Robotic Versus Open Kidney Transplantation: A Single-Center Comparative Study of Operative Outcomes and Renal Function
TL;DR
Robotic kidney transplantation appears feasible and provides medium-term graft function comparable to that of open transplantation, and renal function became comparable between the groups by postoperative day 30 and remained similar thereafter.
Abstract
Objective: Robotic kidney transplantation (RKT) has emerged as a minimally invasive alternative to conventional open kidney transplantation (OKT). Although robotic surgery may reduce surgical trauma and improve perioperative recovery, comparative evidence between robotic and open approaches remains limited. This study aimed to compare operative characteristics, postoperative complications, and renal function trajectories between RKT and OKT in a single-center cohort. Materials and Methods: This retrospective observational study included adult patients who underwent kidney transplantation at a tertiary transplant center. Patients were categorized according to the surgical approach as OKT or RKT. Baseline characteristics, operative parameters, postoperative complications, and renal function outcomes were analyzed. Renal function was assessed using serum creatinine and estimated glomerular filtration rate (eGFR) at predefined postoperative time points for up to 1 year. Continuous variables were compared using the Mann–Whitney U test, and categorical variables were analyzed using Fisher’s exact test. Results: A total of 27 kidney transplant recipients were included, of whom 20 underwent OKT and 7 underwent RKT. Baseline characteristics were comparable between the groups. Robotic transplantation was associated with significantly longer operative and warm ischemia times, whereas estimated intraoperative blood loss was lower in the robotic group. Early postoperative renal recovery appeared slower in robotic recipients, with higher creatinine levels and lower eGFR on postoperative day 3. However, these differences diminished during follow-up, and renal function became comparable between the groups by postoperative day 30 and remained similar thereafter. Conclusion: Robotic kidney transplantation appears feasible and provides medium-term graft function comparable to that of open transplantation.