Comparison of clinical outcomes between robot-assisted and open ABO-incompatible kidney transplantation

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Despite this growing interest, there remains a notable gap in the literature, especially concerning its effectiveness in immunologically high-risk patients compared to the conventional open kidney transplantation (OKT). This study is focused on exploring the viability and success of RAKT in comparison with OKT, particularly for recipients with ABO incompatibility (ABOi). A retrospective analysis was conducted on 239 living-donor transplants at a single center, comprising 210 OKT and 29 RAKT cases. Perioperative outcomes, graft survival, and renal function were assessed. A composite of biopsy-proven acute rejection (BPAR), graft failure, and the development of de novo donor-specific antibodies (DSA) was analyzed through univariate and multivariate models. Both RAKT and OKT groups showed comparable one and two-year BPAR-free survival rates (RAKT: 92.4%, OKT: 93.1% and 91.9% respectively) and similar mean eGFR values (RAKT: 64.41 ml/min/1.73m², OKT: 65.75 ml/min/1.73m²). OKT had a significantly shorter cold ischemic time and operative time but longer hospital stays compared to RAKT. Univariate and multivariate analyses indicate no significant difference in the composite outcome (BPAR, graft failure, de novo DSA) between the two groups. RAKT presents as a safe and effective alternative to OKT in ABOi patients, with similar perioperative outcomes, graft survival rate, and renal function. robot-assisted kidney transplantation ABO incompatible kidney transplantation biopsy-proven acute rejection immunologically high-risk patients allograft outcomes Figures Figure 1 Figure 2 Introduction Kidney transplantation (KT) has become the preferred treatment for end-stage renal disease (ESRD), offering patients enhanced survival, better quality of life, and independence from dialysis maintenance [ 1 – 3 ]. The increasing incidence of ESRD has led to a heightened demand for donor kidneys, while their availability remains scarce. This disparity has resulted in extended waiting periods for those in need of KT. To mitigate this shortage, various strategies have been developed, including significant advancements in desensitization protocols. These protocols have effectively overcome immunological challenges, facilitating transplants across human leukocyte antigen (HLA) and ABO blood group incompatibilities. Historically, ABO incompatibility was considered a definitive barrier to KT due to the high risk of hyperacute rejection and poorer outcomes stemming from blood type mismatches [ 4 ]. Recent advances in immunosuppressive therapies and desensitization techniques, however, have enabled successful ABO-incompatible (ABOi) KT globally. As a result, ABOi KT is now widely recognized as a feasible option for ESRD treatment, yielding outcomes on par with ABO-compatible (ABOc) KT in both adults and children [ 5 – 7 ]. Robot-assisted kidney transplantation (RAKT) has seen impressive progress since its first successful procedure in France in 2001 [ 8 ]. This innovative method has transformed KT, offering superior precision, enhanced visualization, and benefits for surgeons and recipients alike. However, the application of RAKT in immunologically high-risk patients is less documented, and detailed studies comparing RAKT with traditional open KT (OKT) in these scenarios are essential to evaluate the feasibility and advantages of the robotic method. In a preliminary study by T. Prudhomme et al., the perioperative outcomes of ABOi-RAKT, ABOc-RAKT, and ABOi-OKT were examined in obese patients. The study highlighted the benefits of RAKT for this group, such as improved surgical visibility, lower infection rates, reduced wound complications, and less lymphocele formation compared to OKT. The findings indicated no significant difference in kidney graft survival rates two years post-transplant between the ABOi-RAKT and ABOi-OKT groups [ 9 ]. To fully assess the safety and efficacy of RAKT in ABOi-KT, it's crucial to extend research beyond obese patients. Thus, our current study aims to