1
|
López-Abad A, Piana A, Prudhomme T, Bañuelos Marco B, Dönmez MI, Pecoraro A, Boissier R, Campi R, Breda A, Territo A. Biomarkers in kidney transplantation: Where do we stand? Actas Urol Esp 2024; 48:407-409. [PMID: 38185319 DOI: 10.1016/j.acuroe.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 10/20/2023] [Indexed: 01/09/2024]
Affiliation(s)
- A López-Abad
- Servicio de Urología, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | - A Piana
- Servicio de Urología, Hospital San Luigi, Universidad de Turín, Turín, Italy
| | - T Prudhomme
- Servicio de Urología, Trasplante Renal y Andrología, Hospital Universitario de Rangueil, Toulouse, France
| | - B Bañuelos Marco
- Servicio de Urología, Sección de Trasplante Renal y Urología Reconstructiva, Hospital Universitario Clínico San Carlos, Madrid, France
| | - M I Dönmez
- Departamento de Urología, Facultad de Medicina, Universidad de Estambul, Estambul, Turkey
| | - A Pecoraro
- Unidad de Cirugía Robótica Urológica y Trasplante Renal, Universidad de Florencia, Hospital de Careggi, Florencia, Italy
| | - R Boissier
- Servicio de Urología y Trasplante Renal, Hospital Universitario de La Conception, Marsella, France
| | - R Campi
- Unidad de Cirugía Robótica Urológica y Trasplante Renal, Universidad de Florencia, Hospital de Careggi, Florencia, Italy
| | - A Breda
- Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - A Territo
- Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain.
| |
Collapse
|
2
|
Malinzak L, Gartrelle K, Sragi Z, Segal A, Prashar R, Jesse MT. Access to robotic assisted kidney transplant for recipients: a systematic review and call for reporting standards. J Robot Surg 2024; 18:239. [PMID: 38833043 DOI: 10.1007/s11701-024-01927-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 03/24/2024] [Indexed: 06/06/2024]
Abstract
Robot-assisted kidney transplantation (RAKT) is a relatively novel, minimally invasive option for kidney transplantation. However, clarity on recipient selection in the published literature is lacking thereby significantly limiting interpretation of safety and other outcomes. This systematic review aimed to identify and synthesize the data on selection of RAKT recipients, compare the synthesized data to kidney transplant recipients across the USA, and explore geographical clusters of availability of RAKT. Systematic literature review, in accordance with PRISMA, via OVID MEDLINE, Embase, and Web of science from inception to March 5, 2023. All data entry double blinded and quality via Newcastle Ottawa Scale. 44 full-text articles included, encompassing approximately 2402 kidney transplant recipients at baseline but with considerable suspicion for overlap across publications. There were significant omissions of information across studies on patient selection for RAKT and/or analysis. Overall, the quality of studies was very low. Given suspicion of overlap across studies, it is difficult to determine how many RAKT recipients received living (LD) versus deceased donor (DD) organs, but a rough estimate suggests 89% received LD. While the current RAKT literature provides preliminary evidence on safety, there are significant omissions in reporting on patient selection for RAKT which limits interpretation of findings. Two recommendations: (1) international consensus is needed for reporting guidelines when publishing RAKT data and (2) larger controlled trials consistently reporting recipient characteristics are needed to clearly determine selection, safety, and outcomes across both LD and DD recipients.
Collapse
Affiliation(s)
- Lauren Malinzak
- Henry Ford Health, Transplant Institute, 2799 West Grand Boulevard, Clara Ford Pavilion, Detroit, MI, 48202, USA.
