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The following is a summary of “A comparative study on outcomes of ABO-incompatible kidney transplants between robot-assisted vs. open surgery-propensity score-matched analysis: a retrospective cohort study,” published in the November 2024 issue of Nephrology by Kim et al. 

Robot-assisted kidney transplantation (RAKT) is gaining popularity, but its effectiveness in immunologically high-risk patients remains underexplored compared to conventional open kidney transplantation (OKT). 

Researchers conducted a retrospective study to compare the outcomes of RAKT and OKT in ABO incompatibility (ABOi) kidney transplant recipients. 

They conducted a retrospective, single-center study of 239 living-donor transplants from October 2020 to February 2023, including 210 ABOi-OKT and 29 patients with ABOi-RAKT. They analyzed a composite of biopsy-proven acute rejection, graft failure, and de novo donor-specific antibodies using univariate and multivariate models, with propensity score matching (PSM) resulting in 131 OKT and 26 RAKT cases for comparison. 

The results showed no significant difference in 1-year (RAKT: 92.4%, OKT: 93.1%) and two-year BPAR-free survival rates (RAKT: 92.4%, OKT: 91.9%). Mean eGFR at 12 months was similar (RAKT: 62.15 ml/min/1.73 m², OKT: 64.53 ml/min/1.73 m²), but operative and cold ischemic times were longer for RAKT (291.42 vs. 150.81 min, P < 0.001; 119.77 vs. 47.22 min, P < 0.001). Hospital stays were shorter for RAKT (6 vs. 8 days, P < 0.001). There was no significant difference in the composite outcome of BPAR, graft failure, and de novo donor-specific antibodies (HR 0.858, P = 0.848). 

They concluded that RAKT was a safe and effective alternative to OKT for patients with ABOi, with similar outcomes. PSM confirmed its viability for high-risk recipients. 

Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03842-1