ABO-Incompatible Robotic-Assisted Kidney Transplantation in the Obese Recipient
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 (O...
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doaj-6aab9e62e4774279bfc4b722176af4742020-11-25T03:24:49ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2020-08-01710.3389/fsurg.2020.00049560843ABO-Incompatible Robotic-Assisted Kidney Transplantation in the Obese RecipientThomas Prudhomme0Arnaud Del Bello1Federico Sallusto2Marine Lesourd3Nassim Kamar4Nicolas Doumerc5Department of Urology, Kidney Transplantation and Andrology, Toulouse Rangueil University Hospital, Toulouse, FranceDepartment of Nephrology and Organ Transplantation, Toulouse Rangueil University Hospital, Toulouse, FranceDepartment of Urology, Kidney Transplantation and Andrology, Toulouse Rangueil University Hospital, Toulouse, FranceDepartment of Urology, Kidney Transplantation and Andrology, Toulouse Rangueil University Hospital, Toulouse, FranceDepartment of Nephrology and Organ Transplantation, Toulouse Rangueil University Hospital, Toulouse, FranceDepartment of Urology, Kidney Transplantation and Andrology, Toulouse Rangueil University Hospital, Toulouse, FranceObjective: 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.https://www.frontiersin.org/article/10.3389/fsurg.2020.00049/fullrobotic-assisted kidney transplantationABO-incompatibleopen kidney transplantationdesensitization protocolsdelayed graft function |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Thomas Prudhomme Arnaud Del Bello Federico Sallusto Marine Lesourd Nassim Kamar Nicolas Doumerc |
spellingShingle |
Thomas Prudhomme Arnaud Del Bello Federico Sallusto Marine Lesourd Nassim Kamar Nicolas Doumerc ABO-Incompatible Robotic-Assisted Kidney Transplantation in the Obese Recipient Frontiers in Surgery robotic-assisted kidney transplantation ABO-incompatible open kidney transplantation desensitization protocols delayed graft function |
author_facet |
Thomas Prudhomme Arnaud Del Bello Federico Sallusto Marine Lesourd Nassim Kamar Nicolas Doumerc |
author_sort |
Thomas Prudhomme |
title |
ABO-Incompatible Robotic-Assisted Kidney Transplantation in the Obese Recipient |
title_short |
ABO-Incompatible Robotic-Assisted Kidney Transplantation in the Obese Recipient |
title_full |
ABO-Incompatible Robotic-Assisted Kidney Transplantation in the Obese Recipient |
title_fullStr |
ABO-Incompatible Robotic-Assisted Kidney Transplantation in the Obese Recipient |
title_full_unstemmed |
ABO-Incompatible Robotic-Assisted Kidney Transplantation in the Obese Recipient |
title_sort |
abo-incompatible robotic-assisted kidney transplantation in the obese recipient |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Surgery |
issn |
2296-875X |
publishDate |
2020-08-01 |
description |
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. |
topic |
robotic-assisted kidney transplantation ABO-incompatible open kidney transplantation desensitization protocols delayed graft function |
url |
https://www.frontiersin.org/article/10.3389/fsurg.2020.00049/full |
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