Recommendations from the 2024 Minimally Invasive Organ Transplant Consensus Conference – MIOT.CC

Objectives: The Minimally Invasive Organ Transplant Consensus Conference (MIOT.CC) aimed to develop evidence-based recommendations for advancing minimally invasive techniques in organ transplantation. Background: Minimally invasive approaches (laparoscopic/robotic) are underutilized in transplantation compared to other specialties, despite potential advantages such as reduced morbidity and faster recovery. Methods: The conference Held in Riyadh, Saudi Arabia (December 2024) included international experts in minimally invasive donation and/or transplantation of the kidney, liver, pancreas, lung, heart, and uterus. Using the Danish Model of Consensus, participants reviewed current practice and evidence to formulate recommendations. The process included systematic literature reviews according to PRISMA guidelines and assessment of evidence quality using the GRADE approach. Results: Minimally invasive approaches consistently reduced postoperative pain, complications, and hospital stay. Specific recommendations were derived for each organ, with particular attention to donor safety and to the expansion of robotic techniques, if appropriately supported by locally available technology and experience. Conclusion: MIOT.CC delineated a framework to disseminate minimally invasive techniques in both organ donation and transplantation. These recommendations can guide centers worldwide to first implement and subsequently optimize minimally invasive approaches through ongoing evaluation and adaptation based on emerging evidence and technological advancements.