Robotic Kidney Transplantation in Obese Recipients Can Lead to Superior Outcomes in Terms of Wound Infection and Graft Survival
Surgery, Division of Transplantation, University of Illinois at Chicago, Chicago, IL.
Meeting: 2015 American Transplant Congress
Abstract number: 213
Keywords: Kidney transplantation, Obesity, Outcome, Survival
Session Information
Session Name: Concurrent Session: Kidney: Surgical Technique/Complications
Session Type: Concurrent Session
Date: Monday, May 4, 2015
Session Time: 2:15pm-3:45pm
Presentation Time: 2:15pm-2:27pm
Location: Room 115-AB
Introduction
Traditionally kidney transplantation (KT) in obese recipients has been associated with high rates of surgical site infections (SSI). We hypothesize that robotic kidney transplantation (RKT) in obese individuals could decrease the rate of SSI and improve long-term outcomes.
Materials and Methods
From June 2009 to November 2014, 140 obese patients with ESRD underwent RKT at our institution. In a cohort study, the first 28 patients who achieved a follow-up period of 36 months were frequency matched with a control group of 28 morbidly obese patients who underwent standard open KT prior to June 2009.
Results
The mean BMI was 42.6±7.8 kg/m2 in the robotic group and 38.1±5.4 kg/m2 in the control group (p=0.02). No statistically significant differences between the two groups were noted in relation to pre-transplant comorbidities, etiology of ESRD, cold ischemia time, warm ischemia time, blood loss, intraoperative blood transfusion, immunosuppressive medications and hospital stay. At 36 months, the GFR was 53.5±30.7 ml/min/1.73m2 in the robotic group and 60.6±21.8 ml/min/1.73m2 in the control group (p=NS). The rate of SSI was significantly higher in the control group when compared with the robotic group (28.6% vs. 0%, p=0.004). At 3-years post-transplant, 8 patients in the control group (28.5%) experienced graft loss when compared with two patients in the robotic group (7.1%). Three (37.5%) out of the eight patients who lost the graft in the control group had concomitant SSI. The patient survival at 36 months was 96.5% in the robotic group and 92.8% in the control group (p=0.5).
| Demographics | Robotic Group (n=28) | Control Group (n=28) | P value |
| Age (years), mean (SD) | 47.9 (10.7) | 49.8 (10.8) | NS |
| BMI prior to transplant, mean (SD) | 42.6 (7.8) | 38.1 (5.4) | 0.02 |
| Outcome | |||
| GFR at 36 months (ml/min) mean (SD) | 54.5±18.1 | 60.6±21.8 | NS |
| Graft survival at 36 months, (%) | 92.9 | 71.5 | 0.07 |
| Patient survival at 36 months, (%) | 96.5 | 92.8 | NS |
| Post-transplant complications | |||
| SSI (%) | 0 | 28.6 | 0.004 |
| Rejection Episodes | 25 | 18 | NS |
Conclusions
Our preliminary experience has demonstrated the benefit of RKT in obese recipients in terms of SSI and graft survival. We strongly believe that this minimally invasive approach in obese recipients can lead to the same kidney transplant success rates as in patients with a normal BMI.
To cite this abstract in AMA style:
Tzvetanov I, D'Amico G, Georgiev G, Giulianotti P, Jeon H, Garcia-Roca R, Oberholzer J, Benedetti E. Robotic Kidney Transplantation in Obese Recipients Can Lead to Superior Outcomes in Terms of Wound Infection and Graft Survival [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/robotic-kidney-transplantation-in-obese-recipients-can-lead-to-superior-outcomes-in-terms-of-wound-infection-and-graft-survival/. Accessed November 21, 2024.« Back to 2015 American Transplant Congress