A NEW study comparing robot-assisted kidney transplantation (RAKT) and open kidney transplantation (OKT) in patients with ABO-incompatible donors suggests that RAKT is a viable and effective alternative to traditional surgery, with comparable outcomes and some distinct advantages. As robot-assisted procedures gain global traction, this research provides critical insights into their performance in immunologically high-risk kidney transplant recipients.
The retrospective study, conducted at a single centre, analysed 239 living-donor kidney transplants performed between October 2020 and February 2023. Of these, 29 patients underwent ABO-incompatible RAKT, while 210 underwent ABO-incompatible OKT. To ensure a fair comparison, propensity score matching (PSM) was used, resulting in a balanced dataset of 26 RAKT and 131 OKT cases.
Key findings revealed no significant differences between the two groups in one- and two-year biopsy-proven acute rejection (BPAR)-free survival rates or graft function at 12 months post-transplant. However, RAKT showed certain advantages, including shorter hospital stays (median 6 days vs. 8 days for OKT) despite longer operative and cold ischemic times.
The composite outcomes, which included acute rejection, graft failure, and the development of de novo donor-specific antibodies, were similar between the groups, demonstrating that RAKT offers comparable safety and effectiveness to OKT in managing high-risk transplant scenarios.
The study’s results suggest that RAKT can serve as a safe and effective option for patients requiring ABO-incompatible kidney transplants. Its ability to provide similar outcomes with shorter recovery times highlights its growing potential as a modern surgical approach in transplantation.
Reference
Kim JM et al. A comparative study on outcomes of ABO-incompatible kidney transplants between robot-assisted vs. open surgery-propensity score-matched analysis: a retrospective cohort study. BMC Nephrol. 2024;DOI:10.1186/s12882-024-03842-1.
