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Minimally invasive, robot-assisted procedure for kidney transplantation among morbidly obese: Positive outcomes at 5 years post-transplant.
Spaggiari, Mario; Lendacki, Frances Rose; Di Bella, Caterina; Giulianotti, Pier Cristoforo; Benedetti, Enrico; Oberholzer, Jose; Tzvetanov, Ivo.
Afiliação
  • Spaggiari M; Division of Transplantation, University of Illinois at Chicago, Chicago, Illinois.
  • Lendacki FR; Division of Transplantation, University of Illinois at Chicago, Chicago, Illinois.
  • Di Bella C; Division of Transplantation, University of Illinois at Chicago, Chicago, Illinois.
  • Giulianotti PC; Division of Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois.
  • Benedetti E; Division of Transplantation, University of Illinois at Chicago, Chicago, Illinois.
  • Oberholzer J; Division of Transplant, Department of Surgery, University of Virginia Health System, Charlottesville, Virginia.
  • Tzvetanov I; Division of Transplantation, University of Illinois at Chicago, Chicago, Illinois.
Clin Transplant ; 32(11): e13404, 2018 11.
Article em En | MEDLINE | ID: mdl-30216555
ABSTRACT
The pre-transplant weight loss required of end-stage renal disease patients is often unachievable. Though robot-assisted procedures among extremely obese have shown minimal complication, long-term outcomes are understudied. Previously, we reported no difference in 6-month patient and graft survival among 28 robot-assisted transplant cases (2009-2013) and 28 open controls (2004-2010). Groups were frequency-matched on age, sex, race, donor compatibility, disease, and dialysis history. Cases had greater median pre-transplant body mass index (BMI; 42.3 (31.1-64.3) vs 36.8 (30.0-51.1)). Here, we compared patient and graft survival through 5 years post-transplant. Infection, wound complications, and significant re-hospitalizations were collected. One-, three-, and five-year graft survival were 100%, 100%, and 89.3% among cases, and 96.4%, 85.7%, and 78.6% among controls. Rejection within 1 year was greater among cases (11 vs 8). Five-year rates were similar (P = 0.54). Post-transplant BMI remained comparable. No cases and eight controls experienced surgical site infection (SSI). Two cases and one control experienced hernias. Post-transplant diabetes was documented among five cases and six controls. Three deaths occurred among cases, two among controls. This is the most extensive known follow-up of such obese recipients of robot-assisted transplant. Our procedure is a promising pathway to transplant and decreased mortality for those deemed too high risk for conventional surgery.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Obesidade Mórbida / Robótica / Transplante de Rim / Procedimentos Cirúrgicos Minimamente Invasivos / Rejeição de Enxerto / Falência Renal Crônica Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Revista: Clin Transplant Assunto da revista: TRANSPLANTE Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Obesidade Mórbida / Robótica / Transplante de Rim / Procedimentos Cirúrgicos Minimamente Invasivos / Rejeição de Enxerto / Falência Renal Crônica Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Revista: Clin Transplant Assunto da revista: TRANSPLANTE Ano de publicação: 2018 Tipo de documento: Article