Angelo Territo1, Lluis Gausa1, Antonio Alcaraz2, Mireia Musquera2, Nicolas Doumerc3, Karel Decaestecker4, Liesbeth Desender5, Michael Stockle6, Martin Janssen6, Paolo Fornara7, Nasreldin Mohammed7, Giampaolo Siena8, Sergio Serni8, Selcuk Sahin9, Volkan Tuǧcu9, Giuseppe Basile1, Alberto Breda1. 1. Department of Urology, Fundaciò Puigvert, Autonoma University of Barcelona, Barcelona, Spain. 2. Department of Urology, Hospital Clinic, University of Barcelona, Barcelona, Spain. 3. Department of Urology and Renal Transplantation, University Hospital of Rangueil, Toulouse, France. 4. Department of Urology, Ghent University Hospital, Ghent, Belgium. 5. Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium. 6. Department of Urology, University Saarland, Homburg/Saar, Germany. 7. Department of Urology, University Hospital Halle (Saale), Halle, Germany. 8. Department of Urology, Careggi Hospital, University of Florence, Florence, Italy. 9. Bakirkoy Sadi Konuk Training and Research Hospital Centre, Istanbul, Turkey.
Abstract
OBJECTIVES: To evaluate functional results, graft survival and late complications in patients who underwent robot-assisted kidney transplantation (RAKT) and who had a minimum of 1 year of follow-up data, and to analyse the correlations between surgical data and functional results at a minimum of 1-year postoperatively and between renal function in the immediate postoperative period and after 1 year. MATERIALS AND METHODS: A common prospectively collected RAKT database was created by the European Robotic Urological Section (ERUS) RAKT working group, which included eight different European centres. In each centre RAKTs were performed with kidneys from living donors. Data on demographic variables, surgical results, graft survival, functional outcomes (creatinine and estimated glomerular filtration rate [eGFR]) on postoperative days 7 and 30 and at 1 year, and late complications were extracted from the common database. RESULTS: A total of 147 RAKTs were performed by the ERUS RAKT working group. Of the 147 patients, 83 had at least 1-year follow-up (mean [range] 21 [13-27] months). Of these 83 patients, 30 were women. The patients' median (range) age was 43 (30-75) years, body mass index was 25.3 (20-40) kg/m2 , pre-transplantation serum creatinine was 517 (198-1 414) μmol/L and estimated GFR (eGFR) was 10 (3-29) mL/min per 1.73 m2 . Of the 83 cases, 46 were pre-emptive. The median (range) overall ischaemia time was 116 (53-377) min. The median (range) rewarming time was 60 (35-110) min. At 1-year follow-up, the median (range) serum creatinine was 131 (66-244) μmol/L, with a median (range) eGFR of 57.4 (28-97) mL/min per 1.73 m2 . There was no statistically significant difference between functional data at postoperative day 30 and those at 1 year for creatinine (P = 0.78) or eGFR (P = 0.91). Regarding the correlation between the surgical data and the functional outcomes, the data showed that overall operating time and rewarming time did not affect the graft function at 1 year. Three cases of graft loss occurred as a result of massive arterial thrombosis within the first postoperative week. Late complications comprised one case of ureteric stenosis and one case of graft pyelonephritis. No late vascular complications or cases of incisional hernia were recorded. CONCLUSION: Findings at 1-year follow-up indicate RAKT from a living donor to be a safe procedure in a properly selected group of recipients. RAKT was associated with a low complication rate and there was maintenance of excellent graft survival and function. This is the first and largest study to report functional results after RAKT from a living donor with a minimum follow-up of 1 year.
OBJECTIVES: To evaluate functional results, graft survival and late complications in patients who underwent robot-assisted kidney transplantation (RAKT) and who had a minimum of 1 year of follow-up data, and to analyse the correlations between surgical data and functional results at a minimum of 1-year postoperatively and between renal function in the immediate postoperative period and after 1 year. MATERIALS AND METHODS: A common prospectively collected RAKT database was created by the European Robotic Urological Section (ERUS) RAKT working group, which included eight different European centres. In each centre RAKTs were performed with kidneys from living donors. Data on demographic variables, surgical results, graft survival, functional outcomes (creatinine and estimated glomerular filtration rate [eGFR]) on postoperative days 7 and 30 and at 1 year, and late complications were extracted from the common database. RESULTS: A total of 147 RAKTs were performed by the ERUS RAKT working group. Of the 147 patients, 83 had at least 1-year follow-up (mean [range] 21 [13-27] months). Of these 83 patients, 30 were women. The patients' median (range) age was 43 (30-75) years, body mass index was 25.3 (20-40) kg/m2 , pre-transplantation serum creatinine was 517 (198-1 414) μmol/L and estimated GFR (eGFR) was 10 (3-29) mL/min per 1.73 m2 . Of the 83 cases, 46 were pre-emptive. The median (range) overall ischaemia time was 116 (53-377) min. The median (range) rewarming time was 60 (35-110) min. At 1-year follow-up, the median (range) serum creatinine was 131 (66-244) μmol/L, with a median (range) eGFR of 57.4 (28-97) mL/min per 1.73 m2 . There was no statistically significant difference between functional data at postoperative day 30 and those at 1 year for creatinine (P = 0.78) or eGFR (P = 0.91). Regarding the correlation between the surgical data and the functional outcomes, the data showed that overall operating time and rewarming time did not affect the graft function at 1 year. Three cases of graft loss occurred as a result of massive arterial thrombosis within the first postoperative week. Late complications comprised one case of ureteric stenosis and one case of graft pyelonephritis. No late vascular complications or cases of incisional hernia were recorded. CONCLUSION: Findings at 1-year follow-up indicate RAKT from a living donor to be a safe procedure in a properly selected group of recipients. RAKT was associated with a low complication rate and there was maintenance of excellent graft survival and function. This is the first and largest study to report functional results after RAKT from a living donor with a minimum follow-up of 1 year.
Authors: Ulrich Pein; Matthias Girndt; Silke Markau; Annekathrin Fritz; Alberto Breda; Michael Stöckle; Nasreldin Mohammed; Felix Kawan; Andre Schumann; Paolo Fornara; Karl Weigand Journal: World J Urol Date: 2019-05-24 Impact factor: 4.226
Authors: 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 Journal: World J Urol Date: 2020-06-19 Impact factor: 4.226
Authors: J J Rassweiler; A S Goezen; M C Rassweiler-Seyfried; E Liatsikos; T Bach; J-U Stolzenburg; J Klein Journal: Urologe A Date: 2018-09 Impact factor: 0.639
Authors: Julien Grammens; Michal Yaela Schechter; Liesbeth Desender; Tom Claeys; Céline Sinatti; Johan VandeWalle; Frank Vermassen; Ann Raes; Caroline Vanpeteghem; Agnieszka Prytula; Mesrur Selçuk Silay; Alberto Breda; Karel Decaestecker; Anne-Françoise Spinoit Journal: Front Surg Date: 2021-03-25