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ABO-Incompatible Robotic-Assisted Kidney Transplantation in the Obese Recipient

Authors
  • Prudhomme, Thomas1
  • Del Bello, Arnaud2
  • Sallusto, Federico1
  • Lesourd, Marine1
  • Kamar, Nassim2
  • Doumerc, Nicolas1
  • 1 Department of Urology, Kidney Transplantation and Andrology, Toulouse Rangueil University Hospital, Toulouse , (France)
  • 2 Department of Nephrology and Organ Transplantation, Toulouse Rangueil University Hospital, Toulouse , (France)
Type
Published Article
Journal
Frontiers in Surgery
Publisher
Frontiers Media S.A.
Publication Date
Aug 07, 2020
Volume
7
Identifiers
DOI: 10.3389/fsurg.2020.00049
PMID: 32850946
PMCID: PMC7427440
Source
PubMed Central
Keywords
License
Unknown

Abstract

Objective: The objective of this preliminary study was to report and compare the peri-operative and functional results of ABO-incompatible (ABOi) living-donor robotic-assisted kidney transplantation (RAKT), ABO-compatible (ABOc) living-donor RAKT, and ABOi living-donor open kidney transplantation (OKT). Materials and Methods: For the present retrospective study, we analyzed data of consecutive patients who underwent ABOi or ABOc-RAKT and ABOi-OKT, from January 2015 to December 2019, in one French academic center. Patients' baseline characteristics, operative, and functional outcomes were compared between ABOi-RAKT, ABOc-RAKT, and ABOi-OKT. Results: 29 RAKT, including 7 ABOi-RAKT, and 56 ABOi-OKT were performed in our center. Median follow-up was 2.0 years. Median recipient age, pre-emptive kidney transplantation rate, sex ratio and desensitization procedures were similar in ABOi-RAKT, ABOc-RAKT, and ABOi-OKT groups. Recipient BMI at transplantation was statistically higher in ABOi and ABOc-RAKT groups compared to ABOi-OKT. The surgical site complication (principally infection-related) rate was lower in ABOi-RAKT, without statistical differences (0 vs. 8.9%, respectively, in ABOi-RAKT and ABOi-OKT, p = 0.7). The delayed graft function rate was 0% in ABOi-RAKT, 13.6% in ABOc-RAKT, and 10.7% in ABOi-OKT ( p = 0.6). The post-transplantation blood transfusion rate was statistically higher in the ABOi-OKT group (14.3 vs. 13.6 vs. 57.1% in ABOi-RAKT, ABOc-RAKT, and ABOi-OKT, respectively, p = 0.001). The kidney graft survival at 1 month and at last follow-up was not different between ABOi-RAKT and ABOi-OKT. Conclusion: Our data support the use of ABOi-RAKT to restore accessibility to kidney transplantation for obese patients to the greatest extent possible. Large series are required to confirm these encouraging data from a single center.

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