This study confirms that even within the confines of a pediatric urology training program successful collaboration between robotic surgeons, surgical nurses and anesthesiologists can lead to shorter operative times and hospital stays. Long-term surgical success and complication rates were comparable to open surgery.

INTRODUCTION AND OBJECTIVE: For patients who have undergone primary kidney transplant(PKT) and returned to dialysis, second kidney transplantation(SKT) offers improved quality of life and survival advantages. However, SKT is associated with increased immunologic and non-immunologic risk. Despite these challenges, reported outcomes and 5 year allograft survival rates following SKT are acceptable. There are few studies that investigate significant perioperative predictors for long-term renal allograft survival after SKT. We aimed to compare long term survival following SKT with primary kidney transplant at a single centre. We also investigated donor and recipient perioperative predictors for renal allograft failure after SKT.METHODS: An institutional review-board approved study was performed on outcomes of all patients who received a primary or second kidney transplant at a national kidney transplant center between 1993 and 2017. The primary outcomes measurements were renal allograft survival for both first and second kidney transplants and overall patient and graft survival. Secondary outcome measurements were incidence of delayed graft function (DGF), incidence of allograft rejection and predictors for renal allograft survival in SKT recipients.RESULTS: In total, there were 392 SKT and 2,748 PKT recipients. The duration between first and SKT was 10.5 AE 7.4 years and the median follow-up after SKT was 155 (13-309) months. The 1-,5-and 10-year death censored renal allograft survival rates after SKT were 94.1%, 87.0% and 75.1% respectively compared to 95.4%, 89.1% and 78.7% for PKT recipients (p[0.0174). Overall 1-, 5-and 10-year patient and graft survival rates after SKT were 93.4%, 82.0% and 66.7% respectively compared to 93.7%, 81.9% and 65.2% for PKT recipients (p[0.822). Survival of primary renal allograft 6 years (HR0.6, p[0.017), episodes of acute rejection (AR) (HR1.6, p[0.031), delayed graft function (DGF) (HR 2.0, p[0.005) and HLA-DR MM (HR 1.8, p[0.018) were independent predictors of long-term renal allograft failure after SKT. There was no significant difference in rates of acute rejection(15.4% vs 15.8%, p[0.843) and delayed graft function (14.1% vs 16.3%, p[0.228) when PKT and SKT were compared.CONCLUSIONS: We report the largest single centre series of patients to undergo SKT. These findings may provide important information on long-term survival outcomes after SKT and for identifying patients at risk for long-term renal allograft failure after SKT.

The aim of this study is to present the experience from a tertiary center on radical retropubic prostatectomy in renal transplant recipients (RTR) and compare surgical and long term oncological outcomes with a paired non-transplanted (NT) group. This is one of the largest cohorts of RTR submitted to radical retropubic prostatectomy.METHODS: Between 2006 and 2016, 2272 renal transplant procedures were done in our service. Twenty-two of these patients (0,9%) were diagnosed with PCa on follow up. Demographics, prostate-specific antigen (PSA), cancer characteristics and treatment were analyzed. RTR group was paired to a PCa treated nontransplant patient according to Gleason score and pathological staging. Early and late surgical complications and oncological outcomes were compared.RESULTS: Pre, post operatory and oncological data are detailed on table 1. There was no difference between groups in terms of intra operatory bleeding and need of transfusion and there was also no difference concerning erectile disfunction and incontinence rate. In RTR, there were two ureteral graft lesions intraoperatively diagnosed and promptly treated with no impact on allograft function. RTR's hospitalization time was longer. Mean follow-up time was 82 months. There was no difference with control group in terms of biochemical recurrence (8 vs 13,6, p[0.81). Cancer specific survival was 100%. Non-cancerspecific mortality was higher in RTR, mainly due to infection from different sites.CONCLUSIONS: Radical prostatectomy for PCa in RTR is safe and feasible. Oncological outcomes and complications does not appear to be different from non-transplant patients.

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