Robot-assisted vs open kidney transplantation from deceased donors

Objectives To test the hypothesis that the type of surgical approach, robot-assisted kidney transplantation (RAKT) vs open kidney transplantation (OKT), impacts intra-operative and postoperative surgical outcomes of patients receiving kidney transplantation from deceased donors. Materials and Method...

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Autores: Afferi, L, Territo, A, Pecoraro, A, Masieri, L, Ortved, M, Dagnaes-Hansen, JA, Etcheverry, B, Gallioli, A, Cannoletta, D, Vangeneugden, J, Mercier, J, Prudhomme, T, Donnini, I, Vazzana, A, Rohrsted, M, Vigues, F, Doumerc, N, Decaestecker, K, Palou, J, Campi, R, Serni, S, Roder, A, Breda, A
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p19677
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19677
Access Level:acceso abierto
Palabra clave:open kidney transplantation
robot-assisted kidney transplantation
deceased donors
kidney transplantation
renal transplantation
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spelling Robot-assisted vs open kidney transplantation from deceased donorsAfferi, LTerrito, APecoraro, AMasieri, LOrtved, MDagnaes-Hansen, JAEtcheverry, BGallioli, ACannoletta, DVangeneugden, JMercier, JPrudhomme, TDonnini, IVazzana, ARohrsted, MVigues, FDoumerc, NDecaestecker, KPalou, JCampi, RSerni, SRoder, ABreda, Aopen kidney transplantationrobot-assisted kidney transplantationdeceased donorskidney transplantationrenal transplantationObjectives To test the hypothesis that the type of surgical approach, robot-assisted kidney transplantation (RAKT) vs open kidney transplantation (OKT), impacts intra-operative and postoperative surgical outcomes of patients receiving kidney transplantation from deceased donors. Materials and Methods This was a multicentre retrospective cohort study including 676 patients who received RAKT or OKT in the period 2015 to 2023 in one of seven European academic centres. Patient heterogeneity at baseline was balanced using 2:1 nearest neighbour propensity-score matching. Intra- and postoperative complications were reported according to the Clavien-Dindo classification system. Kaplan-Meier estimates and the log-rank test were used to compare dialysis-free survival (DFS), graft survival (GS), reintervention-free survival (RFS) and overall survival (OS) according to the surgical approach used. Results After propensity-score matching, two cohorts of 72 recipients (65%) in the OKT group and 37 (35%) in the RAKT group with similar baseline characteristics were obtained. The site of transplantation was the right iliac fossa in 59 (82%) and 28 patients (76%) undergoing OKT and RAKT, respectively. RAKT was associated with shorter rewarming time (53 vs 39 min), total vascular anastomosis time (55 vs 36 min), and arterial (25 vs 17 min) and venous (28 vs 18 min) anastomosis times (all P < 0.001), whereas OKT was associated with reduced surgical time (180 vs 200 min; P = 0.01). Intra-operative complications were more commonly reported in recipients undergoing OKT (8.3% vs 2.7%; P = 0.4). During follow-up, no differences in terms of postoperative complications, DFS, GS, RFS or OS were detected. Conclusions This is the largest comparative study of RAKT vs OKT in the deceased donor setting. While it confirms the safety of RAKT from deceased donors, it underscores the superiority of RAKT in selected patients in terms of achieving vascular anastomosis and rewarming time in a shorter timeframe.WILEY2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19677BJU INTERNATIONALISSN: 14644096ISSNe: 1464410Xreponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p196772026-06-14T12:41:47Z
dc.title.none.fl_str_mv Robot-assisted vs open kidney transplantation from deceased donors
title Robot-assisted vs open kidney transplantation from deceased donors
spellingShingle Robot-assisted vs open kidney transplantation from deceased donors
Afferi, L
open kidney transplantation
robot-assisted kidney transplantation
deceased donors
