Robotically procured living donor kidneys transplanted into pediatric recipients

Area of Science:

• Pediatric Nephrology
• Transplant Surgery
• Robotic Surgery

Background:

• Living donor kidney transplantation offers optimal outcomes for pediatric recipients.
• Robotic-assisted living donor nephrectomy is a safe and feasible procedure.
• This technique can potentially expand the living donor pool for pediatric kidney transplants, including those with anatomical variants.

Purpose of the Study:

• To evaluate the safety and feasibility of robotically procured living donor kidney grafts in pediatric recipients.
• To assess the outcomes of pediatric kidney transplants utilizing grafts with anatomical variants requiring reconstruction.

Main Methods:

• Retrospective review of pediatric patients (≤18 years) receiving open kidney transplants with robotically procured living donor grafts.
• Analysis of recipient and donor demographics, peri-operative data, and graft characteristics.
• Evaluation of graft reconstruction, ischemia times, and post-transplant complications.

Main Results:

• Eight pediatric recipients (mean age 11 years) received transplants.
• Four grafts required back-table reconstruction, including vascular reconstruction for anatomical variants.
• No delayed graft function or post-operative vascular/urological complications were observed.
• Mean serum creatinine levels remained stable post-transplant.

Conclusions:

• Robotically procured living donor kidney grafts are a safe and feasible option for pediatric kidney transplantation.
• Utilizing grafts with vascular abnormalities after reconstruction does not increase complication risk.
• This approach can significantly expand the donor pool for pediatric transplant candidates.