Robot-assisted Kidney Transplantation from Deceased Donor: The European Experience

Background and objective: In the context of deceased donors (DDs), roboticassisted kidney transplantation (RAKT) is underutilized due to specific logistical and technical challenges. The aim of this study was to report the outcomes of DD-RAKT performed in centers involved in the European Association of Urology Robotic Urology Section (ERUS)-RAKT working group. Methods: This retrospective analysis is based on a prospectively collected multicenter database including data on DD-RAKT performed at seven referral ERUS-RAKT European centers from July 2015 to April 2024. Intraoperative, perioperative, and midterm functional outcomes after DD-RAKT were assessed. The decision-making strategy regarding the selection of a robotic versus an open surgical approach for kidney transplantation was also reported across the included centers. Key findings and limi terquartile range [I after brain death (8 (10.4%); there were time was 14.8 h (IQ while 59 patients ( and the median re (IQR: 42–60), res (Clavien-Dindo 3) enced delayed graft tations: A total of 67 patients with a median age of 36 yr (inQR]: 24–58) underwent DD-RAKT. Most donors were donors 0.6%), followed by donors after uncontrolled circulatory death 26 ‘‘expanded criteria’’ donors (39%). The median cold ischemia R: 11.0–19.0). Eight patients (11.9%) had orthotopic DD-RAKT, 88.1%) had heterotopic DD-RAKT. The median operative time warming time were 220 min (IQR: 180.0–252.0) and 50 min pectively. The major postoperative surgical complications occurred in 11 patients (16%). Eighteen patients (27%) experifunction. At a median follow-up of 27.1 mo (IQR: 9.5–59.4)