604 Serum N-glycan profiling predict antibody mediated rejection in patients undergoing living kidney transplantation

Abstract

INTRODUCTION AND OBJECTIVES: With the development of living donor nephrectomy in recent years, the surgical management of nephrectomy has also evolved. Standard laparoscopic donor nephrectomy (SLDN) has been largely developed, nevertheless the robotassisted approach is not widespread in this indication. The objective of this study was to compare perioperative outcomes between SDN and robot-assisted laparoscopic donor nephrectomy (RALDN). METHODS: Between 2003 and 2015, in two academic centres, all patients who underwent a donor nephrectomy by SLDN (group A) or RALDN were compared. We assessed patient’s characteristics and perioperative outcomes including: type of surgery, operating time, warm ischemia time, complications and hospital length of stay. Comparison betweens groups were performed using c2 test and Fisher exact test for discrete variables and Mann-Whitney test for continuous variables. RESULTS: We included 277 patients, 226 in the SLDN group and 51 in the RaLDN. Mean age was similar in both groups (51 years vs. 52 years, p1⁄40.59), as mean BMI (25.1 kg/m2 vs. 25.6kg/m2; p1⁄40.39). Groups were also comparable for ASA score (ASA 1: 79% vs. 82%; p1⁄40.66), side of nephrectomy (Left in 94% vs. 88%; p1⁄40.12) in group A and B respectively. Study of perioperative outcomes, revealed a longer operating time in the RaLDN (143 min vs. 233min; p<0.001), and a longer warm ischemia time (3.5 min vs. 6.2min; p<0.001). Hospital length of stay was shorter in the RaLDN group (5.7 days vs. 5.1 days; p1⁄40.006). Complications rate was similar in both groups (p1⁄40.66). Only one hemorrhagic complication occurred in group B (surgeon at the beginning of the learning curve) requiring a transfusion. CONCLUSIONS: Robot-assisted laparoscopic living donor nephrectomy is feasible, operating time and warm ischemia time are longer but hospital length of stay is shorter. Complications rate is similar with SDN, nevertheless it is necessary to perform this procedure once the learning curve of robotic surgery passed. Long-term data on the receiver are needed to confirm the feasibility of RALDN.