| | - Kendyll Gartrelle
- Henry Ford Health, Transplant Institute, 2799 West Grand Boulevard, Clara Ford Pavilion, Detroit, MI, 48202, USA
| | - Zara Sragi
- Henry Ford Health, Transplant Institute, 2799 West Grand Boulevard, Clara Ford Pavilion, Detroit, MI, 48202, USA
| | - Antu Segal
- Henry Ford Health, Transplant Institute, 2799 West Grand Boulevard, Clara Ford Pavilion, Detroit, MI, 48202, USA
| | - Rohini Prashar
- Henry Ford Health, Transplant Institute, 2799 West Grand Boulevard, Clara Ford Pavilion, Detroit, MI, 48202, USA
| | - Michelle T Jesse
- Henry Ford Health, Transplant Institute, 2799 West Grand Boulevard, Clara Ford Pavilion, Detroit, MI, 48202, USA
| |
Collapse
|
3
|
Caamiña L, Pietropaolo A, Basile G, Dönmez MI, Uleri A, Territo A, Fraile P. Does obesity really affect renal transplantation outcomes? Actas Urol Esp 2024; 48:125-133. [PMID: 37604402 DOI: 10.1016/j.acuroe.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 08/23/2023]
Abstract
INTRODUCTION Kidney transplantation is the treatment of choice for patients with stage 5 chronic kidney disease (CKD). About 60% of CKD patients are overweight or obese at the time of kidney transplantation, and post-transplant obesity occurs in 50% of patients, with a weight gain of 10% in the first year and high risk of cardiovascular mortality. Obesity is associated with an increased risk of delayed graft function (DGF), acute rejection, surgical complications, graft loss and mortality. The aim of this study is to assess the clinical evolution of obese and overweight patients that have received a kidney transplant, based on short- and long-term complications associated with a higher BMI. MATERIAL AND METHODS A descriptive, observational, cross-sectional study was conducted with 104 kidney or pancreas-kidney transplant patients between March 2017 and December 2020, with a follow-up until April 2021. For comparative analysis, patients were grouped according to BMI. RESULTS Mean age was of 56.65 years, 60.6% male and 39.4 % female. Overweight patients experienced prolonged surgeries, more surgical wound dehiscence, delayed graft function, hernias, proteinuria and more indications for renal biopsies. Additionally, obese patients displayed more DGF, indications for renal biopsies, proteinuria, development of diabetes mellitus, atrial fibrillation and needed prolonged hospital stays. CONCLUSIONS Despite a high prevalence of comorbidity in the overweight and/or obese population, we found no reduction in patient and/or graft survival. However, longer follow-up is needed.
Collapse
Affiliation(s)
- L Caamiña
- Nefrología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain; Urología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain; Servicio de Urología, Hospital Universitario de Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - A Pietropaolo
- Servicio de Urología, Hospital Universitario de Southampton NHS Foundation Trust, Southampton, United Kingdom; Grupo de trabajo de Trasplante Renal y grupo de trabajo de Urolitiasis y Endourología de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands.
| | - G Basile
- Grupo de trabajo de Trasplante Renal y grupo de trabajo de Urolitiasis y Endourología de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands; Servicio de Urología, Fundación Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - M I Dönmez
- Grupo de trabajo de Trasplante Renal y grupo de trabajo de Urolitiasis y Endourología de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands; Servicio de Urología, Facultad de Medicina de Estambul, Universidad de Estambul, Estambul, Turkey
| | - A Uleri
- Grupo de trabajo de Trasplante Renal y grupo de trabajo de Urolitiasis y Endourología de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands; Servicio de Urología, Fundación Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - A Territo
- Grupo de trabajo de Trasplante Renal y grupo de trabajo de Urolitiasis y Endourología de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands; Servicio de Urología, Fundación Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - P Fraile
- Nefrología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| |
Collapse
|
4
|
Territo A, Bajeot AS, Mesnard B, Campi R, Pecoraro A, Hevia V, Piana A, Doumerc N, Breda A, Boissier R, Prudhomme T. Open versus robotic-assisted kidney transplantation: A systematic review by the European Association of Urology (EAU) - Young Academic Urologists (YAU) Kidney Transplant Working Group. Actas Urol Esp 2023; 47:474-487. [PMID: 36965855 DOI: 10.1016/j.acuroe.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 03/27/2023]
Abstract
INTRODUCTION In the last 20 years, robotic assisted procedures were evaluated in the field of kidney transplantation to provide a mini-invasive approach for this particularly fragile population. As a relatively new issue, few studies compared open kidney transplantation (OKT) and robotic-assisted kidney transplantation (RAKT), mostly in small cohorts. To improve current knowledge, we wanted here to gather comparative data of OKT vs RAKT in a systematic review. METHODS A systematic review was performed according to preferred reporting items for systematic reviews and meta-analyses. Medline, Embase, and Cochrane databases were searched to identify all studies reporting post-operative outcomes of RAKT versus OKT. RESULTS A total of 2136 patients in 13 studies were included. Median recipient age was 42.6 years (OKT: 43.5 years and RAKT: 40.3 years). Median preemptive kidney transplantation rate was 27.1 % (OKT: 23.3 % and RAKT: 33.2 %). Median total operative time and rewarming were respectively: 235 and 49 min in OKT population; 250 and 60 min in RAKT population. Post-operative complications rates were: 26.2 % in OKT population and 17.8 % in RAKT population. Delayed graft function rates were: 4.9 % in OKT population and 2.3 in RAKT population. Mid-term functional outcomes, patient and graft survival were similar in OKT and RAKT population. CONCLUSION This systematic review showed that RAKT may be associated with a lower incidence of delayed graft function and post-operative surgical complications and similar mid-term functional outcomes, patient and graft survival, compared to OKT for end-stage renal disease patients.
