Less is More: Robotic Kidney Transplantation in Polycystic Kidney Disease Without Preemptive or Simultaneous Native Nephrectomy

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People with autosomal dominant polycystic kidney disease (ADPKD) often have very large native kidneys, which sometimes leads transplant teams to remove one or both native kidneys before or during a kidney transplant. This single-centre retrospective study reviewed 16 adults with ADPKD who had a robotic kidney transplant without having their native kidneys removed. The authors used scans to calculate how much of the abdomen and pelvis was taken up by the native kidneys — on average about one quarter of the space. In these 16 patients, robotic transplantation without native kidney removal was completed across a range of kidney sizes, with a median operative time of 267 minutes and median blood loss of 50 mL. This is a small single-centre series and does not compare robotic surgery directly with open surgery or routine kidney removal.