Single-center retrospective assessment of robotic-assisted simultaneous pancreas-kidney transplants: Exploring clinical utility

Mario Spaggiari; Alessandro Martinino; Egor Petrochenkov; Giulia Bencini; Jing Chen Zhang; Victor Roth Cardoso; Stepan Akshelyan; Pierpaolo Di Cocco; Jorge Almario-Alvarez; Ivo Tzvetanov; Enrico Benedetti

doi:10.1016/j.ajt.2023.12.021

Single-center retrospective assessment of robotic-assisted simultaneous pancreas-kidney transplants: Exploring clinical utility

Am J Transplant. 2023 Dec 28:S1600-6135(23)00924-3. doi: 10.1016/j.ajt.2023.12.021. Online ahead of print.

Affiliations

¹ Division of Transplantation, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois, USA.
² Division of Transplantation, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois, USA. Electronic address: alessandro.martinino@gmail.com.
³ University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA.
⁴ Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK.

PMID: 38158189
DOI: 10.1016/j.ajt.2023.12.021

Abstract

The diabetic population is witnessing a rise in obesity rates, creating specific hurdles for individuals seeking pancreas transplantation because they are frequently disqualified due to their elevated body weight. Introducing a robotic-assisted approach to transplantation has been proven to yield improved outcomes, particularly in patients with obesity. A retrospective analysis was conducted between January 2015 and September 2023. The study included a total of 140 patients, with 16 receiving robotic-assisted simultaneous pancreas-kidney transplantation (RSPK) and 124 undergoing open approach simultaneous pancreas-kidney transplantation (OSPK) during the study period. The median age was 45 (36.8-52.7) and 44.5 years (36.8-51.8) (RSPK vs OSPK, P = .487). There were no significant differences in demographics except body mass index (RSPK vs OSPK, 34.9 vs 28.1, P < .001) and a higher percentage of patients with high cardiac risk in the RSPK group. The robotic approach has a lengthier overall operative time and warm ischemia time. Surgical and nonsurgical complications at 30-days and 1-year grafts and patient survival (93.8% vs 96.8%, RSPK vs OSPK, P = .521) were similar. Our findings suggest that employing robotic assistance in simultaneous pancreas-kidney transplantation is safe. Wider adoption and utilization of this technique could potentially improve transplant accessibility for individuals with obesity and diabetes.

Keywords: diabetes; obesity; pancreas transplantation; robotics in transplantation.