Introducing robot‐assisted laparoscopic donor nephrectomy after experience in retroperitoneal endoscopic approach: a matched propensity score analysis

Abstract

Objectives: To assess the safety and efficacy of introducing robotic-assisted laparoscopic donor nephrectomy (RALDN) to the standard retroperitoneal endoscopic donor nephrectomy (REDN). Methods: Data were collected prospectively from 124 consecutive living kidney donors (93 for REDN subgroup and 31 for RALDN subgroup) from February 2018 to December 2020. Donor baseline demographics, perioperative outcomes and recipient outcomes were recorded, and these parameters were compared between the two subgroups before and after propensity-score matching. Results: Mean age was 51.1 AE 9.1 years; 42.7% were males; mean body mass index was 22.7 AE 2.4; and there were 109 (88%) left kidneys. The following data of REDN and RALDN was, respectively, recorded: operative time (213 AE 43 versus 216 AE 39 min, p = 0.721), warm ischemic time (4.7 AE 1.2 versus 4.9 AE 1.4 min, p = 0.399), postoperative complications (5.4% versus 6.5%, p = 1), haemoglobin (g/L) drop (9.4 AE 7.2 versus 9.7 AE 6.6, p = 0.836), blood creatinine at 6 month (1.15 AE 0.23 versus 1.13 AE 0.24 mg/dL, p = 0.734) and at 1 year (1.09 AE 0.22 versus 1.17 AE 0.28 mg/dL, p = 0.591). In postpropensity score matched analyses, there was no significant differences between the two groups including intraoperative and postoperative complications. Conclusions: RALDN could be safely introduced into a living donor program experienced in laparoscopic donor nephrectomy. The outcomes of our study comparing these minimally invasive techniques are mostly similar in terms of intraoperative and postoperative outcomes for kidney donors.Abbreviations: ASA American society of anesthesiologists; BMI body mass index; eGFR estimated glomerular filtration rate; HLA Human Leukocyte Antigens; RALDN Robotic-assisted laparoscopic donor nephrectomy; REDN Retroperitoneal endoscopic donor nephrectomy; SCr serum creatinine.Bold values are p-value less than 0.05 and are considered statistically significant.