compare perioperative and graft outcomes between ABOi-RAKT and -OKT across a more diverse patient population. Methods Study Patients This retrospective, single-center study encompassed 210 patients who underwent ABOi-OKT and 29 who underwent ABOi-RAKT between October 2020 and February 2023. All RAKT procedures were performed by the same surgeon, while the OKT procedures were carried out by a team of experienced surgeons at our center. Notably, all transplants in this study were from living donors. Prior to surgery, recipients underwent preoperative computed tomography to evaluate their vascular anatomy and detect potential atherosclerosis in the iliac vessels, critical for vascular anastomosis. Our center adhered to stringent protocols for preoperative donor evaluation, immunosuppressant regimens, postoperative care, and follow-up. The study was approved by the Ethics Committee of Asan Medical Center (reference number: 2023-0085). Owing to the retrospective nature of the study, the requirement for informed consent was waived. Desensitization Protocol Our prior publications [ 10 – 12 ] provide a comprehensive overview of the desensitization procedures we have developed for managing ABO incompatibilities. These include using rituximab, an anti-CD20 monoclonal antibody, and therapeutic plasma exchange (TPE) to lower antibody levels. ABOi recipients receive a single rituximab dose (100–200 mg) one week before commencing TPE, which continues until immunoglobulin M isoagglutinin levels are safely reduced (≤ 1:4). If there is a rebound in isoagglutinin levels, reaching or exceeding a titer of 1:16, postoperative TPE is considered. Surgical Techniques of RAKT In our earlier publication [ 13 ], we have provided a thorough description of the surgical technique and the instruments used for RAKT. In brief, during the surgical procedure for RAKT, the patient was positioned at a 45-degree angle in the Trendelenburg position and securely fastened to the operating table. The initial steps involved exposing the iliac vessels and creating an extraperitoneal pouch, followed by the separation of the bladder to prepare for the ureteroneocystostomy. The graft, enclosed in a gauze jacket, was introduced into the abdominal cavity through the GelPOINT device. Regional hypothermia was induced by applying 200 to 250 cc of ice slush to cool the graft via the GelPOINT. Subsequently, a venotomy was made with Potts scissors, and the renal vein of the graft was joined to the external iliac vein in a continuous end-to-side manner. The external iliac artery was clamped, and an arteriotomy was created using robotic Potts scissors and the clamped artery was washed with heparinized saline. The renal artery was then connected to the external iliac artery in an end-to-side continuous manner. Once the anastomosis was confirmed to be secure, the blood supply to the kidney was restored and assessed for color and turgor. Throughout the entire anastomosis procedure, the pneumoperitoneum was reduced to 8 mm Hg to facilitate the detection of any bleeding. Following this, the kidney was placed into the extraperitoneal pouch, and the ureterovesical anastomosis was performed using a modified Lich-Gregoir technique. This involved creating two semi-continuous sutures with 4 − 0 Monocryl sutures over a previously inserted 6F, 14 cm Double-J stent. Finally, the detrusor muscle was closed using a continuous suture to establish an anti-reflux mechanism. Clinical Outcomes We retrospectively reviewed patient records to collect clinical data. The primary endpoint was biopsy-proven acute rejection (BPAR). Allograft biopsies were evaluated based on Banff 2015 [ 14 ] and Banff 2017 criteria [ 15 ]. Graft survival was defined as the time from KT to graft removal or the resumption of dialysis. We included composite outcomes in our analysis, comprising BPAR, graft failure, and de novo donor-specific antibody (DSA) occurrences. Kidney graft function was assessed by measuring the estimated glomerular filtration rate (eGFR) for up to one year post-KT, calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation [ 16 ]. Statistical Analysis We presented continuous variables