Robot-assisted kidney transplant (RAKT) recently proved to provide functional results similar to the preferred open kidney transplant (OKT), but with inferior wound morbidity. In a comparative prospective study, we explored the systemic inflammatory response syndrome (SIRS) after KT and compared OKT with RAKT.
Forty-nine patients underwent pre-emptive ABO-compatible kidney transplantations (KT) between January 2017 and December 2018 in 2 centers: 25 RAKT, 24 OKT. Postoperative SIRS was biologically assessed by serum markers (NGAL, CRP and IL-6) measured at: T0 (preoperative/baseline), T1(H1), T2(H6), T3(H12), T4(H24), T5(D2), T6(D3) and T7(D5) after KT.
Inflammatory markers + eGFR were assessed in OKT vs. RAKT. IL-6 peak value occurred at H6 and reached ×9 from baseline. CRP peak occurred at H24 and reached ×28 from baseline (All P < 0.05). NGAL decreased after surgery with a plateau (divided by 2 from baseline) from H12 to D5. There was no significant difference in IL-6, CRP and NGAL kinetics and peak values between RAKT and OKT (All P > 0.05). Serum creatinine and eGFR on postoperative days 1, 3 and 7 were similar in RAKT and OKT (All P > 0.05). Delayed graft function was not observed.
In this exploratory study, the biological evaluation of postoperative SIRS after living-donor kidney transplant revealed no significant difference between OKT and RAKT and similar functional outcomes in the short term. These results highlight the safety of RAKT as an alternative to OKT in this setting.
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Robot-assisted kidney transplantation
Open kidney transplantation
Systemic inflammatory response syndrome
Neutrophil gelatinase-associated lipocalin
Estimated glomerular filtration rate
Ethylene diamine tetra-acetic acid
Compensatory anti-inflammatory response syndrome
Multiple organ dysfunction syndrome
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We are grateful to Dr. S. Mateu (clinical research coordinator at Fundaciò Puigvert) for institutional review board approval and the European Association of Urology Scholarship Program (EUSP) to support this study.
Angelo Territo, Federica Regis and Romain Boissier received grants from the European Urology Scholarship Program (EUSP) for 1 year scholarships, respectively, from December 2016 to December 2017, January 2018 to December 2018, and September 2018 to August 2019, at Fundació Puigvert (Barcelona, Spain) where this study was conducted.
Conflict of interest
All authors certify that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (e.g., employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: None.
Research involving human participants and/or animals
The study adhered to the tenets of the Declaration of Helsinki. The study was approved by the ethics committee of Fundació Puigvert. The study also guaranteed compliance at all times with Law 15/1999 for the Protection of Personal Data (Spanish Government).
Informed consent was obtained from all patients prior to inclusion in the study.
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Territo, A., Boissier, R., Subiela, J.D. et al. Prospective comparative study of postoperative systemic inflammatory syndrome in robot-assisted vs. open kidney transplantation. World J Urol (2021). https://doi.org/10.1007/s00345-021-03836-w
- Kidney transplant
- Robot-assisted kidney transplantation
- Open kidney transplantation
- Inflammatory biomarkers