Robotic Kidney Transplantation with Multiple Arteries: Safety and Efficacy in a Multicenter US Cohort

Document Type

Conference Proceeding

Publication Date

8-1-2025

Publication Title

Am J Transplant

Abstract

Purpose: Robot-assisted kidney transplantation (RAKT) is increasingly adopted, but outcomes for grafts with multiple arteries (GMA) remain unclear. This study evaluates early outcomes of RAKT using GMA compared to RAKT using grafts with single arteries (GSA) and open kidney transplantation with GMA (OKT-GMA). Methods: Retrospective review of 283 OKT-GMA, 276 RAKT-GSA, and 58 RAKT-GMA cases (January 2018-December 2023) extracted from 2 transplant centers. Primary outcome was 90-day Clavien-Dindo grade ≥3 complication rates. Secondary outcomes included one-year graft and patient survival. Results: Regarding baseline characteristics, age (51.6, 47.4, and 49.1 years, respectively; p=0.21) showed no significant difference between OKT-GMA, RAKT-GSA, and RAKT-GMA groups. BMI was 29.6, 38.7, and 35.2, respectively (p=0.08). The rate of diabetes as a past medical history was also comparable (46.4%, 46.9%, and 44.2%, respectively; p=0.94). For the primary outcome, 90-day complication rates were higher in RAKT-GMA vs. RAKT-GSA (19.3% vs. 9.4%, p=0.031) but not different from OKT-GMA (19.3% vs. 21.1%, p=0.52). One-year graft survival was comparable across groups (96.1% OKT-GMA, 95.3% RAKT-GSA, 93.2% RAKT-GMA, p=0.28). One-year patient survival was also comparable (96.8% OKT-GMA, 96.8% RAKT-GSA, 94.7% RAKT-GMA, p=0.34). Conclusions: RAKT using GMA demonstrates comparable 90-day complication rates to open surgery and acceptable one-year graft/patient survival, despite higher complications than RAKT with single arteries. RAKT using GMA is a viable option in select patients. [Formula presented] CITATION INFORMATION: Miyake K., Alaniz J., Rocha I., Kortan E., Oki R., Di Cocco P., Denny J., Almario Alvarez J., Malinzak L., Kim D., Bartlett S., Tzvetanov I., Abouljoud M., Nagai S., Benedetti E., Spaggiari M., Yoshida A. Robotic Kidney Transplantation with Multiple Arteries: Safety and Efficacy in a Multicenter US Cohort AJT, Volume 25, Issue 8 Supplement 1 DISCLOSURES: K. Miyake: None.

Volume

25

Issue

8

First Page

S431

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