{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T21:09:59Z","timestamp":1788901799348,"version":"build-2803163510"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Robotic donor nephrectomy (RDN) offers a minimally invasive alternative to open and laparoscopic techniques for living kidney donation. As obesity rises among potential donors, data comparing RDN outcomes between non-obese and obese donors remain limited. This study evaluates the safety and feasibility of RDN in obese living kidney donors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A single-center retrospective analysis included 212 consecutive donors who underwent RDN between August 2020 and April 2025; after excluding one donor with incomplete covariate data, 211 (137 low BMI [&lt;\u200930\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ], 74 high BMI [\u2265\u200930\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ]) formed the analytic cohort. To account for baseline imbalance, the primary between-group comparison used propensity-score overlap weighting, with weighted differences and 95% confidence intervals (CIs) estimated by robust weighted regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Low BMI donors were modestly older (46.2 vs. 42.2\u00a0years; largest imbalance, standardized mean difference 0.32); overlap weighting reduced all covariate differences to approximately zero. After weighting, operating time was longer in high BMI donors (weighted difference +\u00a015.6\u00a0min, 95% CI 6.4\u201324.8;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), whereas estimated blood loss, conversion to open surgery (1.4% vs. 0.7%), complications (2.7% vs. 2.2%; all Clavien\u2013Dindo Grade I), length of stay, and renal function through six months did not differ (all weighted\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&gt;\u00a00.10). No perioperative deaths occurred. Exploratory subgroup analyses showed longer operating times for high BMI donors with single renal arteries (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.011) and left nephrectomies (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.024), without differences in blood loss or complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In a rigorously selected cohort, RDN yielded short-term perioperative and functional outcomes in obese donors comparable to non-obese donors, with only a modest increase in operative time that persisted after overlap weighting. These findings support RDN as one component of responsibly expanding the donor pool; however, short-term parity does not establish long-term donor or recipient safety, and expansion must remain contingent on stringent selection, risk counseling, and structured long-term surveillance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-026-13330-2","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T20:29:51Z","timestamp":1788899391000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Expanding the living kidney donor pool: outcomes of robotic donor nephrectomy in obese versus non-obese donors"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1499-5162","authenticated-orcid":false,"given":"Jacob","family":"Hallesy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derick","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devi Preetham Reddy","family":"Veeramgari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Imai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuzuru","family":"Sambommatsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinay","family":"Kumaran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Saeed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aamir","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Cotterell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Bruno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Duk","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"13330_CR1","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1056\/NEJM199508103330601","volume":"333","author":"PI Terasaki","year":"1995","unstructured":"Terasaki PI, Cecka JM, Gjertson DW, Takemoto S (1995) High survival rates of kidney transplants from spousal and living unrelated donors. 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