Korean J Transplant.  2023 Nov;37(Suppl 1):S243. 10.4285/ATW2023.F-8370.

Advancing patient care through robotic-assisted donor nephrectomy for transplants

• Abreu P
• Manzi J
• Morsi M
• Figueiro J
• Burke G
• Ciancio G
• Guerra G
• Vianna R

• KMID: 2551872
• DOI: http://doi.org/10.4285/ATW2023.F-8370

Abstract

Background
Kidney transplantation significantly improves survival in end-stage renal disease patients. Living donation enhances allograft survival and recipient quality of life, but traditional open or laparoscopic donor recovery poses barriers. We present an 86-case series of robotic-assisted donor nephrectomies.
Methods
Prospective data from robotic-assisted left/right donor nephrectomies at the Miami Transplant Institute (October 2022–August 2023) were analyzed. Preoperative, intraoperative, and postoperative data included patient demographics, surgical metrics, and pathology findings. Statistical analysis used Student t-test for continuous variables, chi-square for categorical ones (P<0.05).
Results
Among 86 cases, 44.2% were male and median age was 38 years. Median body mass index was 24.79 kg/m2 (interquartile range, 22.7–29.33 kg/m2). To relatives, 63.9% was donated. Kidney anatomy: single artery/vein/ureter in 73%. Faced anatomical issues, 26.7% experienced them. Pfannenstiel incision was common. Median robotic console time was 45 minutes. Graft artery, vein, and ureter sizes were 4 cm (3.75–4), 5 cm (45.75), 15 cm, respectively. All used robotic staplers. Foley catheter removed in OR, <24-hour stay. Procurement damage in 1.4%. Postoperative readmissions was 4 (4.6%); complications, 13 (15.1%); no surgical reinterventions. No conversions to laparoscopic/open. Immediate graft function in 72 cases; 2.3% had delayed graft function, all transplanted robotically.
Conclusions
Robotic-assisted donor nephrectomy is safe with minimal complications and excellent graft function. It is a preferred approach in centers with robotic capabilities, advancing living donor care and enhancing treatment quality.