Robotic kidney transplantation in the obese patient: 10-year experience from a single center.

Autor: Tzvetanov IG; Division of Transplantation, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois., Spaggiari M; Division of Transplantation, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois., Tulla KA; Division of Transplantation, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois., Di Bella C; Division of Transplantation, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois., Okoye O; Division of Transplantation, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois., Di Cocco P; Division of Transplantation, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois., Jeon H; Department of Surgery, Tulane University, New Orleans, Louisiana., Oberholzer J; Charles O. Strickler Transplant Center, University of Virginia Health System, Charlottesville, Virginia., Cristoforo Giulianotti P; Division of General, Minimally Invasive, & Robotic Surgery, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois., Benedetti E; Division of Transplantation, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois.
Jazyk: angličtina
Zdroj: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2020 Feb; Vol. 20 (2), pp. 430-440. Date of Electronic Publication: 2019 Dec 24.
DOI: 10.1111/ajt.15626
Abstrakt: Despite increasing obesity rates in the dialysis population, obese kidney transplant candidates are still denied transplantation by many centers. We performed a single-center retrospective analysis of a robotic-assisted kidney transplant (RAKT) cohort from January 2009 to December 2018. A total of 239 patients were included in this analysis. The median BMI was 41.4 kg/m 2 , with the majority (53.1%) of patients being African American and 69.4% of organs sourced from living donors. The median surgery duration and warm ischemia times were 4.8 hours and 45 minutes respectively. Wound complications (mostly seromas and hematomas) occurred in 3.8% of patients, with 1 patient developing a surgical site infection (SSI). Seventeen (7.1%) graft failures, mostly due to acute rejection, were reported during follow-up. Patient survival was 98% and 95%, whereas graft survival was 98% and 93%, at 1 and 3 years respectively. Similar survival statistics were obtained from patients undergoing open transplant over the same time period from the UNOS database. In conclusion, RAKT can be safely performed in obese patients with minimal SSI risk, excellent graft function, and patient outcomes comparable to national data. RAKT could improve access to kidney transplantation in obese patients due to the low surgical complication rate.
(© 2019 The American Society of Transplantation and the American Society of Transplant Surgeons.)
Databáze: MEDLINE
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