Robotic-assisted kidney transplantation in obese recipients compared to non-obese recipients: the European experience

Springer Science and Business Media LLC - Tập 39 - Trang 1287-1298 - 2020
Thomas Prudhomme1, Jean Baptiste Beauval2, Marine Lesourd1, Mathieu Roumiguié1, Karel Decaestecker3, Graziano Vignolini4, Riccardo Campi4, Sergio Serni4, Angelo Territo5, Luis Gausa5, Volkan Tugcu6, Selcuk Sahin6, Antonio Alcaraz7, Mireia Musquera7, Michael Stockle8, Martin Janssen8, Paolo Fornara9, Nasreldin Mohammed9, Arnaud Del Bello10, Nassim Kamar10, Federico Sallusto1, Alberto Breda5, Nicolas Doumerc1
1Department of Urology and Kidney Transplantation, University Hospital of Rangueil, Toulouse, France
2Department of Urology, Clinique La Croix du Sud, Toulouse, France
3Department of Urology, Ghent University Hospital, Ghent, Belgium
4Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
5Department of Urology, Fundaciò Puigvert, Autonoma University of Barcelona, Barcelona, Spain
6Department of Urology, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
7Department of Urology, Hospital Clinic, Barcelona, Spain
8Department of Urology, Saarland University, HomburgSaar, Germany
9Department of Urology, Halle University Hospital (Saale), Halle, Germany
10Department of Nephrology and Organ Transplantation, University Hospital of Rangueil, Toulouse, France

Tóm tắt

The main objective was to compare minor (Clavien I–II) and major (Clavien ≥ III) intra- and postoperative complications of living donor robotic assisted kidney transplantation (RAKT) in obese (≥ 30 kg/m2 BMI), overweight (< 30/ ≥ 25 kg/m2 BMI) and non-overweight recipients (< 25 kg/m2 BMI). For the present retrospective study, we reviewed the multi-institutional ERUS-RAKT database to select consecutive living donor RAKT recipients. Functional outcomes, intra- and postoperative complications were compared between obese, overweight and non-overweight recipients. 169 living donor RAKTs were performed, by 10 surgeons, from July 2015 to September 2018 in the 8 European centers. 32 (18.9%) recipients were obese, 66 (39.1%) were overweight and 71 (42.0%) were non-overweight. Mean follow-up was 1.2 years. There were no major intra-operative complications in either study group. Conversion to open surgery occurred in 1 obese recipient, in 2 overweight recipients and no conversion occurred in non-overweight recipients (p = 0.3). Minor and major postoperative complications rates were similar in the 3 groups. At one-year of follow-up, median eGFR was similar in all groups [54 (45–60) versus 57 (46–70) versus 63 (49–78) ml/min/1.73 m2 in obese, overweight and non-overweight recipient groups, respectively, p = 0.5]. Delayed graft function rate was similar in the 3 groups. Only the number of arteries was an independent predictive factor of suboptimal renal function at post-operative day 30 in the multivariate analysis. RAKT in obese recipients is safe, compared to non-overweight recipients and yields very good function, when it performed at high-volume referral centers by highly trained transplant teams.

Tài liệu tham khảo

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