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TAIPEI, TAIWAN (UroToday.com) - Introduction and Objectives: Minimally invasive approaches to kidney transplantation (KT) have recently been described. We recently developed and described a novel technique of robotic KT (RKT) using intra corporeal graft cooling. We assessed the comparative effectiveness of RKT and open KT (OKT) by evaluating peri and post-operative outcomes.

wceMethods: From Jan-Dec 2013, a total of 247 patients with end stage renal disease underwent KT at a tertiary referral center of which 225 patients who met the selection criteria were enrolled into this prospective two-arm non-randomized controlled trial (IDEAL Phase-2b). Primary outcome was post transplant graft function. Secondary outcomes measured included surgical and immunologic complications, and peri-operative parameters. All patients had a minimum follow up of 6 months.

Results: Fifty and 175 patients underwent RKT and OKT, respectively. The basic characteristics of the two groups were comparable. Mean serum creatinine at discharge was 1.3 and 1.2mg/dl in RKT and OKT patients respectively (p= 0.71). Post-operative pain and analgesic requirements were significantly less in patients undergoing RKT (p = 0.01).One patient of RKT and 4(2.2%) of OKT needed post transplant dialysis. No lymphocele was detected in protocol non contrast CT done at 3 months in the RKT group (0% vs. 23.8%; p = 0.05). One graft was lost in the OKT group. One patient death in RKT (1.5 months post transplant, cardiac failure) and 2 in OKT group were noted respectively.

Conclusions: RKT with regional hypothermia is safe and easily reproducible. Early outcomes are equivalent to OKT; with trends towards lower complications, quicker graft function recovery and shorter patient convalescence.

Source of Funding: None

 
Listen to an interview with Prasun Ghosh, one of the authors of this study.

 

Presented by Prasun Ghosh,1 Akshay Sood,2 Vijay Kher,1 Wooju Jeong,2 Ronney Abaza,3 Mahendra Bhandari,2 Mani Menon,2 and Rajesh Ahlawat1 at the 32nd World Congress of Endourology & SWL - September 3 - 7, 2014 - Taipei, Taiwan

1Medanta-The Medicity, India
2Henry Ford Hospital, Detroit, MI USA
3Ohio Health Dublin Methodist Hospital, USA

 

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