Right versus left fully robotic live donor nephrectomy and open kidney transplantation: Does the laterality of the donor kidney really matter?
Objective: Robotic-assisted live donor nephrectomy (LDN) is being gradually adopted across transplant centers. The left donor kidney is preferred over right due to anatomical factors and ease of procurement. We aimed to study donor and recipient outcomes after robotic procurement and subsequent open...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-10-01
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| Series: | Asian Journal of Urology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214388223000905 |
| _version_ | 1797636513471660032 |
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| author | Brianna Ruch Deki Tsering Chandra Bhati Dhiren Kumar Muhammad Saeed Seung Duk Lee Aamir Khan Daisuke Imai David Bruno Marlon Levy Adrian Cotterell Amit Sharma |
| author_facet | Brianna Ruch Deki Tsering Chandra Bhati Dhiren Kumar Muhammad Saeed Seung Duk Lee Aamir Khan Daisuke Imai David Bruno Marlon Levy Adrian Cotterell Amit Sharma |
| author_sort | Brianna Ruch |
| collection | DOAJ |
| description | Objective: Robotic-assisted live donor nephrectomy (LDN) is being gradually adopted across transplant centers. The left donor kidney is preferred over right due to anatomical factors and ease of procurement. We aimed to study donor and recipient outcomes after robotic procurement and subsequent open implantation of right and left kidneys. Methods: All fully robotic LDNs and their corresponding open kidney transplants performed at our center between February 2016 and December 2021 were retrospectively analyzed. Results: Out of 196 robotic LDN (49 [right] vs. 147 [left]), 10 (5.1%) donors had intra-operative events (6.1% [right] vs. 4.8% [left], p=0.71). None of the LDN required conversion to open surgery. The operative times were comparable for the two groups. Nausea (13.3%) was the most common post-operative complication. There was no mortality in either LDN group. Herein, we report our outcomes on 156 recipients (39 right and 117 left allografts) excluding robotic implants, exports, and pediatric recipients. There were no significant differences between right and left kidney recipients with respect to 1-year post-transplant patient survival (100.0% vs. 98.1%, p=0.45) or graft survival (93.9% vs. 97.1%, p=0.11), or delayed graft function (7.7% vs. 5.1%, p=0.55). Conclusion: Non-hand-assisted robotic live donor nephrectomies can be safely performed with excellent outcomes. Right LDN was not associated with higher incidence of complications compared to left LDN. Open implantation of robotically procured right renal allografts was not associated with higher risk of recipient complications. |
| first_indexed | 2024-03-11T12:35:18Z |
| format | Article |
| id | doaj.art-1a884368e3664f3c88a31585f3bd4201 |
| institution | Directory Open Access Journal |
| issn | 2214-3882 |
| language | English |
| last_indexed | 2024-03-11T12:35:18Z |
| publishDate | 2023-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Urology |
| spelling | doaj.art-1a884368e3664f3c88a31585f3bd42012023-11-06T04:21:26ZengElsevierAsian Journal of Urology2214-38822023-10-01104453460Right versus left fully robotic live donor nephrectomy and open kidney transplantation: Does the laterality of the donor kidney really matter?Brianna Ruch0Deki Tsering1Chandra Bhati2Dhiren Kumar3Muhammad Saeed4Seung Duk Lee5Aamir Khan6Daisuke Imai7David Bruno8Marlon Levy9Adrian Cotterell10Amit Sharma11Hume-Lee Transplant Center, Virginia Commonwealth University, Richmond, VA, USAHume-Lee Transplant Center, Virginia Commonwealth University, Richmond, VA, USADivision of Transplant Surgery, University of Maryland, Baltimore, MD, USAHume-Lee Transplant Center, Virginia Commonwealth University, Richmond, VA, USAHume-Lee Transplant Center, Virginia Commonwealth University, Richmond, VA, USAHume-Lee Transplant Center, Virginia Commonwealth University, Richmond, VA, USAHume-Lee Transplant Center, Virginia Commonwealth University, Richmond, VA, USAHume-Lee Transplant Center, Virginia Commonwealth University, Richmond, VA, USAHume-Lee Transplant Center, Virginia Commonwealth University, Richmond, VA, USAHume-Lee Transplant Center, Virginia Commonwealth University, Richmond, VA, USAHume-Lee Transplant Center, Virginia Commonwealth University, Richmond, VA, USAHume-Lee Transplant Center, Virginia Commonwealth University, Richmond, VA, USA; Corresponding author.Objective: Robotic-assisted live donor nephrectomy (LDN) is being gradually adopted across transplant centers. The left donor kidney is preferred over right due to anatomical factors and ease of procurement. We aimed to study donor and recipient outcomes after robotic procurement and subsequent open implantation of right and left kidneys. Methods: All fully robotic LDNs and their corresponding open kidney transplants performed at our center between February 2016 and December 2021 were retrospectively analyzed. Results: Out of 196 robotic LDN (49 [right] vs. 147 [left]), 10 (5.1%) donors had intra-operative events (6.1% [right] vs. 4.8% [left], p=0.71). None of the LDN required conversion to open surgery. The operative times were comparable for the two groups. Nausea (13.3%) was the most common post-operative complication. There was no mortality in either LDN group. Herein, we report our outcomes on 156 recipients (39 right and 117 left allografts) excluding robotic implants, exports, and pediatric recipients. There were no significant differences between right and left kidney recipients with respect to 1-year post-transplant patient survival (100.0% vs. 98.1%, p=0.45) or graft survival (93.9% vs. 97.1%, p=0.11), or delayed graft function (7.7% vs. 5.1%, p=0.55). Conclusion: Non-hand-assisted robotic live donor nephrectomies can be safely performed with excellent outcomes. Right LDN was not associated with higher incidence of complications compared to left LDN. Open implantation of robotically procured right renal allografts was not associated with higher risk of recipient complications.http://www.sciencedirect.com/science/article/pii/S2214388223000905RoboticsLaparoscopyDonor nephrectomyComplicationRenal transplantOutcome |
| spellingShingle | Brianna Ruch Deki Tsering Chandra Bhati Dhiren Kumar Muhammad Saeed Seung Duk Lee Aamir Khan Daisuke Imai David Bruno Marlon Levy Adrian Cotterell Amit Sharma Right versus left fully robotic live donor nephrectomy and open kidney transplantation: Does the laterality of the donor kidney really matter? Asian Journal of Urology Robotics Laparoscopy Donor nephrectomy Complication Renal transplant Outcome |
| title | Right versus left fully robotic live donor nephrectomy and open kidney transplantation: Does the laterality of the donor kidney really matter? |
| title_full | Right versus left fully robotic live donor nephrectomy and open kidney transplantation: Does the laterality of the donor kidney really matter? |
| title_fullStr | Right versus left fully robotic live donor nephrectomy and open kidney transplantation: Does the laterality of the donor kidney really matter? |
| title_full_unstemmed | Right versus left fully robotic live donor nephrectomy and open kidney transplantation: Does the laterality of the donor kidney really matter? |
| title_short | Right versus left fully robotic live donor nephrectomy and open kidney transplantation: Does the laterality of the donor kidney really matter? |
| title_sort | right versus left fully robotic live donor nephrectomy and open kidney transplantation does the laterality of the donor kidney really matter |
| topic | Robotics Laparoscopy Donor nephrectomy Complication Renal transplant Outcome |
| url | http://www.sciencedirect.com/science/article/pii/S2214388223000905 |
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