Robotic-assisted kidney transplantation in obese recipients compared to non-obese recipients: the European experience



The main objective was to compare minor (Clavien I–II) and major (Clavien ≥ III) intra- and postoperative complications of living donor robotic assisted kidney transplantation (RAKT) in obese (≥ 30 kg/m2 BMI), overweight (< 30/ ≥ 25 kg/m2 BMI) and non-overweight recipients (< 25 kg/m2 BMI).


For the present retrospective study, we reviewed the multi-institutional ERUS-RAKT database to select consecutive living donor RAKT recipients. Functional outcomes, intra- and postoperative complications were compared between obese, overweight and non-overweight recipients.


169 living donor RAKTs were performed, by 10 surgeons, from July 2015 to September 2018 in the 8 European centers. 32 (18.9%) recipients were obese, 66 (39.1%) were overweight and 71 (42.0%) were non-overweight. Mean follow-up was 1.2 years. There were no major intra-operative complications in either study group. Conversion to open surgery occurred in 1 obese recipient, in 2 overweight recipients and no conversion occurred in non-overweight recipients (p = 0.3). Minor and major postoperative complications rates were similar in the 3 groups. At one-year of follow-up, median eGFR was similar in all groups [54 (45–60) versus 57 (46–70) versus 63 (49–78) ml/min/1.73 m2 in obese, overweight and non-overweight recipient groups, respectively, p = 0.5]. Delayed graft function rate was similar in the 3 groups. Only the number of arteries was an independent predictive factor of suboptimal renal function at post-operative day 30 in the multivariate analysis.


RAKT in obese recipients is safe, compared to non-overweight recipients and yields very good function, when it performed at high-volume referral centers by highly trained transplant teams.

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Fig. 1
Fig. 2



Body Mass Index


Cold ischemia time


Delayed graft function


Estimated glomerular function rate


European robotic urological section


End-stage renal disease




Innovation, development, exploration, assessment, long-term study


Kidney transplantation


Laparoscopic sleeve gastrectomy


Modified diet in renal disease


Multiple renal arteries


Open kidney transplantation


Pulmonary embolism


Post-operative day


Robotic assisted kidney transplantation


Rewarming time


Single renal artery


Visual Analog Scale


Warm ischemia time


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Author information




TP and AB: protocol development, data collection, data analysis, manuscript writing; JBB: protocol development, data analysis, manuscript writing and editing; ML, MR, GV, RC, SS, AT, LG, VT, SS, AA, MM, MS, MJ, PF and NM: data collection, data analysis; KD: protocol development, data collection, data analysis; ADB: protocol development, data analysis, manuscript editing; NK and FS: protocol development, data analysis; ND: protocol development, data collection, data analysis, manuscript writing and editing.

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Correspondence to Thomas Prudhomme.

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Prudhomme, T., Beauval, J.B., Lesourd, M. et al. Robotic-assisted kidney transplantation in obese recipients compared to non-obese recipients: the European experience. World J Urol (2020).

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  • Obese patients
  • Kidney transplantation
  • Robot-assisted kidney transplantation
  • Robotic surgery
  • Vascular anastomosis