Deceased Donors
title_full Robotic Versus Open Kidney Transplantation from Deceased Donors
title_fullStr Robotic Versus Open Kidney Transplantation from Deceased Donors
title_full_unstemmed Robotic Versus Open Kidney Transplantation from Deceased Donors
title_sort Robotic Versus Open Kidney Transplantation from Deceased Donors
dc.creator.none.fl_str_mv Campi, Riccardo|||0000-0001-5237-0888
Pecoraro, Alessio|||0000-0002-0667-1468
Li Marzi, Vincenzo|||0000-0002-6328-7980
Tuccio, Agostino
Giancane, Saverio
Peris, Adriano
Cirami, Calogero Lino
Breda, Alberto|||0000-0002-7842-9048
Vignolini, Graziano
Serni, Sergio
author Campi, Riccardo|||0000-0001-5237-0888
author_facet Campi, Riccardo|||0000-0001-5237-0888
Pecoraro, Alessio|||0000-0002-0667-1468
Li Marzi, Vincenzo|||0000-0002-6328-7980
Tuccio, Agostino
Giancane, Saverio
Peris, Adriano
Cirami, Calogero Lino
Breda, Alberto|||0000-0002-7842-9048
Vignolini, Graziano
Serni, Sergio
author_role author
author2 Pecoraro, Alessio|||0000-0002-0667-1468
Li Marzi, Vincenzo|||0000-0002-6328-7980
Tuccio, Agostino
Giancane, Saverio
Peris, Adriano
Cirami, Calogero Lino
Breda, Alberto|||0000-0002-7842-9048
Vignolini, Graziano
Serni, Sergio
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Complications
Deceased donor
Kidney
Renal function
Robotic
Transplant
topic Complications
Deceased donor
Kidney
Renal function
Robotic
Transplant
description Background: While robot-assisted kidney transplantation (RAKT) from living donors has been shown to achieve favourable outcomes, there is a lack of evidence on the safety and efficacy of RAKT as compared with the gold standard open kidney transplantation (OKT) in the setting of deceased donors, who represent the source of most grafts worldwide. Objective: To compare the intraoperative, perioperative, and midterm outcomes of RAKT versus OKT from donors after brain death (DBDs). Design, setting, and participants: Data from consecutive patients undergoing RAKT or OKT from DBDs at a single academic centre between October 2017 and December 2020 were prospectively collected. Intervention: RAKT or OKT. Outcome measurements and statistical analysis: The primary outcomes were intraoperative adverse events, postoperative surgical complications, delayed graft function (DGF), and midterm functional outcomes. A multivariable logistic regression analysis assessed the independent predictors of DGF, trifecta, and suboptimal graft function (estimated glomerular filtration rate [eGFR] <45 ml/min/1.73 m) at the last follow-up. Results and limitations: Overall, 138 patients were included (117 [84.7%] OKTs and 21 [15.3%] RAKTs). The yearly proportion of RAKT ranged between 10% and 18% during the study period. The OKT and RAKT cohorts were comparable regarding all graft-related characteristics, while they differed regarding a few donor- and recipient-related factors. The median second warm ischaemic time, ureterovesical anastomosis time, postoperative complication rate, and eGFR trajectories did not differ significantly between the groups. A higher proportion of patients undergoing OKT experienced DGF; yet, at a median follow-up of 31 mo (interquartile range 19-44), there was no difference between the groups regarding the dialysis-free and overall survival. At the multivariable analysis, donor- and/or recipient-related factors, but not the surgical approach, were independent predictors of DGF, trifecta, and suboptimal graft function at the last follow-up. The study is limited by its nonrandomised nature and the small sample size. Conclusions: Our study provides preliminary evidence supporting the noninferiority of RAKT from DBDs as compared with the gold standard OKT in carefully selected recipients. Patient summary: Kidney transplantation using kidneys from deceased donors is still being performed with an open surgical approach in most transplant centres worldwide. In fact, no study has compared the outcomes of open and minimally invasive (robotic) kidney transplantation from deceased donors. In this study, we evaluated whether robotic kidney transplantation using grafts from deceased donors was not inferior to open kidney transplantation regarding the intraoperative, postoperative, and midterm functional outcomes. We found that, in experienced hands and provided that there was a time-efficient organisation of the transplantation pathway, robotic kidney transplantation from deceased donors was feasible and achieved noninferior outcomes as compared with open kidney transplantation.
