Korean J Transplant.  2023 Nov;37(Suppl 1):S138. 10.4285/ATW2023.F-7211.

Robotic assisted kidney transplant from deceased donor: initial experience

• Moon J
• Hwang J
• Cho H
• Kim M
• Ban T
• Lim J
• Choi L
• Shin C

• KMID: 2551758
• DOI: http://doi.org/10.4285/ATW2023.F-7211

Abstract

With emerging concept of the minimally invasive procedures and the rising obesity prevalence, robotic-assisted kidney transplant (RAKT) is performed for the first time in France in 2001. During past two decades, RAKT has been proven feasible in various studies and accepted as a modality of KT besides open and laparoscopic KT. However, while other countries have reported many RAKTs performed on deceased donors, there was no report in Korea despite its eligible medical environment. This case report aims to provide an overall assessment of the preoperative evaluations, surgical techniques, and patient outcomes in the first attempt of robotic-assisted deceased donor kidney transplant in Korea. The donor was 36 years old hypoxic brain injury female who is relatively young age and had no sign of renal damage without any underlying disease (kidney donor profile index, 37%; kidney donor risk index, 0.87). While in determination of brain death, 58-year-old female patient with the chronic glomerulonephritis history was selected for recipient. The recipient had completed the work-up 3 months before the surgery through close collaboration with the nephrologist, and there was no limitation for surgery. The procedure was performed with DaVinci-Xi robotic surgical system in the manner of transperitoneal regional hypothermia (modified Vattikuti Urology Institute-Medanta technique). As the operator was expert in open KT, but not in robotic modality, operation proceeded with the assistance of an expert alongside the surgeon. The surgery was completed without any specific complications. Basiliximab was used as induction therapy, and sustained with tacrolimus and mycophenolate. The recipient was discharged on the 12th day without any abnormal finding in the ultrasound and magnetic resonance angiography. We have not done enough number of cases for establishing statistical significance, and there are some limitations such as increased rewarming time. But based on this case, with decent collaboration with the nephrologist, RAKT could be a viable option for deceased donor kidney transplant in Korea.