Robotic Kidney Transplantation With Regional Hypothermia: Results from a Prospective Two-Arm Non-Randomized Controlled Trial (Ideal Phase 2b)
1Institute of Kidney and Urology, Medanta, the Medicity, Gurgaon, Haryana, India
2Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI.
Meeting: 2015 American Transplant Congress
Abstract number: 217
Keywords: Kidney, Kidney transplantation, Surgical complications
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: 3:03pm-3:15pm
Location: Room 115-AB
Objectives
Minimally-invasive approaches to kidney transplantation are up-coming. We recently developed and described a novel technique of robotic KT (RKT) using intra corporeal graft cooling. Here, we assess the comparative effectiveness of RKT and open KT (OKT) by evaluating peri- and postoperative outcomes.
Methods
From January 1, 2013 to February 15, 2014, a total of 273 patients with end stage renal disease underwent KT at a tertiary referral center of which 227 patients who met the selection criteria (live donor, first transplant, single organ transplant and low-intermediate immunologic risk) were enrolled into this prospective two-arm non-randomized controlled trial (IDEAL Phase-2b). Primary outcome was post transplant graft function. Secondary outcomes included surgical and immunologic complications, and perioperative parameters. All patients had a minimum follow up of 6 months.
Results
Fifty nine and 168 patients underwent RKT and OKT, respectively. The baseline characteristics of the two groups were comparable. Mean serum creatinine at discharge was 1.2 and 1.3 mg/dl in RKT and OKT patients respectively (p=0.71). Post-operative pain (VAS score at 24-hr 2.2 vs. 3.4; p<0.001) and analgesic requirements (16.9 vs. 29.7 mg morphine equivalent PCA; p<0.001) were significantly less in patients undergoing RKT. None of the RKT patients developed any wound complications and none had delayed graft function (vs. 1.2% in OKT). Eight patients (13.6%) in RKT group developed acute rejection (vs. 19.6% in OKT). One RKT patient and 4 of OKT (2.4% [including the 2 DGF patients]) needed post-transplant dialysis. No lymphocele was detected on protocol non-contrast CT done at 3 months in the RKT group (0% vs. 23.8% in OKT; p=0.05). One graft was lost in the OKT group. Two patient death in RKT (1.5 and 7 months post-transplant, cardiac failure in both) and 3 in OKT group were noted, respectively.
Conclusions
RKT with regional hypothermia is safe and easily reproducible. Early outcomes are equivalent to OKT; with trends towards lower complications, quicker graft function recovery and shorter patient convalescence.
To cite this abstract in AMA style:
Ahlawat R, Sood A, Ghosh P, Kher V, Bhandari M, Menon M. Robotic Kidney Transplantation With Regional Hypothermia: Results from a Prospective Two-Arm Non-Randomized Controlled Trial (Ideal Phase 2b) [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/robotic-kidney-transplantation-with-regional-hypothermia-results-from-a-prospective-two-arm-non-randomized-controlled-trial-ideal-phase-2b/. Accessed May 17, 2025.« Back to 2015 American Transplant Congress