as median and range and categorical variables as numbers and percentages. Categorical variables were analyzed using the χ2 test or Fisher's exact test, depending on the sample size. Continuous variables were examined using the Student's t -test or Wilcoxon rank-sum test, based on their distribution. Rejection-free survival rates were analyzed using Kaplan-Meier curves and the log-rank test. Univariate and multivariate analyses using the Cox proportional hazards method were conducted to identify factors influencing graft survival and rejection events. Statistical significance was set at a p-value of less than 0.05. All analyses were performed using IBM SPSS version 22.0 (IBM Corp., Armonk, NY, USA). Results Baseline Characteristics of Study Population This study aimed to evaluate various parameters among 239 kidney transplant recipients, including 210 who received OKT and 29 who underwent RAKT. Table 1 outlines the baseline characteristics of the RAKT and OKT cohorts. The recipients' average age was 50.1 years, with no significant age difference between the groups ( p = 0.15). Gender distribution was also similar across both groups ( p = 0.63). The average body mass index (BMI) for the entire cohort was 23.36 kg/m 2 , with no significant difference between the RAKT and OKT groups ( p = 0.30). A key finding was the variation in dialysis duration prior to transplantation between the two groups. The entire cohort had a median dialysis duration of 4 months, ranging from 0 to 10 months. The OKT group experienced a slightly longer median dialysis duration of 5 months (range: 0–11 months) compared to 1 month (range: 0–6 months) in the RAKT group, a statistically significant difference ( p = 0.02). Retransplantation rates were similar between the two groups ( p = 0.14). The primary causes of ESRD included hypertension, diabetes mellitus (DM), glomerulonephritis (GN), and immunoglobulin A nephropathy (IgAN), with no significant differences in prevalence between the groups ( p = 0.76). The number of HLA mismatches was comparable between the RAKT and OKT groups ( p = 0.99). In comparing rituximab dosages, a higher proportion of RAKT recipients, 68.97%, received doses below 200mg, compared to 48.1% in the Open KT group. In contrast, only 31.03% of RAKT recipients received higher doses (≥ 200mg), against 51.9% in Open KT ( p = 0.04). No significant differences were found in the presence of pre-transplant DSA or de novo DSA between the two groups ( p = 0.34 and p > 0.99, respectively), suggesting similar immunological profiles and antibody-mediated rejection risks. The use of induction immunosuppressants, such as basiliximab or thymoglobulin, was also comparable between the groups ( p = 0.79). The majority of recipients in both groups were treated with tacrolimus, with no significant difference in the use of calcineurin inhibitors ( p = 0.48). Donor characteristics, including age, gender distribution, BMI, and comorbidities like DM and hypertension, showed no significant differences between the two groups. Additionally, donor renal function, evaluated by 24-hour creatinine clearance and urine protein levels, was similar in both groups. Table 1 Baseline characteristics of studied population between open KT and RAKT Variables Total Open KT RAKT p-value n = 239 (n = 210) (n = 29) Recipient Mean age, years 50.10 11.81 50.51 11.97 47.17 10.25 0.154 Female gender, n (%) 109 45.61 97 46.19 12 41.38 0.626 Body mass index, kg/m 2 23.36 3.88 23.24 3.73 24.23 4.85 0.300 Preemptive transplant, n (%) 43 17.99 35 16.67 8 27.59 0.151 Dialysis duration in months, median (IQR) 4 0–10 5 0–11 1 0–6 0.021 Retransplantation, n (%) 18 7.53 18 8.57 0 0 0.140 Cause of ESRD 0.763 HTN, n( %) 23 9.62 20 9.52 3 10.34 DM, n (%) 70 29.29 60 28.57 10 34.48 GN, n (%) 24 10.04 20 9.52 4 13.79 IgAN, n (%) 45 18.83 39 18.57 6 20.69 FSGS, n (%) 7 2.93 6 2.86 1 3.45 PCKD, n (%) 15 6.28 15 7.14 0 0 Unknown, n (%) 40 16.74 37 17.62 3 10.34 Others, n (%) 15 6.28 13 6.19 2 6.9 Number of HLA mismatch (ABDR), median (IQR) 4 3–5 4 3–5 4 3–5 0.993 3.64 1.56 3.64 1.57 3.66 1.52 HLA-incompatible KT, n (%) 32 13.39 30 14.29 2 6.9 0.388 Rituximab dose (desensitization) 