Laparoscopic donor nephrectomy has been a widely accepted technical improvement in kidney transplantation. Since 2000, we have introduced robotic living donor nephrectomy (RLDN) in our clinical practice which is characterized by high prevalence of obesity.

1038 RLDNs were reviewed retrospectively, from 2000 to 2016 in our Center. Donors were divided into 4 groups according to their BMI: <25 (group1-23.5%); 25-29.9 (group2-35.6%); 30-34.9 (group3-26.2%) and ≥35 (group4-14.6%).

Mean donor BMI was 29.32±5.98 with a predominance of male living related donors. 40.8% were morbidly obese(BMI>30). The majority underwent left nephrectomy (95%); multiple arteries were present in 24 cases (2%). Mean surgical time was 164±40 min with a warm ischemia time of 172±92 sec. On average the hospitalization was 2.8 days. Conversion to open was required in 5 cases (for major bleeding and malfunctioning staplers). All the conversions occurred early in the experience (the last one 11 years ago). Perioperative complications occurred in 10.2% of the cases and the majority were minor (Grade I-II) with the exception of 1 death, non-related to technical issues. There were no statistical differences in the 4 groups on surgical outcomes and postoperative complications.

Recipients' outcomes were excellent with 1-year patient and graft survival of 97.6% and 95.8%, respectively.

RLDN is a reasonable alternative to conventional laparoscopy. The robotic technique allows successful procedures without additional morbidity in otherwise suitable obese donors.

CITATION INFORMATION: Di Bella C., Spaggiari M., Tulla K., Di Cocco P., Oberholzer J., Tzvetanov I., Benedetti E. Donor Safety in Obese Patients: 1038 Consecutive Robotic Living Donor Nephrectomies Am J Transplant. 2017;17 (suppl 3).

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