Robotic-assisted kidney transplantation seen as safe for patients with obesity
Researchers of a published study found patients with obesity who underwent robotic-assisted kidney transplantation had comparable patient and graft survival to those without obesity who underwent open transplant during the same time period. The rate of surgical complications was also low.
“Clinically, patients have shorter hospital stays, minimal postoperative pain, fewer wound infections and better cosmesis [with robotic-assisted techniques],” Ivo G. Tzvetanov, MD, of the division of transplantation in the department of surgery at the University of Illinois at Chicago, and colleagues wrote. “ ... The first intra-abdominal robotic kidney transplant in an obese patient was performed by our group in 2009. Despite the encouraging results of this approach, the technique continues to be cautiously adopted. The idea of applying robotic surgery to kidney transplantation was borne out of the need to reduce the morbidity of open kidney transplant in obese candidates.”
Researchers compared outcomes between 239 patients who received robotic-assisted kidney transplant (median BMI, 41.4 kg/m2; 53.1% were African Americans) and patients who underwent open transplant (identified through the United Network for Organ Sharing database) between January 2009 and December 2018.
Similar survival statistics were observed between the two groups (patient survival for robotic-assisted transplant recipients at 1 year and 3 years: 98% and 93%, respectively; graft survival: 98% and 95%, respectively), with 3.8% of those who received robotic-assisted transplants developing a wound complication and one patient developing a surgical site infection.
Researchers noted that, “Despite increasing obesity rates in the dialysis population, obese kidney transplant candidates are still denied transplantation by many centers.”
In a related press release, study-author Mario Spaggiari, MD, said, “The patients who received transplants spent more than 3.5 years on dialysis before undergoing surgery, and that is just the median number. Without surgery, these people would have had no choice but to remain on dialysis — which can itself be a barrier to achieving the ‘ideal’ weight for transplant — and accept the limitation it places on their quality of life. With surgery, they can get back to normal life, which is most important. They can also have increased chances of achieving other health-promoting behaviors, like exercise or weight loss.” – by Melissa J. Webb
Disclosures: The authors report no relevant financial disclosures.