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In this retrospective, single-center study, we reviewed a prospectively maintained registry of patients who underwent RAKT between October 2019 and December 2025 and evaluated perioperative, postoperative, and allograft outcomes. A total of 228 patients underwent RAKT, including 125 (54.8%) deceased-donor kidney transplants (DDKT) and 103 (45.2%) living-donor kidney transplants (LDKT). SP and MP platforms were utilized in 30.7% and 69.3% of cases, respectively. Six patients received dual-kidney transplants and four underwent simultaneous kidney-pancreas transplantation. Annual case volume increased from one procedure in 2019 to 115 procedures in 2025. Median operative times were 3\u00a0h 38\u00a0min for DDKT and 4\u00a0h 6\u00a0min for LDKT, with median vascular anastomosis times of 44 and 40\u00a0min, respectively. Conversion to open surgery occurred in one patient (0.4%). Median length of stay was four days for DDKT and two days for LDKT. Delayed graft function occurred in 30.4% of DDKT recipients and 4.8% of LDKT recipients; among the 121 recipients with available one-year serum creatinine, median one-year serum creatinine was 1.49\u00a0mg\/dL and 1.37\u00a0mg\/dL, respectively. Graft-loss occurred in two DDKT recipients (1.6%) and one LDKT recipient (0.9%), while three deaths (2.4%) occurred after DDKT and one death (0.9%) after LDKT. In this large single-center experience, RAKT was associated with low conversion rates, favorable perioperative outcomes, and good one-year graft function despite increasing procedural complexity, supporting its continued expansion in appropriately selected patients.<\/jats:p>","DOI":"10.1007\/s11701-026-03773-z","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T03:31:15Z","timestamp":1786419075000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Robot-assisted kidney transplantation in living and deceased donors: a six-year experience"],"prefix":"10.1007","volume":"20","author":[{"given":"Hafiz Umair","family":"Siddiqui","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan","family":"Isaacson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Shoucair","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkatesh","family":"Krishnamurthi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Chia","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvin","family":"Wee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihad","family":"Kaouk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Eltemamy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"issue":"23","key":"3773_CR1","doi-asserted-by":"publisher","first-page":"1725","DOI":"10.1056\/NEJM199912023412303","volume":"341","author":"RA Wolfe","year":"1999","unstructured":"Wolfe RA, Ashby VB, Milford EL, Ojo AO, Ettenger RE, Agodoa LY, Held PJ, Port FK (1999) Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. 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