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Der Urologe. Ausg. A
Dec, 2020;59 (12): 1512-1518.

[The first 50 robot-assisted donor nephrectomies : Lessons learned].

Philip Zeuschner, Stefan Siemer, Michael Stöckle, Matthias Saar
Author Information
  1. Philip Zeuschner: Klinik für Urologie und Kinderurologie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Kirrberger Straße 100, 66421, Homburg/Saar, Deutschland. philip.zeuschner@uks.eu.
  2. Stefan Siemer: Klinik für Urologie und Kinderurologie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Kirrberger Straße 100, 66421, Homburg/Saar, Deutschland.
  3. Michael Stöckle: Klinik für Urologie und Kinderurologie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Kirrberger Straße 100, 66421, Homburg/Saar, Deutschland.
  4. Matthias Saar: Klinik für Urologie und Kinderurologie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Kirrberger Straße 100, 66421, Homburg/Saar, Deutschland.
PMID: 32780177 DOI: 10.1007/s00120-020-01302-w

Abstract

BACKGROUND: Minimally invasive donor nephrectomy (DN) is considered the gold standard, but the role of robot-assisted surgery is still controversial.
OBJECTIVES: The first 50 robot-assisted DN (RDN) of a urologic transplant department in Germany were retrospectively analyzed.
MATERIALS AND METHODS: Patient characteristics as well as intra- and postoperative surgical parameters were obtained. The kidney function of the donor was assessed within 5 years of follow-up. Predictors of postoperative kidney function at discharge and 1 year after RDN were estimated by multivariate regression analysis.
RESULTS: RDN has an excellent surgical outcome with low complication rates, short warm (WIT) and cold ischemia time (CIT), little blood loss, and short patient stay. The side of donor nephrectomy does not affect surgical outcome. After RDN, 50% of donors suffer from mild to moderate renal insufficiency without further consequences, as their kidney function does not further decrease. Preoperative eGFR (estimated glomerular filtration rate) and donor age at surgery are the best predictors of postoperative kidney function after RDN.
CONCLUSIONS: Robot-assisted donor nephrectomy is an excellent alternative to other minimally invasive approaches rendering solid surgical results possible right from the start.

Keywords

Kidney transplantation Living kidney donation Minimally-invasive surgical procedures Robot-assisted donor nephrectomy Robot-assisted surgery

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MeSH Term

Germany
Humans
Kidney
Laparoscopy
Living Donors
Nephrectomy
Retrospective Studies
Robotics
Tissue Donors
Treatment Outcome
Journal Article

Word Cloud

Created with Highcharts 10.0.0donorRDNsurgicalkidneynephrectomyfunctionsurgerypostoperativeRobot-assistedinvasiveDNfirst50 robot-assistedestimatedexcellentoutcomeshortBACKGROUND:Minimallyconsideredgoldstandardrolerobot-assistedstillcontroversialOBJECTIVES:a urologictransplantdepartmentGermanyretrospectivelyanalyzedMATERIALSANDMETHODS:Patientcharacteristicswellintra-parametersobtainedassessedwithin5 yearsfollow-upPredictorsdischarge1 yearmultivariateregressionanalysisRESULTS:lowcomplicationrateswarmWITcoldischemiatimeCITlittlebloodlosspatientstaysideaffect50%donorssuffermildmoderaterenalinsufficiencywithoutconsequencesdecreasePreoperativeeGFRglomerularfiltrationrateagebestpredictorsCONCLUSIONS:alternativeminimallyapproachesrenderingsolidresultspossiblerightstart[Thenephrectomies:Lessonslearned]KidneytransplantationLivingdonationMinimally-invasiveprocedures

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