EAU 2019: Prospective Propensity Matched Non-Randomized Comparison Between Open and Robot-Assisted Kidney Transplantation

Barcelona, Spain (UroToday.com) End-stage renal disease (ESRD) usually occurs when kidney function is less than 10 percent of normal and kidney transplant is often the preferred treatment compared to being on dialysis forever. Open Kidney transplant (OKT) has been the method used but with the invention of the robotic technique, Robot-Assisted Kidney Transplantation (RAKT) has been on the rise. This study compares the initial 60 RAKT to 60 OKT performed at the Max Healthcare center over a period of 28 months between 2016 and 2018.

Charts of 60 patients who underwent RAKT were prospectively collected and compared to 60 matched patients who underwent OKT (out of total 293 during that period of time). All kidneys were harvested in the same fashion (laparoscopically) and grafted in the recipients’ abdominal cavities following a midline umbilical approach or Pfannenstiel approach.

Certain differences existed between the two cohorts. Patients of the RAKT group had higher body mass index, required less perioperative analgesia, had significantly longer rewarm ischemia time. No functional outcomes differences in terms of serum creatinine were found between both groups at 7 and 90 days postoperatively.

RAKT looks like a promising technique as this study showed advantages over OKT by decreasing wound morbidity yet achieving similar functional outcomes on the short run. Although encouraging, long term follow-up of a larger number of patients is still needed to confirm such findings.

Comparison Between Open and Robot-Assisted Kidney Transplantation

Presented by: Anant Kumar, Max Healthcare, Dept. of Urology, Uro-Oncology, Robotics, and Renal Transplantation, New Delhi, India

Written by: Farouk M. El-Khatib, MD, Clinical Research Fellow., UC Irvine Health, Department of Urology, at the 34th European Association of Urology (EAU 2019) #EAU19 conference in Barcelona, Spain, March 15-19, 2019.