Robot-assisted kidney transplantation for right versus left living donor kidneys: A single-center outcome and learning curve analysis.
5 affiliations
- 1Department of Urology, Kidney Care Centre, Tirunelveli, Tamil Nadu, India.
- 2Department of Urology, Smt. G R Doshi and Smt. K M Mehta Institute of Kidney Diseases and Research Center and Dr. H L Trivedi Institute of Transplantation, Ahmedabad, Gujarat, India.
- 3Department of Nephrology, Smt. G R Doshi and Smt. K M Mehta Institute of Kidney Diseases and Research Center and Dr. H L Trivedi Institute of Transplantation, Ahmedabad, Gujarat, India.
- 4Anesthesiology, Smt. G R Doshi and Smt. K M Mehta Institute of Kidney Diseases and Research Center and Dr. H L Trivedi Institute of Transplantation, Ahmedabad, Gujarat, India.
- 5Department of Urology, Continental Hospitals, Hyderabad, Telangana, India.
Abstract
Introduction
Robot-assisted kidney transplantation (RAKT) is the standard of care in experienced hands. Transplantation of right kidney (RK) from a living donor (LD) is challenging because the right renal vein is shorter and thinner, which can lead to underutilization of RKs from LD. Data for RK-RAKT are scarce. We aim to compare the surgical, peri-operative, and long-term outcomes after RAKT from RK donors versus left kidney (LK) donors and the learning curve (LC) for the entire RAKT cohort.Methods
After ethical committee approval, we retrospectively analyzed 409 adult RAKTs from LDs performed by a single surgeon between 2013 and 2021. We compared donor/recipient demographics, intra-operative data, immediate and late graft function, and graft/patient survival.Results
Overall, 18.5% were RK-RAKT. Donor/recipient demographics were similar between the groups. Total vascular (32.9 ± 8.9 vs. 29.6 ± 5.8 min, P = 0.003) and venous anastomosis times (14.4 ± 6.1 vs. 11.4 ± 2.5 min, P < 0.0001) were significantly longer in the RK group. No significant differences were observed in the serum creatinine and estimated glomerular filtration rate levels at day 1 and 7; 1 month; 1, 3, 5, 7, 10 years. 10-year Death-censored graft survival (77.4% for left vs. 79.17% for right, P = 0.917) and patient survival (83.9% for left vs. 75% for right, P = 0.10) were comparable. LC was shorter for critical vascular steps and graft functional outcomes.Conclusions
RK-RAKT achieves equivalent functional and survival outcomes to LK-RAKT. Concerns regarding vascular thrombosis are not supported by our findings. These results advocate for broader use of RK, potentially decreasing the wait times and improving the access to transplantation.
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BibTeX
@article{prasad2026robotassisted,
title = {{Robot-assisted kidney transplantation for right versus left living donor kidneys: A single-center outcome and learning curve analysis.}},
author = {S R Prasad and Pranjal R Modi and Suresh Kumar and Rohit Chauhan and Himanshu V Patel and Vivek B Kute and Beena Kandarpkumar Parikh and Manisha P Modi and V Spurthi and Virendra K Soni and Syed J Rizvi},
journal = {Indian journal of urology : IJU : journal of the Urological Society of India},
year = {2026},
month = sep,
doi = {10.4103/iju.iju_283_26},
url = {https://europepmc.org/article/MED/42910396},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Robot-assisted kidney transplantation for right versus left living donor kidneys: A single-center outcome and learning curve analysis.
AU - S R Prasad
AU - Pranjal R Modi
AU - Suresh Kumar
AU - Rohit Chauhan
AU - Himanshu V Patel
AU - Vivek B Kute
AU - Beena Kandarpkumar Parikh
AU - Manisha P Modi
AU - V Spurthi
AU - Virendra K Soni
AU - Syed J Rizvi
PY - 2026
DA - 2026/09/29
JO - Indian journal of urology : IJU : journal of the Urological Society of India
DO - 10.4103/iju.iju_283_26
UR - https://europepmc.org/article/MED/42910396
AB - Introduction Robot-assisted kidney transplantation (RAKT) is the standard of care in experienced hands. Transplantation of right kidney (RK) from a living donor (LD) is challenging because the right renal vein is shorter and thinner, which can lead to underutilization of RKs from LD. Data for RK-RAKT are scarce. We aim to compare the surgical, peri-operative, and long-term outcomes after RAKT from RK donors versus left kidney (LK) donors and the learning curve (LC) for the entire RAKT cohort.Methods After ethical committee approval, we retrospectively analyzed 409 adult RAKTs from LDs performed by a single surgeon between 2013 and 2021. We compared donor/recipient demographics, intra-operative data, immediate and late graft function, and graft/patient survival.Results Overall, 18.5% were RK-RAKT. Donor/recipient demographics were similar between the groups. Total vascular (32.9 ± 8.9 vs. 29.6 ± 5.8 min, P = 0.003) and venous anastomosis times (14.4 ± 6.1 vs. 11.4 ± 2.5 min, P < 0.0001) were significantly longer in the RK group. No significant differences were observed in the serum creatinine and estimated glomerular filtration rate levels at day 1 and 7; 1 month; 1, 3, 5, 7, 10 years. 10-year Death-censored graft survival (77.4% for left vs. 79.17% for right, P = 0.917) and patient survival (83.9% for left vs. 75% for right, P = 0.10) were comparable. LC was shorter for critical vascular steps and graft functional outcomes.Conclusions RK-RAKT achieves equivalent functional and survival outcomes to LK-RAKT. Concerns regarding vascular thrombosis are not supported by our findings. These results advocate for broader use of RK, potentially decreasing the wait times and improving the access to transplantation.
SN - 0970-1591
SN - 1998-3824
ER -