{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T22:32:51Z","timestamp":1793313171777,"version":"4.5.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Kidney360"],"published-print":{"date-parts":[[2026,10]]},"abstract":"\n Key Points<\/jats:title>\n \n \n \n \n Robotic kidney transplantation demonstrates equivalent perioperative safety across body mass index strata, including body mass index \u226540 kg\/m\n 2<\/jats:sup>\n .\n <\/jats:p>\n <\/jats:list-item>\n \n High body mass index alone was not associated with higher surgical complexity, delayed graft function, or early graft loss.<\/jats:p>\n <\/jats:list-item>\n \n Robotic kidney transplant may expand equitable access to transplantation by mitigating traditional obesity-related surgical risks.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n \n Obesity remains a common barrier to kidney transplantation, with many centers enforcing strict body mass index (BMI) cutoffs because of concerns regarding surgical complexity and postoperative complications. Robotic kidney transplantation (RKT) has emerged as a minimally invasive alternative that may mitigate obesity-associated surgical risks. However, outcomes across granular BMI subgroups, particularly among patients with morbid obesity (BMI \u226540 kg\/m\n 2<\/jats:sup>\n ), remain incompletely characterized.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We performed a retrospective cohort study of adult patients undergoing RKT at a single academic transplant center between November 2021 and September 2025. Patients were stratified by BMI into two primary cohorts (BMI <30 versus \u226530 kg\/m\n 2<\/jats:sup>\n ) with a secondary subgroup analysis comparing those with BMI 30\u201340 versus \u226540 kg\/m\n 2<\/jats:sup>\n . Demographic characteristics, intraoperative metrics, and 30-day postoperative outcomes were compared.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 104 patients underwent RKT, with 26 patients with BMI <30 kg\/m\n 2<\/jats:sup>\n , 53 with BMI between 30 and 40 kg\/m\n 2<\/jats:sup>\n , and 25 with BMI \u226540 kg\/m\n 2<\/jats:sup>\n . No significant differences were observed between BMI <30 and \u226530 cohorts in operative time, ischemia times, estimated blood loss, length of stay, delayed graft function, or 30-day readmission. Patients with BMI <30 had a higher rate of 30-day all-cause reoperation (15% versus 3%,\n P<\/jats:italic>\n = 0.03). In subgroup analysis, patients with BMI \u226540 demonstrated comparable intraoperative parameters and postoperative complication rates to those with BMI 30\u201340, with no significant differences in graft or patient survival.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n RKT is associated with comparable perioperative outcomes across BMI categories, including among patients with morbid obesity. These findings challenge rigid BMI-based exclusion criteria and support a more individualized approach to transplant candidacy in the era of robotic surgery.<\/jats:p>\n <\/jats:sec>","DOI":"10.34067\/kid.0000001241","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T18:14:17Z","timestamp":1782929657000},"page":"2355-2362","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Safety in Robotic Kidney Transplant for All-Comers"],"prefix":"10.34067","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4381-5635","authenticated-orcid":false,"given":"Haaris","family":"Kadri","sequence":"first","affiliation":[{"name":"University of Colorado School of Medicine, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8218-2723","authenticated-orcid":false,"given":"Rossana","family":"Maffei","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9696-5568","authenticated-orcid":false,"given":"Keith","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6993-255X","authenticated-orcid":false,"given":"Dor","family":"Yoeli","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4949-6241","authenticated-orcid":false,"given":"Marissa","family":"Di Napoli","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4231-0026","authenticated-orcid":false,"given":"Cassidy","family":"Yoshida","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"Lyons","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0367-1734","authenticated-orcid":false,"given":"Sixto","family":"Giusti","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4380-4550","authenticated-orcid":false,"given":"Terri","family":"Montague","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Cooper","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3325-3090","authenticated-orcid":false,"given":"Rashikh","family":"Choudhury","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9423-9279","authenticated-orcid":false,"given":"Kendra","family":"Conzen","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0148-1593","authenticated-orcid":false,"given":"Megan","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Kennealey","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Bak","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5341-7286","authenticated-orcid":false,"given":"Jesse D.","family":"Schold","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9033-5140","authenticated-orcid":false,"given":"Trevor","family":"Nydam","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7584-7108","authenticated-orcid":false,"given":"Thomas","family":"Pshak","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6340-7738","authenticated-orcid":false,"given":"Phillipe","family":"Abreu","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"issue":"8","key":"B1-20261029","doi-asserted-by":"crossref","first-page":"2143","DOI":"10.1111\/ajt.15784","article-title":"Obesity, transplantation, and bariatric surgery: an 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Nutr."},{"issue":"4","key":"B26-20261029","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1001\/jamacardio.2019.5738","article-title":"Cardiovascular functional reserve before and after kidney transplant","volume":"5","author":"Lim","year":"2020","journal-title":"JAMA Cardiol."},{"issue":"23","key":"B27-20261029","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1161\/CIRCULATIONAHA.125.077192","article-title":"Why we must rethink kidney transplantation as a cardiovascular risk\u2013reducing intervention in kidney 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Considered?"],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":27,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.34067\/kid.0000001241","relation":{},"ISSN":["2641-7650","2641-7650"],"issn-type":[{"value":"2641-7650","type":"electronic"},{"value":"2641-7650","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7,1]]},"assertion":[{"value":"2026-02-12","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-16","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}