Erschienen in:
19.06.2020 | Original Article
Robotic-assisted kidney transplantation in obese recipients compared to non-obese recipients: the European experience
verfasst von:
Thomas Prudhomme, Jean Baptiste Beauval, Marine Lesourd, Mathieu Roumiguié, Karel Decaestecker, Graziano Vignolini, Riccardo Campi, Sergio Serni, Angelo Territo, Luis Gausa, Volkan Tugcu, Selcuk Sahin, Antonio Alcaraz, Mireia Musquera, Michael Stockle, Martin Janssen, Paolo Fornara, Nasreldin Mohammed, Arnaud Del Bello, Nassim Kamar, Federico Sallusto, Alberto Breda, Nicolas Doumerc
Erschienen in:
World Journal of Urology
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Ausgabe 4/2021
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Abstract
Purpose
The main objective was to compare minor (Clavien I–II) and major (Clavien ≥ III) intra- and postoperative complications of living donor robotic assisted kidney transplantation (RAKT) in obese (≥ 30 kg/m2 BMI), overweight (< 30/ ≥ 25 kg/m2 BMI) and non-overweight recipients (< 25 kg/m2 BMI).
Methods
For the present retrospective study, we reviewed the multi-institutional ERUS-RAKT database to select consecutive living donor RAKT recipients. Functional outcomes, intra- and postoperative complications were compared between obese, overweight and non-overweight recipients.
Results
169 living donor RAKTs were performed, by 10 surgeons, from July 2015 to September 2018 in the 8 European centers. 32 (18.9%) recipients were obese, 66 (39.1%) were overweight and 71 (42.0%) were non-overweight. Mean follow-up was 1.2 years. There were no major intra-operative complications in either study group. Conversion to open surgery occurred in 1 obese recipient, in 2 overweight recipients and no conversion occurred in non-overweight recipients (p = 0.3). Minor and major postoperative complications rates were similar in the 3 groups. At one-year of follow-up, median eGFR was similar in all groups [54 (45–60) versus 57 (46–70) versus 63 (49–78) ml/min/1.73 m2 in obese, overweight and non-overweight recipient groups, respectively, p = 0.5]. Delayed graft function rate was similar in the 3 groups. Only the number of arteries was an independent predictive factor of suboptimal renal function at post-operative day 30 in the multivariate analysis.
Conclusion
RAKT in obese recipients is safe, compared to non-overweight recipients and yields very good function, when it performed at high-volume referral centers by highly trained transplant teams.