Yangming Tang, Haohan Zhang, Saifu Yin, Yue Li, Jun Zeng, Tao Lin, Turun Song
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All vascular reconstructions of grafts with multiple arteries were performed ex vivo on the bench in iced slush, followed by robotic anastomosis of the single reconstructed artery to the external iliac artery.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 212 living donor RAKT procedures were performed by two experienced surgeons at a single institution. Using propensity score analysis, 125 recipients of grafts with a single artery (the GSA group) were selected and compared with 25 recipients of grafts with multiple renal arteries (the GMA group). There were no significant differences in the perioperative parameters or graft function outcomes between the GMA and GSA groups. Although the median operative time and revascularization ischemia times were higher in the GMA cohort, the differences were not statistically significant (200 versus 190 min, <i>p</i> = 0.5, and 60 versus 55 min, <i>p</i> = 0.8, respectively). No major intra- or postoperative complications were recorded in the GMA cohort. 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引用次数: 0
摘要
目的：机器人辅助肾移植（RAKT）使用多动脉移植物（GMAs）是否可行很少被研究。本研究分享了我们使用活体供体gma进行RAKT的经验，重点是评估技术可行性和早期术后结果。材料和方法：在2020年7月至2024年1月期间，我们前瞻性地收集了本中心连续接受活体供体RAKT的患者的数据。我们回顾性分析了使用单动脉（GSA）或GMAs移植物进行RAKT的患者的临床资料。所有多动脉移植血管的体外重建均在冰冻泥中进行，然后将单个重建动脉与髂外动脉进行机器人吻合。结果：共有212例活体供体RAKT手术由两名经验丰富的外科医生在同一家机构完成。采用倾向评分分析，选择125例单动脉移植受者（GSA组）与25例多肾动脉移植受者（GMA组）进行比较。GMA组和GSA组围手术期参数和移植物功能结果无显著差异。虽然GMA组中位手术时间和血运重建缺血时间较高，但差异无统计学意义（分别为200 vs 190 min， p = 0.5, 60 vs 55 min, p = 0.8）。在GMA队列中没有记录到重大的手术内或术后并发症。此外，在随访期间，两组均未发生移植物丢失或死亡。结论：本研究是利用GMAs进行活体供体RAKT的最大单中心研究，证明了该方法的技术可行性，可实现最佳的围手术期和早期功能结果。试验注册：ClinicalTrials.gov标识符：NCT06577805。
The Early Outcomes of Robotic-Assisted Kidney Transplantation Using Grafts With Multiple Arteries From a High-Volume Center: A Retrospective Cohort Study
Purpose
Whether robot-assisted kidney transplantation (RAKT) using grafts with multiple arteries (GMAs) is feasible has rarely been examined. This study shares our experience with RAKT using GMAs from living donors, focusing on assessing the technical feasibility and early postoperative outcomes.
Materials and Methods
Between July 2020 and January 2024, we prospectively collected data from consecutive patients undergoing living donor RAKT in our center. We retrospectively analyzed the clinical data of patients who underwent RAKT using grafts with a single artery (GSA) or GMAs. All vascular reconstructions of grafts with multiple arteries were performed ex vivo on the bench in iced slush, followed by robotic anastomosis of the single reconstructed artery to the external iliac artery.
Results
A total of 212 living donor RAKT procedures were performed by two experienced surgeons at a single institution. Using propensity score analysis, 125 recipients of grafts with a single artery (the GSA group) were selected and compared with 25 recipients of grafts with multiple renal arteries (the GMA group). There were no significant differences in the perioperative parameters or graft function outcomes between the GMA and GSA groups. Although the median operative time and revascularization ischemia times were higher in the GMA cohort, the differences were not statistically significant (200 versus 190 min, p = 0.5, and 60 versus 55 min, p = 0.8, respectively). No major intra- or postoperative complications were recorded in the GMA cohort. Additionally, there were no instances of graft loss or mortality during the follow-up period in either group.
Conclusions
This study, the largest single-center study of RAKT from living donors utilizing GMAs, demonstrates the technical feasibility of this approach, achieving optimal perioperative and early functional outcomes.
期刊介绍：
Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored.
Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include:
Immunology and immunosuppression;
Patient preparation;
Social, ethical, and psychological issues;
Complications, short- and long-term results;
Artificial organs;
Donation and preservation of organ and tissue;
Translational studies;
Advances in tissue typing;
Updates on transplant pathology;.
Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries.
Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.
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