Robot-Assisted Kidney Transplantation: Initial Experience with a Modified Hypothermia Technique

Introduction: The aim of the study was to report our initial experience of robot-assisted kidney transplantation (RAKT) with a modified hypothermia technique. Methods: Between March 2018 and May 2020, 12 patients with end-stage renal disease underwent RAKT at the Chinese PLA General Hospital, and a modified regional hypothermia was implemented by wrapping the kidney in a sealed plastic jacket filled with ice slush. Baseline, surgical, and functional outcomes were analyzed. Results: All surgeries were successfully performed. The mean operative time was 180.5 min, with a mean console time of 133.3 min. Mean warm ischemia, cold ischemia, and rewarming times were 1.5, 135.1, and 48.4 min, respectively. The median blood loss was 50 mL, and the median hospital stay was 9.5 days. No complications were observed. The mean serum creatinine levels were 119.4, 100.5, 108, and 108.5 μmol/L 7 days, 1 month, 6 months, and 1 year postoperatively, respectively. All patients and grafts survived at a median follow-up of 32.2 months. Conclusion: RAKT is a safe and feasible procedure for surgical teams with expertise in open kidney transplantation and robotic surgery. Our modification of the hypothermia technique can maintain the kidney at a constant low temperature without repeatedly adding ice and prevent the complication of paralytic ileus.