Outcomes after robotic and open kidney transplant: A propensity score-matched analysis.

H. Kadri Rossana Maffei Ryan Dang Keith Hansen D. Yoeli M. Di Napoli C. Yoshida Ivan E. Rodriguez C. Gonçalves Shannon Lyons Sixto Giusti Terri Montague J. Cooper Rashikh A. Choudhury K. Conzen Megan A. Adams K. Mekeel P. Kennealey Thomas Bak Jesse D. Schold T. Nydam T. Pshak Phillipe Abreu

Sep 2026 · American Journal of Surgery · Vol 262, pp. 117245 · 0 citations · 25 references

Medicine

Abstract

INTRODUCTION Robotic kidney transplant (RKT) has been noted to be an alternative procedure compared to open kidney transplant (OKT). This study compares outcomes after RKT and OKT from one transplant center.

Methods

This was a single-center propensity score-matched observational study, 11/2021-09/2025. A multivariable propensity model was developed including recipient age, obesity, time period, pre-transplant dialysis, diabetes, and donor type, and patients were matched 2:1 OKT:RKT. Matched patients were compared using weighted or Firth penalized regression.

Results

Of 1004 kidney transplants, 103 (10.3%) were robotic. Through matching, the average standardized mean difference between covariates went from 0.456 to 0.118. Outcomes after matched RKTs and OKTs were similar, except lower rates of Clavien-Dindo II complications in RKTs (7.8% vs 18.4%, p = 0.013).

Conclusions

As RKT expands, benchmarking is crucial to ensure safety. In this analysis, outcomes were similar to OKT, highlighting that it is an appropriate alternative that should continue to be refined.

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