0.035 =200mg, n (%) 118 49.37 109 51.9 9 31.03 IgM titer, median (IQR) 64 32–128 64 32–128 32 16–64 0.094 117.80 298.48 125.69 316.79 60.69 65.74 Pre-transplant DSA, n (%) 49 20.5 45 21.43 4 13.79 0.340 de novo DSA, n (%) 16 6.69 14 6.67 2 6.9 > .999 Immunosuppressants Induction, n (%) 0.795 Basiliximab 199 83.26 174 82.86 25 86.21 Thymoglobulin 40 16.74 36 17.14 4 13.79 Calcineurin inhibitor, n (%) 0.479 Tacrolimus 234 97.91 206 98.1 28 96.55 Cyclosporine 5 2.09 4 1.9 1 3.45 Donor Mean age, years 50.79 11.30 51.02 11.06 49.14 12.98 0.401 Female gender, n (%) 143 59.83 123 58.57 20 68.97 0.285 Body mass index, kg/m 2 24.34 3.23 24.40 3.14 23.88 3.85 0.424 Relation to a recipient, n (%) 0.317 Living-related 103 43.1 88 41.9 15 51.72 Living-unrelated 136 56.9 122 58.1 14 48.28 DM, donor 12 5.02 11 5.24 1 3.45 > .999 HTN, donor 73 30.54 66 31.43 7 24.14 0.424 24-h creatinine clearance, mL/min 111.20 26.68 111.17 27.49 111.47 20.21 0.954 24-h urine protein, mg/day 83.42 30.61 83.66 31.95 81.65 18.48 0.624 Left kidney donation, n (%) 142 59.41 127 60.48 15 51.72 0.368 Operative results Cold ischemic time, min 56.85 38.82 48.57 30.06 116.83 42.70 < .0001 Anastomosis time, min 24.04 10.44 21.09 6.40 45.41 9.08 < .0001 Rewarming time, min 58 9.66 Operative time, min 170.37 68.45 152.90 49.75 296.83 49.98 < .0001 Hospitalization after KT, days 9.96 8.14 10.37 8.52 7.03 3.21 < .0001 eGFR (CKD-EPI) one month after KT, ml/min/1.73/m 2 68.60 19.25 68.23 19.55 71.28 16.95 0.426 CKD-EPI, chronic kidney disease epidemiology collaboration; DM, diabetes mellitus; DSA, donor-specific antibody; eGFR, estimated glomerular filtration rate; ESRD, end-stage renal disease; FSGS, focal segmental glomerulosclerosis; GN, glomerulonephritis; HLA, human leukocyte antigen; HTN, hypertension; IQR, Interquartile Range; IgAN, immunoglobulin A nephropathy; PCKD, polycystic kidney disease; Perioperative Outcomes In our study examining surgical outcomes, we observed significant differences between the OKT and RAKT groups. Our findings revealed that the cold ischemic time was notably shorter in the OKT group, averaging 48.57 ± 30.06 minutes, compared to 116.83 ± 42.70 minutes in the RAKT group ( p < 0.001). A similar trend was seen in anastomosis time, with the OKT group averaging 21.09 ± 6.40 minutes, significantly less than the RAKT group's 45.41 ± 9.09 minutes ( p < 0.001). The overall operative time also differed significantly, being shorter for the OKT group (152.91 ± 49.75 minutes) compared to the RAKT group (296.83 ± 49.98 minutes, p < 0.001). Additionally, we observed a difference in the length of hospital stay post-transplantation, with the RAKT group averaging shorter stays (7.03 ± 3.21 days) compared to the OKT group (10.37 ± 8.52 days, p < 0.001). Univariate and Multivariate Analysis For A Composite of BPAR, graft failure, and de novo DSA Table 2 displays the results of both univariate and multivariate analyses, focusing on a composite outcome of BPAR, graft failure, and de novo DSA. In the univariate analysis, the type of surgery did not significantly influence this composite outcome. However, HLA-incompatible kidney transplants were significantly associated with the outcome, demonstrating a hazard ratio (HR) of 3.75 (95% CI: 1.744–8.074, p = 0.0007). The multivariable analysis indicates that this association might be significant, with an HR of 2.889 (95% CI: 0.974–8.564, p = 0.0557), suggesting a potential differential impact of HLA incompatibility across transplant groups. Pre-transplant DSA also displayed a significant association in the univariate analysis (HR 3.092, 95% CI: 1.475–6.482, p = 0.0028), but this significance was not maintained in the multivariate analysis (HR 2.161, 95% CI: 0.842–5.547, p = 0.1091). Additionally, thymoglobulin induction was significantly associated with the composite outcome in the univariate analysis (HR 2.527, 95% CI: 1.15–5.553, p = 0.021), but this association was not significant in the multivariate analysis, indicating that thymoglobulin's effect might be influenced by additional variables. Lastly, no donor factors showed significant association with the composite outcome. Overall, these