Thomas Prudhomme1, Jean Baptiste Beauval2, Marine Lesourd3, Mathieu Roumiguié3, Karel Decaestecker4, Graziano Vignolini5, Riccardo Campi5, Sergio Serni5, Angelo Territo6, Luis Gausa6, Volkan Tugcu7, Selcuk Sahin7, Antonio Alcaraz8, Mireia Musquera8, Michael Stockle9, Martin Janssen9, Paolo Fornara10, Nasreldin Mohammed10, Arnaud Del Bello11, Nassim Kamar11, Federico Sallusto3, Alberto Breda6, Nicolas Doumerc3. 1. Department of Urology and Kidney Transplantation, University Hospital of Rangueil, Toulouse, France. prudhomme.t@chu-toulouse.fr. 2. Department of Urology, Clinique La Croix du Sud, Toulouse, France. 3. Department of Urology and Kidney Transplantation, University Hospital of Rangueil, Toulouse, France. 4. Department of Urology, Ghent University Hospital, Ghent, Belgium. 5. Department of Urology, Careggi Hospital, University of Florence, Florence, Italy. 6. Department of Urology, Fundaciò Puigvert, Autonoma University of Barcelona, Barcelona, Spain. 7. Department of Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey. 8. Department of Urology, Hospital Clinic, Barcelona, Spain. 9. Department of Urology, Saarland University, HomburgSaar, Germany. 10. Department of Urology, Halle University Hospital (Saale), Halle, Germany. 11. Department of Nephrology and Organ Transplantation, University Hospital of Rangueil, Toulouse, France.
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.
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.
Authors: Allan J Collins; Robert N Foley; Blanche Chavers; David Gilbertson; Charles Herzog; Kirsten Johansen; Bertram Kasiske; Nancy Kutner; Jiannong Liu; Wendy St Peter; Haifeng Guo; Sally Gustafson; Brooke Heubner; Kenneth Lamb; Shuling Li; Suying Li; Yi Peng; Yang Qiu; Tricia Roberts; Melissa Skeans; Jon Snyder; Craig Solid; Bryn Thompson; Changchun Wang; Eric Weinhandl; David Zaun; Cheryl Arko; Shu-Cheng Chen; Frank Daniels; James Ebben; Eric Frazier; Christopher Hanzlik; Roger Johnson; Daniel Sheets; Xinyue Wang; Beth Forrest; Edward Constantini; Susan Everson; Paul Eggers; Lawrence Agodoa Journal: Am J Kidney Dis Date: 2012-01 Impact factor: 8.860
Authors: P Giulianotti; V Gorodner; F Sbrana; I Tzvetanov; H Jeon; F Bianco; K Kinzer; J Oberholzer; E Benedetti Journal: Am J Transplant Date: 2010-05-10 Impact factor: 8.086
Authors: Alberto Breda; Angelo Territo; Luis Gausa; Volkan Tuğcu; Antonio Alcaraz; Mireia Musquera; Karel Decaestecker; Liesbeth Desender; Michael Stockle; Martin Janssen; Paolo Fornara; Nasreldin Mohammed; Giampaolo Siena; Sergio Serni; Luis Guirado; Carma Facundo; Nicolas Doumerc Journal: Eur Urol Date: 2017-09-12 Impact factor: 20.096
Authors: J L Gore; P T Pham; G M Danovitch; A H Wilkinson; J T Rosenthal; G S Lipshutz; J S Singer Journal: Am J Transplant Date: 2006-02 Impact factor: 8.086
Authors: Victor Zaydfudim; Irene D Feurer; Deonna R Moore; Derek E Moore; C Wright Pinson; David Shaffer Journal: J Am Coll Surg Date: 2010-02-01 Impact factor: 6.113
Authors: Y Foucher; M Lorent; L Albano; S Roux; V Pernin; M Le Quintrec; C Legendre; F Buron; E Morelon; S Girerd; M Ladrière; D Glotz; C Lefaucher; C Kerleau; J Dantal; J Branchereau; M Giral Journal: BMC Nephrol Date: 2021-03-05 Impact factor: 2.388