AUTHOR=Prudhomme Thomas , Del Bello Arnaud , Sallusto Federico , Lesourd Marine , Kamar Nassim , Doumerc Nicolas 

TITLE=ABO-Incompatible Robotic-Assisted Kidney Transplantation in the Obese Recipient

JOURNAL=Frontiers in Surgery

VOLUME=7

YEAR=2020

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2020.00049

DOI=10.3389/fsurg.2020.00049

ISSN=2296-875X

ABSTRACT=<p><bold>Objective:</bold> The objective of this preliminary study was to report and compare the peri-operative and functional results of ABO-incompatible (ABOi) living-donor robotic-assisted kidney transplantation (RAKT), ABO-compatible (ABOc) living-donor RAKT, and ABOi living-donor open kidney transplantation (OKT).</p><p><bold>Materials and Methods:</bold> For the present retrospective study, we analyzed data of consecutive patients who underwent ABOi or ABOc-RAKT and ABOi-OKT, from January 2015 to December 2019, in one French academic center. Patients' baseline characteristics, operative, and functional outcomes were compared between ABOi-RAKT, ABOc-RAKT, and ABOi-OKT.</p><p><bold>Results:</bold> 29 RAKT, including 7 ABOi-RAKT, and 56 ABOi-OKT were performed in our center. Median follow-up was 2.0 years. Median recipient age, pre-emptive kidney transplantation rate, sex ratio and desensitization procedures were similar in ABOi-RAKT, ABOc-RAKT, and ABOi-OKT groups. Recipient BMI at transplantation was statistically higher in ABOi and ABOc-RAKT groups compared to ABOi-OKT. The surgical site complication (principally infection-related) rate was lower in ABOi-RAKT, without statistical differences (0 vs. 8.9%, respectively, in ABOi-RAKT and ABOi-OKT, <italic>p</italic> = 0.7). The delayed graft function rate was 0% in ABOi-RAKT, 13.6% in ABOc-RAKT, and 10.7% in ABOi-OKT (<italic>p</italic> = 0.6). The post-transplantation blood transfusion rate was statistically higher in the ABOi-OKT group (14.3 vs. 13.6 vs. 57.1% in ABOi-RAKT, ABOc-RAKT, and ABOi-OKT, respectively, <italic>p</italic> = 0.001). The kidney graft survival at 1 month and at last follow-up was not different between ABOi-RAKT and ABOi-OKT.</p><p><bold>Conclusion:</bold> Our data support the use of ABOi-RAKT to restore accessibility to kidney transplantation for obese patients to the greatest extent possible. Large series are required to confirm these encouraging data from a single center.</p>