Robotic-assisted Versus Open Technique for Living Donor Kidney Transplantation: A Comparison Using Propensity Score Matching for Intention to Treat.
| Autor: | Tinney F; Division of Transplant and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, MI., Ivanics T; Division of Transplant and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, MI., Stracke J; Department of General Surgery, Mercy Health Saint Mary's, Grand Rapids, MI., Malinzak L; Division of Transplant and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, MI., Elsabbagh AM; Department of Surgery, Mansoura University, Mansoura, Egypt., McEvoy T; Division of Transplant and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, MI., Nagai S; Division of Transplant and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, MI., Yoshida A; Division of Transplant and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, MI. |
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| Jazyk: | angličtina |
| Zdroj: | Transplantation direct [Transplant Direct] 2022 Apr 12; Vol. 8 (5), pp. e1320. Date of Electronic Publication: 2022 Apr 12 (Print Publication: 2022). |
| DOI: | 10.1097/TXD.0000000000001320 |
| Abstrakt: | Living donor robotic-assisted kidney transplantation (RAKT) is an alternative to open kidney transplantation (OKT), but experience with this technique is limited in the United States. Methods: A retrospective review of living donor kidney transplants performed between 2016 and 2018 compared RAKT with OKT with regard to recipient, donor, and perioperative parameters. A 1:1 propensity score matching was performed on recipient/donor age, sex, body mass index, race, preoperative dialysis, and calculated panel reactive antibodies. Results: Outcomes of patient survival, graft survival, and postoperative complications were assessed for 139 transplants (47 RAKT and 92 OKT). Propensity score analysis (47:47) showed that RAKT recipients had longer warm ischemic times (49 versus 40 min; P < 0.001) and less blood loss (100 versus 150 mL; P = 0.005). Operative time and length of stay were similar between groups. Postoperative serum creatinine was similar during a 2-y follow-up. Post hoc analysis excluding 4 open conversions showed lower operative time with RAKT (297 versus 320 min; P = 0.04) and lower 30-d (4.7% versus 23.4%; P = 0.02) and 90-d (7% versus 27.7%; P = 0.01) Clavien-Dindo grade ≥3 complications. Conclusions: Our findings suggest that RAKT is a safe alternative to OKT. Competing Interests: A.Y. is a consultant and proctor for Intuitive Surgical. The other authors declare no funding or conflicts of interest. (Copyright © 2022 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.) |
| Databáze: | MEDLINE |
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