Despite increasing obesity rates in the dialysis population, obese kidney transplant candidates are still denied transplantation by many centers. We performed a single-center retrospective analysis of a robotic-assisted kidney transplant (RAKT) cohort from January 2009 to December 2018. A total of 239 patients were included in this analysis. The median BMI was 41.4 kg/m2 , with the majority (53.1%) of patients being African American and 69.4% of organs sourced from living donors. The median surgery duration and warm ischemia times were 4.8 hours and 45 minutes respectively. Wound complications (mostly seromas and hematomas) occurred in 3.8% of patients, with 1 patient developing a surgical site infection (SSI). Seventeen (7.1%) graft failures, mostly due to acute rejection, were reported during follow-up. Patient survival was 98% and 95%, whereas graft survival was 98% and 93%, at 1 and 3 years respectively. Similar survival statistics were obtained from patients undergoing open transplant over the same time period from the UNOS database. In conclusion, RAKT can be safely performed in obese patients with minimal SSI risk, excellent graft function, and patient outcomes comparable to national data. RAKT could improve access to kidney transplantation in obese patients due to the low surgical complication rate.

中文翻译：

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肥胖患者的机器人肾移植：单一中心 10 年的经验。

尽管透析人群的肥胖率不断上升，但许多中心仍然拒绝对肥胖的肾移植候选者进行移植。我们对 2009 年 1 月至 2018 年 12 月的机器人辅助肾移植 (RAKT) 队列进行了单中心回顾性分析。共有 239 名患者被纳入该分析。BMI 中位数为 41.4 kg/m2，大多数 (53.1%) 患者为非裔美国人，69.4% 的器官来自活体捐献者。中位手术持续时间和热缺血时间分别为 4.8 小时和 45 分钟。3.8% 的患者发生伤口并发症（主要是血清肿和血肿），其中 1 名患者出现手术部位感染 (SSI)。随访期间报告了 17 例 (7.1%) 移植失败，主要是由于急性排斥反应。患者存活率为 98% 和 95%，而移植物在 1 年和 3 年时的存活率分别为 98% 和 93%。从 UNOS 数据库的同一时期接受开放式移植的患者获得了类似的生存统计数据。总之，RAKT 可以在肥胖患者中安全地进行，具有最小的 SSI 风险、出色的移植物功能和与国家数据相当的患者结果。由于手术并发症发生率低，RAKT 可以改善肥胖患者进行肾移植的机会。