Purpose: To evaluate the outcomes of obese recipients undergoing minimal invasive, robotic kidney transplantation versus conventional open surgery within 18 months post-transplant.
Methods: Since 2009, a prospective cohort of 28 obese patients with ESRD has undergone robotic kidney transplantation and completed a follow-up period of 18 months post-transplant. We compared outcomes with a retrospective control group of 28 frequency matched obese patients undergoing kidney transplantation by open surgical technique from 2004 to 2009.
Results: The majority of the recipients in both groups were African-American (46.4%) and Hispanic (35.7%). The mean BMI in robotic and control group at transplantation was 42.6±7.8 kg/m2 vs. 38.1±5.4 kg/m2, respectively; p=0.02. At 18 months post-transplant the control group gained more weight and effaced the difference as compared to the robotic group. The graft function measured by glomerular filtration rate (GFR) in the robotic and control group at 18 months post-transplant was 56.3±18.1 vs.60.9±23.6 ml/min, respectively; p=0.44. The graft and patient survival (100%) were the same in both groups. The control group presented surgical site infections (SSI) in eight patients (28.6%) compared to none patient in the robotic group (0%; p=0.004) [Table 1]. Conclusions: We successfully reduced surgical site infections using the minimal invasive robotic technique. Both patient and graft survival are excellent this far. Further follow up will show whether obese patients exhibit similar outcome to non-obese kidney recipients.
|Robotic Transplant (N=28)||Controls (N=28)|
|Age (years), mean (SD)||47.9 (10.7)||49.8 (10.8)|
|Gender (male), No. (%)||13 (46.4)||11 (39.3)|
|Race (African American/Hispanic/White), No. (%)||13/10/5 (46.4/35.7/17.9)||13/10/5 (46.4/35.7/17.9)|
|BMI prior to transplant, mean (SD)||42.6 (7.8)||38.1 (5.4)|
|BMI at 18 months follow up, mean (SD)||42.9 (8.7)||39.9 (8.8)|
|Creatinine at 18 months (mg/dl), mean (SD)||1.5 (0.6)||1.5 (0.8)|
|GFR at 18 months (ml/min) mean (SD)||56.3 (18.1)||60.9 (23.6)|
|Graft survival at 18 months, No. (%)||28 (100)||28 (100)|
|Patient survival at 18 months, No. (%)||28 (100)||28 (100)|
|UTI No. (%)||9 (32.1)||13 (46.4)|
|SSI No. (%)||0 (0)||8 (28.6)|
|Rejection episodes No. (%)||11 (39.3)||6 (21.4)|
To cite this abstract in AMA style:Tzvetanov I, Bejarano-Pineda L, Giulianotti P, Bianco F, Ayloo S, Oberholzer J, Benedetti E. Eighteen Months Follow-Up in Obese Recipients with Robotic Kidney Transplantation [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/eighteen-months-follow-up-in-obese-recipients-with-robotic-kidney-transplantation/. Accessed October 21, 2020.
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