Robotic Pancreas Kidney Transplantation For Type 1 Diabetic Patient With End stage Renal Disease: First Year Experience In Single Institute

S. Lee¹, L. A. Cantrell², A. Agarwal¹, S. K. Rasmussen¹, S. Pelletier¹, K. Brayman¹, J. Oberholzer¹

¹Division of Transplant Surgery, Department of Surgery, University of Virginia Health Sciences Center, Charlottesville, VA, ²Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Virginia Health Sciences Center, Charlottesville, VA

Meeting: 2019 American Transplant Congress

Abstract number: C358

Keywords: Kidney/pancreas transplantation, Laparoscopy

Topic:

Session Information

Session Name: Poster Session C: Surgical Issues: All Organs

Date: Monday, June 3, 2019

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall C & D

*Purpose: Simultaneous pancreas kidney transplantation for type 1 diabetic patients with end-stage renal disease is a highly successful, but also very invasive surgical procedure. Robotic assistance facilitates a minimal invasiveness, laparoscopic approach to this rather advanced surgery. The present study aimed to evaluate the feasibility and outcome of introducing robotic pancreas kidney transplantation (RPKT) for type 1 diabetic patients with end-stage kidney disease in first year in a new institute without previous experience in robotic transplant surgery.

*Methods: From October 2017 to October 2018, we enrolled consecutive cases of RPKT in University of Virginia. Operative and clinical features including graft and patient survivals were retrospectively analyzed. The pancreas and kidney were introduced via a short Pfannenstil incision.

*Results: Six patients (3 male/3 female) successfully underwent RPKT during study period. Median age was 32 years old (30-46). Pre-transplant body mass index (BMI) was 25.5 (20.6-33.4). Operation time and estimated blood loss were 593 min (473-733) and 300cc (150-400), respectively. Total cold ischemic time and warm ischemic time were 436 min (242-585) for pancreas/725min (403-835) for kidney and 43 min (34-60) for pancreas/56min (44-69) for kidney, respectively. We had 5 enteric and 1 bladder drainage from transplant pancreas. No patient was converted to open method. No major complications during surgery were observed. We reported one case of delayed graft function of kidney and two cases of rejection with complete recovery. We found one patient with a minor trocar wound dehiscence and revision of ureterocystostomy for stricture. There was one pancreas graft loss at postoperative 7 days due to graft vein thrombosis. No patient death was noted.

*Conclusions: RPKT for type 1 diabetic patients with end-stage renal disease appears to be a safe and effective surgical procedure with minimal invasiveness with potential advantages of wound complication, quality of vascular anastomosis, and shorter recovery with minimal incision compared to conventional open surgery.

To cite this abstract in AMA style:

Lee S, Cantrell LA, Agarwal A, Rasmussen SK, Pelletier S, Brayman K, Oberholzer J. Robotic Pancreas Kidney Transplantation For Type 1 Diabetic Patient With End stage Renal Disease: First Year Experience In Single Institute [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/robotic-pancreas-kidney-transplantation-for-type-1-diabetic-patient-with-end-stage-renal-disease-first-year-experience-in-single-institute/. Accessed May 8, 2021.

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