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We tested the hypothesis that intraoperative and postoperative complication rates are similar between RAKT and OKT in this patient population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This was a multicenter retrospective cohort study including 78 patients with ESRD who received RAKT or OKT from living donor between 2015 and 2023 in 7 European academic centers. All patients had received an OKT in the past. The primary outcome was to assess perioperative safety in terms of intra- and postoperative complications, described using the Clavien-Dindo classification. Secondary outcomes included dialysis-free survival (DFS), surgical reintervention-free survival (RFS) and renal function at discharge. Kaplan Meier estimates and log-rank test were used to compare DFS and RFS according to the surgical approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 78 patients who previously underwent OKT, 29 (37%) patients subsequently underwent RAKT and 49 (63%) OKT. Patients\u2019 baseline characteristics were comparable between groups. The site of transplantation was the left iliac fossa in 24 (83%) and 30 (61%) patients undergoing RAKT and OKT, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.07). Cold ischemia time was shorter in the RAKT group (60 vs. 114\u00a0min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), as was total vascular anastomosis time (33 vs. 38\u00a0min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). Estimated blood loss, rewarming time and intraoperative complications were similar in both groups. Early and late postoperative complications were similar in RAKT and OKT (respectively: 17% vs. 33%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.1; and 14% vs. 10%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.7). Over a median follow-up of 42 (IQR: 20\u201374) months, DFS was similar between RAKT and OKT, whereas RFS was higher in the RAKT group (100% vs. 84%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). Main limitations are represented by patient selection and the small sample size.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In selected patients undergoing kidney re-transplantation after a previous OKT, RAKT appears to be technically feasible and provides perioperative outcomes comparable to the open approach. In this challenging surgical setting, RAKT may represent a valuable option in experienced centres.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00345-026-06754-x","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T09:11:47Z","timestamp":1788513107000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Robot-assisted versus open kidney transplantation in patients who previously underwent an open kidney transplant"],"prefix":"10.1007","volume":"44","author":[{"given":"Luca","family":"Afferi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isacco","family":"Donnini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Gallioli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Begonya","family":"Etcheverry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joris","family":"Vangeneugden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Mercier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Territo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Prudhomme","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Masieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio","family":"Pecoraro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Ortiz Benitez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Garc\u00eda-Baquero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milla","family":"Ortved","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malene","family":"Rohrsted","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Roder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia Abildgaard","family":"Dagnaes-Hansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesc","family":"Vigu\u00e9s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Doumerc","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Palou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Campi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Serni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karel","family":"Decaestecker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Breda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"issue":"24","key":"6754_CR1","first-page":"02758","volume":"S0302\u20132838","author":"A Territo","year":"2025","unstructured":"Territo A, Afferi L, Musquera M, Gaya Sopena JM, Pecoraro A, Campi R et al (2025) Robot-assisted kidney transplantation: the 8-year European experience. 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