kidney transplantation
renal transplantation
title_short Robot-assisted vs open kidney transplantation from deceased donors
title_full Robot-assisted vs open kidney transplantation from deceased donors
title_fullStr Robot-assisted vs open kidney transplantation from deceased donors
title_full_unstemmed Robot-assisted vs open kidney transplantation from deceased donors
title_sort Robot-assisted vs open kidney transplantation from deceased donors
dc.creator.none.fl_str_mv Afferi, L
Territo, A
Pecoraro, A
Masieri, L
Ortved, M
Dagnaes-Hansen, JA
Etcheverry, B
Gallioli, A
Cannoletta, D
Vangeneugden, J
Mercier, J
Prudhomme, T
Donnini, I
Vazzana, A
Rohrsted, M
Vigues, F
Doumerc, N
Decaestecker, K
Palou, J
Campi, R
Serni, S
Roder, A
Breda, A
author Afferi, L
author_facet Afferi, L
Territo, A
Pecoraro, A
Masieri, L
Ortved, M
Dagnaes-Hansen, JA
Etcheverry, B
Gallioli, A
Cannoletta, D
Vangeneugden, J
Mercier, J
Prudhomme, T
Donnini, I
Vazzana, A
Rohrsted, M
Vigues, F
Doumerc, N
Decaestecker, K
Palou, J
Campi, R
Serni, S
Roder, A
Breda, A
author_role author
author2 Territo, A
Pecoraro, A
Masieri, L
Ortved, M
Dagnaes-Hansen, JA
Etcheverry, B
Gallioli, A
Cannoletta, D
Vangeneugden, J
Mercier, J
Prudhomme, T
Donnini, I
Vazzana, A
Rohrsted, M
Vigues, F
Doumerc, N
Decaestecker, K
Palou, J
Campi, R
Serni, S
Roder, A
Breda, A
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv open kidney transplantation
robot-assisted kidney transplantation
deceased donors
kidney transplantation
renal transplantation
topic open kidney transplantation
robot-assisted kidney transplantation
deceased donors
kidney transplantation
renal transplantation
description Objectives To test the hypothesis that the type of surgical approach, robot-assisted kidney transplantation (RAKT) vs open kidney transplantation (OKT), impacts intra-operative and postoperative surgical outcomes of patients receiving kidney transplantation from deceased donors. Materials and Methods This was a multicentre retrospective cohort study including 676 patients who received RAKT or OKT in the period 2015 to 2023 in one of seven European academic centres. Patient heterogeneity at baseline was balanced using 2:1 nearest neighbour propensity-score matching. Intra- and postoperative complications were reported according to the Clavien-Dindo classification system. Kaplan-Meier estimates and the log-rank test were used to compare dialysis-free survival (DFS), graft survival (GS), reintervention-free survival (RFS) and overall survival (OS) according to the surgical approach used. Results After propensity-score matching, two cohorts of 72 recipients (65%) in the OKT group and 37 (35%) in the RAKT group with similar baseline characteristics were obtained. The site of transplantation was the right iliac fossa in 59 (82%) and 28 patients (76%) undergoing OKT and RAKT, respectively. RAKT was associated with shorter rewarming time (53 vs 39 min), total vascular anastomosis time (55 vs 36 min), and arterial (25 vs 17 min) and venous (28 vs 18 min) anastomosis times (all P < 0.001), whereas OKT was associated with reduced surgical time (180 vs 200 min; P = 0.01). Intra-operative complications were more commonly reported in recipients undergoing OKT (8.3% vs 2.7%; P = 0.4). During follow-up, no differences in terms of postoperative complications, DFS, GS, RFS or OS were detected. Conclusions This is the largest comparative study of RAKT vs OKT in the deceased donor setting. While it confirms the safety of RAKT from deceased donors, it underscores the superiority of RAKT in selected patients in terms of achieving vascular anastomosis and rewarming time in a shorter timeframe.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19677
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19677
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv WILEY
publisher.none.fl_str_mv WILEY
dc.source.none.fl_str_mv BJU INTERNATIONAL
ISSN: 14644096
ISSNe: 1464410X
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
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