Living-Donor Kidney Transplantation: Comparison of Robotic-Assisted Versus Conventional Open Technique

Abstract

The aim was to compare intraoperative, postoperative and functional outcomes of patients undergoing living donor RAKT versus OKT. A retrospective analysis of all living donor’s kidney transplantation performed in a tertiary center between 2013 and 2024 comparing RAKT with OKT was performed. All recipients in the OKT group were eligible for a RAKT. A total of 400 patients (200 RAKT and 200 OKT) were included. Recipients were younger in the RAKT cohort (48.0 versus 51.5 years, p = 0.045). Median operative time was significantly longer in the RAKT group (185.5 versus 120.0 min, p < 0.0001). Intraoperative complications rate was similar in both study group. A significantly higher proportion of recipients receiving OKT undergone post-operative surgical complications (p < 0.0001) and major post-operative complications (8.0% versus 19.5%, p = 0.001). Seven patients required graft nephrectomy during the early post-operative period (of whom all were in the RAKT group). Median length of hospitalization was significantly longer in the OKT group (7.0 versus 9.0 days, p < 0.0001). 1-, 3- and 5-years patient and graft survival were comparable between the RAKT and OKT cohorts. The postoperative opioid requirement was not evaluated. Our analysis confirms the safety and efficacy of RAKT in the setting of living donors, in comparison to conventional OKT.