Impact of Enhanced Recovery after Surgery Protocols on Robotic Living Kidney Donor Outcomes: A Single Center Experience
Virginia Commonwealth University, Richmond, VA
Meeting: 2020 American Transplant Congress
Abstract number: A-033
Keywords: Donation, Kidney transplantation
Session Information
Session Name: Poster Session A: Kidney Living Donor: Other
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: Traditional management of living donor nephrectomies includes intraoperative volume loading to maintain renal perfusion and urine output. Recently our center initiated fluid restriction as part of an enhanced recovery after surgery (ERAS) protocol for all robotic living donor nephrectomies (RLDN). Outcomes for robotic kidney donors managed with intraoperative fluid restriction has not previously been reported.
*Methods: A retrospective analysis of all RLDN performed at our single center from 01/2016 to 10/2019 was performed. Robotic nephrectomy outcomes Pre-ERAS (2016-2018) and post-ERAS protocol initiation (2019) were compared using standard t-test for unequal variances. A p-value < .05 was considered significant.
*Results: A total of 132 robotic donor nephrectomies were performed (98 Pre-ERAS and 34 Post-ERAS). The two groups were comparable in terms of age, gender, BMI and race (Table 1). Post-ERAS there was a statistically significant decrease in hospital stay (3.15 ± 0.50 days Post-ERAS vs 3.4 ± 0.68 days Pre-ERAS, p-value 0.03). There was a significant decrease in intraoperative fluid administration (2005.9 ± 573.63 mL vs 3569.3 ± 929.43 mL, p-value < 0.001) and urine output (726.62 ± 318.33 mL vs 1085.85 ± 437.86 mL, p-value < 0.001) but no negative effect on postoperative donor creatinine or glomerular filtration rate (GFR).
*Conclusions: Implementation of enhanced recovery for robotic living donor nephrectomies significantly decreased hospital stay. Intra operative fluid restriction did not negatively affect post-operative renal function in our robotic donors. Further studies are needed to evaluate the impact of kidney donor ERAS protocols on renal allograft outcomes in recipients.
| Pre-ERAS (N = 98) | Post-ERAS (N = 34) | p-value | |
| Age (mean ±SD) | 42.3 ± 13.0 | 43.6 ± 11.5 | 0.57 |
| BMI (mean ±SD) | 27.2 ± 4.4 | 26.2 ± 4.4 | 0.28 |
| Female (%) | 66.3 % | 61.8 % | ns |
| Caucasian (%) | 70.4 % | 70.6 % | ns |
| Pre-ERAS (N = 98) | Post-ERAS (N = 34) | p-value | |
| Intra-op fluids (mL, mean ±SD) | 3569.3 ± 929.43 | 2005.9 ± 573.63 | <0.001 |
| Intra-op urine output (mL, mean ±SD) | 1085.85 ± 437.86 | 726.62 ± 318.33 | <0.001 |
| Hospital stay (days, mean ±SD) | 3.4 ± 0.68 | 3.15 ± 0.50 | 0.03 |
| S. Creatinine (mg/dL) Pre-donation | 0.82 ± 0.15 | 0.84 ± 0.16 | 0.43 |
| S. Creatinine (mg/dL) At discharge | 1.33 ± 0.28 | 1.36 ± 0.28 | 0.61 |
| GFR (mL/min) Pre-donation | 100.61 ± 14.55 | 98.32 ± 15.69 | 0.46 |
| GFR (mL/min) At discharge | 58.66 ± 12.24 | 57.53 ± 10.95 | 0.62 |
To cite this abstract in AMA style:
Ruch B, Sharma A, Amery J, Bhati C, Khan A, Cotterell A, Scott M, Levy M. Impact of Enhanced Recovery after Surgery Protocols on Robotic Living Kidney Donor Outcomes: A Single Center Experience [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-enhanced-recovery-after-surgery-protocols-on-robotic-living-kidney-donor-outcomes-a-single-center-experience/. Accessed November 22, 2024.« Back to 2020 American Transplant Congress