Robotic Kidney Transplant Beyond the Learning Curve: 8-Year Single-center Experience and Matched Comparison With Open Kidney Transplant

Abstract

ObjectivesTo investigate the medium to long-term outcomes of RAKT and propensity matched comparison with Open kidney transplant (OKT). Material and methodsWe retrospectively reviewed 342 patients from database, who underwent RAKT and OKT from January 2015 to May 2022, at our centre. Various demographic, intraoperative and postoperative parameters were evaluated. Statistical analysis including propensity matching using nearest neighbour algorithm was performed to ensure comparability between the RAKT and OKT groups.The statistical analyses were performed using SPSS v.22.0 (IBM Corp., Armonk, NY, USA) and STATA 13 (Stata Corp., College Station, TX, USA). All statistical tests were two-sided, and a significance level of p < 0.05 was considered statistically significant. ResultsAfter applying exclusion criteria,196 RAKT patients and 102 OKT patients were included in the analysis. Propensity score matching resulted in the inclusion of 173 patients in the RAKT group. In the propensity-matched comparison of intra/perioperative parameters, RAKT showed significant reductions in total surgical time (p <0.001), wound length (p < 0.001), blood loss (p <0.001), blood transfusion rate (p <0.001), pain score (p < 0.001), and analgesia requirement (p< 0.001). Graft survival and patient survival rates were comparable in RAKT and OKT groups at the end of 60 months. ConclusionRAKT offers several advantages over OKT in terms of reduced operative time, blood loss, pain, and analgesia requirements. RAKT shows comparable graft and patient survival rates to OKT in the medium to long term.