publishDate 2022
dc.date.none.fl_str_mv 2
2022-01-01
2022
2022-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/277662
https://dx.doi.org/urn:doi:10.1016/j.euros.2022.03.007
url https://ddd.uab.cat/record/277662
https://dx.doi.org/urn:doi:10.1016/j.euros.2022.03.007
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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spelling Robotic Versus Open Kidney Transplantation from Deceased DonorsA Prospective Observational StudyCampi, Riccardo|||0000-0001-5237-0888Pecoraro, Alessio|||0000-0002-0667-1468Li Marzi, Vincenzo|||0000-0002-6328-7980Tuccio, AgostinoGiancane, SaverioPeris, AdrianoCirami, Calogero LinoBreda, Alberto|||0000-0002-7842-9048Vignolini, GrazianoSerni, SergioComplicationsDeceased donorKidneyRenal functionRoboticTransplantBackground: While robot-assisted kidney transplantation (RAKT) from living donors has been shown to achieve favourable outcomes, there is a lack of evidence on the safety and efficacy of RAKT as compared with the gold standard open kidney transplantation (OKT) in the setting of deceased donors, who represent the source of most grafts worldwide. Objective: To compare the intraoperative, perioperative, and midterm outcomes of RAKT versus OKT from donors after brain death (DBDs). Design, setting, and participants: Data from consecutive patients undergoing RAKT or OKT from DBDs at a single academic centre between October 2017 and December 2020 were prospectively collected. Intervention: RAKT or OKT. Outcome measurements and statistical analysis: The primary outcomes were intraoperative adverse events, postoperative surgical complications, delayed graft function (DGF), and midterm functional outcomes. A multivariable logistic regression analysis assessed the independent predictors of DGF, trifecta, and suboptimal graft function (estimated glomerular filtration rate [eGFR] <45 ml/min/1.73 m) at the last follow-up. Results and limitations: Overall, 138 patients were included (117 [84.7%] OKTs and 21 [15.3%] RAKTs). The yearly proportion of RAKT ranged between 10% and 18% during the study period. The OKT and RAKT cohorts were comparable regarding all graft-related characteristics, while they differed regarding a few donor- and recipient-related factors. The median second warm ischaemic time, ureterovesical anastomosis time, postoperative complication rate, and eGFR trajectories did not differ significantly between the groups. A higher proportion of patients undergoing OKT experienced DGF; yet, at a median follow-up of 31 mo (interquartile range 19-44), there was no difference between the groups regarding the dialysis-free and overall survival. At the multivariable analysis, donor- and/or recipient-related factors, but not the surgical approach, were independent predictors of DGF, trifecta, and suboptimal graft function at the last follow-up. The study is limited by its nonrandomised nature and the small sample size. Conclusions: Our study provides preliminary evidence supporting the noninferiority of RAKT from DBDs as compared with the gold standard OKT in carefully selected recipients. Patient summary: Kidney transplantation using kidneys from deceased donors is still being performed with an open surgical approach in most transplant centres worldwide. In fact, no study has compared the outcomes of open and minimally invasive (robotic) kidney transplantation from deceased donors. In this study, we evaluated whether robotic kidney transplantation using grafts from deceased donors was not inferior to open kidney transplantation regarding the intraoperative, postoperative, and midterm functional outcomes. We found that, in experienced hands and provided that there was a time-efficient organisation of the transplantation pathway, robotic kidney transplantation from deceased donors was feasible and achieved noninferior outcomes as compared with open kidney transplantation.Universitat Autònoma de Barcelona 22022-01-0120222022-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/277662https://dx.doi.org/urn:doi:10.1016/j.euros.2022.03.007reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2776622026-06-06T12:50:31Z
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