Table 2.
Peri-operative outcomes and functional outcomes after robot-assisted kidney transplantation (RAKT), stratified by donor type (living vs. deceased).
| Donor type | p | ||||
|---|---|---|---|---|---|
| Overall (n = 39) | Living donors (n = 18) | Deceased donors (DBD or DCD) (n = 21) | |||
| Peri-operative outcomes | |||||
| LOH in intensive care unit, days (median, IQR) | 2 (1–3) | 2 (1–3) | 2 (2–3) | 0.3 | |
| Overall LOH, days (median, IQR) | 14 (10–20) | 14 (11–19) | 14 (10–22) | 0.8 | |
| Postoperative graft biopsy (n, %) | 6 (15.4) | 3 (16.7) | 3 (14.3) | 0.8 | |
| Rejection (n, %) | 1 (2.6) | 1 (5.6) | 0 (0.0) | 0.2 | |
| FU, months (median, IQR) | 16 (7-22) | 9 (7-21) | 18 (8-22) | 0.4 | |
| Graft nephrectomy (n, %) | 1 (2.6) | 0 (0.0) | 1 (4.8) | 0.3 | |
| Surgical complications (Clavien Dindo classification) (n, %) | Grade 1 | 15 (38.4) | 10 (55.6) | 5 (23.8) | 0.08 |
| Grade 2 | 24 (61.5) (n = 3 [7.7%] transfusion) |
8 (44.4) (n = 1 [5.6%] transfusion) |
16 (76.2) (n = 2 [9.5%] transfusions) |
0.042 (0.6) | |
| Grade 3a | 4 (10.3) | 2 (11.1) (n = 1 ureteral stenosis requiring percutaneous placement of nephrostomy tube and JJ stent*; n = 1 percutaneous drainage of symptomatic lymphocele) |
2 (9.5) (n = 1 TRAS requiring PTA + stenting; n = 1 ureteral stenosis requiring percutaneous placement of nephrostomy tube and JJ stent) |
0.8 | |
| Grade 3b | 1 (2.6) | 0 (0.0) | 1 (4.8) (n = 1 graft nephrectomy for arterial thrombosis [DCD donor]) |
0.3 | |
| Grade 4–5 | 0 (0.0) | 0 (0.0) | 0 (0.0) | - | |
|
Postoperative Hb, g/dL (median, IQR) |
POD 1 | 11 (10–12) | 11 (10–11) | 10 (9–12) | 0.50 |
| At hospital discharge | 10 (9–10) | 10 (9–10) | 9 (9–10) | 0.10 | |
| Functional outcomes | |||||
| eGFR, mL/min/1.73 m2 (median, IQR) | POD 1 | 11 (8–17) | 16 (12–18) | 8 (7–11) | <0.001 |
| POD 3 | 33 (9–43) | 43 (33–48) | 10 (8–35) | <0.001 | |
| POD 7 | 41 (14–58) | 54 (44–60) | 16 (9–38) | <0.001 | |
| At hospital discharge | 51 (34–59) | 54 (47–66) | 39 (29–56) | 0.059 | |
| At last follow-up | 55 (43–73) | 51 (42–71) | 57 (45–76) | 0.6 | |
| DGF (n, %) | 7 (17.9) | 0 (0.0) | 7 (33.3) | 0.007 | |
| Dialysis at FU (n, %) | 2 (5.1) | 0 (0.0) | 2 (9.5) (n = 1 graft nephrectomy; n = 1 PNF [both DCD donors]) |
0.1 | |
DGF, delayed graft function (defined as need of dialysis in the first week after transplantation); eGFR, estimated glomerular filtration rate (CDK-EPI formula); FU, follow-up; LOH length of hospitalization; POD, postoperative day.
In this case, the graft showed a uretero-pelvic junction obstruction (UPJO), not requiring intervention on bench surgery; however, during the postoperative period, the patient developed hydronephrosis and required percutaneous placement of a nephrostomy tube with antegrade placement of a double J stent; the stent was removed after 3 months with no further medical or surgical complications. Bold values highlight the statistically significant results. Italic values describe detail on surgical complications.