Collapse
Affiliation(s)
- A Territo
- Uro-oncology and Kidney Transplant Unit, Department of Urology at "Fundació Puigvert" Hospital, Autonoma University of Barcelona, Barcelona, Spain
| | - A S Bajeot
- Department of Urology and Kidney Transplantation, Rangueil University Hospital, Toulouse, France
| | - B Mesnard
- Department of Urology and Kidney Transplantation, Nantes University Hospital, Nantes, France
| | - R Campi
- Department of Urology, Florence University Hospital, Florence, Italy
| | - A Pecoraro
- Department of Urology, Florence University Hospital, Florence, Italy
| | - V Hevia
- Department of Urology, University Hospital Ramón y Cajal, Madrid, Spain
| | - A Piana
- Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - N Doumerc
- Department of Urology and Kidney Transplantation, Rangueil University Hospital, Toulouse, France
| | - A Breda
- Uro-oncology and Kidney Transplant Unit, Department of Urology at "Fundació Puigvert" Hospital, Autonoma University of Barcelona, Barcelona, Spain
| | - R Boissier
- Department of Urology, La Conception University Hospital, Marseille, France
| | - T Prudhomme
- Department of Urology and Kidney Transplantation, Rangueil University Hospital, Toulouse, France.
| |
Collapse
|
5
|
Andras I, Pecoraro A, Piana A, Prudhomme T, Campi R, Hevia V, Boissier R, Crisan N, Breda A, Territo A. Aims and limits to compare open vs. robotic assisted kidney transplantation. Actas Urol Esp 2023; 47:193-194. [PMID: 36372359 DOI: 10.1016/j.acuroe.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 10/11/2022] [Indexed: 05/05/2023]
Affiliation(s)
- I Andras
- Urology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Urology Department, Clinical Municipal Hospital, Cluj-Napoca, Romania.
| | - A Pecoraro
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy
| | - A Piana
- Department of Urology, San Luigi Gonzaga Hospital, Univerity of Turin, Orbassano, Turin, Italy
| | - T Prudhomme
- Department of Urology and Kidney Transplantation, Toulouse University Hospital, Toulouse, France
| | - R Campi
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - V Hevia
- Hospital Universitario Ramón y Cajal, Alcala University, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | - R Boissier
- Service de Chirurgie Urologique et de Transplantation Renale, CHU Conception, Aix-Marseille Universite, Marseille, France
| | - N Crisan
- Urology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Urology Department, Clinical Municipal Hospital, Cluj-Napoca, Romania
| | - A Breda
- Departement of Urology, Fundacio Puigvert, Autonomous University of Barcelona, Barcelona, Spain
| | - A Territo
- Departement of Urology, Fundacio Puigvert, Autonomous University of Barcelona, Barcelona, Spain
| |
Collapse
|
6
|
Andras I, Pecoraro A, Piana A, Prudhomme T, Campi R, Hevia V, Boissier R, Crisan N, Breda A, Territo A. Objetivos y limitaciones al comparar el trasplante renal abierto frente al asistido por robot. Actas Urol Esp 2023. [DOI: 10.1016/j.acuro.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
|