Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2021 Apr;39(4):1287-1298.
doi: 10.1007/s00345-020-03309-6. Epub 2020 Jun 19.

Robotic-assisted kidney transplantation in obese recipients compared to non-obese recipients: the European experience

Thomas Prudhomme  1 , Jean Baptiste Beauval  2 , Marine Lesourd  3 , Mathieu Roumiguié  3 , Karel Decaestecker  4 , Graziano Vignolini  5 , Riccardo Campi  5 , Sergio Serni  5 , Angelo Territo  6 , Luis Gausa  6 , Volkan Tugcu  7 , Selcuk Sahin  7 , Antonio Alcaraz  8 , Mireia Musquera  8 , Michael Stockle  9 , Martin Janssen  9 , Paolo Fornara  10 , Nasreldin Mohammed  10 , Arnaud Del Bello  11 , Nassim Kamar  11 , Federico Sallusto  3 , Alberto Breda  6 , Nicolas Doumerc  3
Affiliations
Comparative Study

Robotic-assisted kidney transplantation in obese recipients compared to non-obese recipients: the European experience

Thomas Prudhomme et al. World J Urol. 2021 Apr.

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.

Keywords: Kidney transplantation; Obese patients; Robot-assisted kidney transplantation; Robotic surgery; Vascular anastomosis.

PubMed Disclaimer

References

    1. Jensen MD, Ryan DH, Apovian CM et al (2014) American College of Cardiology/American Heart Association Task Force on Practice Guidelines; Obesity Society. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol 63(25 Pt B):2985–3023. https://doi.org/10.1016/j.jacc.2013.11.004
    1. Collins AJ, Foley RN, Chavers B, Gilbertson D, Herzog C, Johansen K, Kasiske B, Kutner N, Liu J, St Peter W, Guo H, Gustafson S, Heubner B, Lamb K, Li S, Li S, Peng Y, Qiu Y, Roberts T, Skeans M, Snyder J, Solid C, Thompson B, Wang C, Weinhandl E, Zaun D, Arko C, Chen SC, Daniels F, Ebben J, Frazier E, Hanzlik C, Johnson R, Sheets D, Wang X, Forrest B, Constantini E, Everson S, Eggers P, Agodoa L (2012) United States Renal Data System 2011 annual data report: atlas of chronic kidney disease & end-stage renal disease in the United States. Am J Kidney Dis 59(1 Suppl 1):A7, e1-420. https://doi.org/10.1053/j.ajkd.2011.11.015 - DOI - PubMed
    1. Gill JS, Hendren E, Dong J, Johnston O, Gill J (2014) Differential association of body mass index with access to kidney transplantation in men and women. Clin J Am Soc Nephrol 9(5):951–959. https://doi.org/10.2215/CJN.08310813 - DOI - PubMed - PMC
    1. Hossain M, Woywodt A, Augustine T, Sharma V (2017) Obesity and listing for renal transplantation: weighing the evidence for a growing problem. Clin Kidney J 10(5):703–708. https://doi.org/10.1093/ckj/sfx022 - DOI - PubMed - PMC
    1. Lafranca JA, Jn IJ, Betjes MG, Dor FJ (2015) Body mass index and outcome in renal transplant recipients: a systematic review and meta-analysis. BMC Med 13:111. https://doi.org/10.1186/s12916-015-0340-5 - DOI - PubMed - PMC

LinkOut - more resources