analyses suggest that factors such as HLA incompatibility and pre-transplant DSA have significant associations in univariate contexts, but their impacts become more nuanced in multivariate analyses. Table 2 Univariate and multivariate analysis of factors associated with a composite of graft failure, BPAR and de novo DSA Factors Univariable Multivariable HR 95%CI p-value HR 95%CI p-value Open KT 1 0.7105 0.961 RAKT 0.797 0.241 2.636 0.97 0.292 3.229 Recipient Mean age, years 0.998 0.968 1.028 0.8786 Female gender, n (%) 1.309 0.632 2.712 0.4688 Body mass index, kg/m 2 1.069 0.985 1.161 0.11 Preemptive transplant, n (%) 0.894 0.341 2.344 0.8199 Dialysis duration, months 0.995 0.974 1.016 0.6424 Retransplantation, n (%) NA Number of HLA mismatch (ABDR), (range) 1.196 0.94 1.521 0.1453 HLA-incompatible KT, n (%) 3.753 1.744 8.074 0.0007 2.889 0.974 8.564 0.056 Rituximab dose (desentization) 0.4621 200mg, n(%) 0.758 0.362 1.587 IgM titer (IQR) 1 0.999 1.001 0.6989 Pre-transplant DSA, n(%) 3.092 1.475 6.482 0.0028 2.161 0.842 5.547 0.109 Immunosuppressants Induction, n (%) 0.021 0.671 Basiliximab 1 1 Thymoglobulin 2.527 1.15 5.553 0.78 0.248 2.452 Calcineurin inhibitor, n (%) 0.8085 Tacrolimus 1 Cyclosporine 1.28 0.174 9.435 Donor Mean age, years 0.992 0.96 1.025 0.6489 Female gender, n (%) 0.695 0.335 1.44 0.3277 Body mass index, kg/m 2 1.1 0.986 1.228 0.089 Relation to a recipient, n (%) 0.1136 Living-related 1 Living-unrelated 1.889 0.859 4.154 DM, donor 0.583 0.079 4.286 0.5958 HTN, donor 0.96 0.424 2.172 0.9211 24-h creatinine clearance, mL/min 1.006 0.993 1.018 0.385 24-h urine protein, mg/day 0.984 0.967 1.001 0.073 Left kidney donation, n (%) 1.524 0.694 3.348 0.2935 DM, diabetes mellitus; DSA, donor-specific antibody; HLA, human leukocyte antigen; HTN, hypertension; IQR, Interquartile Range; RAKT, robot-assisted kidney transplantation. Comparison of Biopsy-Proven Acute Rejection-Free Graft Survival and Renal Function Between RAKT and OKT Recipients To illustrate the comparison in BPAR-free graft survival between RAKT and OKT recipients, we utilized Kaplan-Meier curves, as shown in Fig. 1 . Both groups demonstrated comparable BPAR-free graft survival throughout the observation periods. Specifically, the RAKT group exhibited a BPAR-free survival rate of 92.4% at both 1 and 2 years. In contrast, the OKT group recorded rates of 93.1% at 1 year and 91.9% at 2 years. However, the difference in BPAR-free survival between the two groups was not statistically significant ( p = 0.99). Figure 2 depicts the overall trend in eGFR values, determined via the CKD-EPI Creatinine Equation. The patterns observed between the RAKT and OKT groups were notably similar ( p = 0.20). Specifically, the mean eGFR values were 64.41 ml/min/1.73m 2 for the RAKT group and 65.75 ml/min/1.73m 2 for the OKT group. Infectious Complications Table 3 offers a detailed comparative analysis of the etiologies behind post-transplant infections necessitating hospital admission. It is essential to approach the data with an understanding that the numerical differences in infection incidences are influenced by the varying sample sizes of the two groups, and not necessarily indicative of a higher infection risk in either group. In the realm of urinary tract infections, the OKT group showed a diverse range of causative organisms. Escherichia coli (E.coli) was the most common, identified in 20 cases (9.5%), followed by Klebsiella pneumoniae (K. pneumoniae) in 11 cases (5.2%). Other organisms such as Klebsiella aerogenes, Enterococci, and Proteus mirabilis were also reported, with incidences of 2.4%, 3.3%, and 1% respectively. For the RAKT group, incidences were notably lower, with E. coli and K. pneumoniae appearing in 2 (6.9%) and 4 (13.8%) cases respectively. Table 3 Comparative Analysis of Post-Transplant Infection Etiologies between two groups Incidences Causes Etiologies Open KT (n = 210) RAKT (n = 29) Urinary tract infection Escherichia coli 20 2 Klebsiella aerogenes 5 0 Klebsiella oxytoca 1 0 Klebsiella pneumoniae 11 4 Enterococci 7 1 Proteus mirabilis 2 0 Citrobacter freundii 1 0 Morganella morganii 1 0 Candida albicans 1 0 Pneumonia Covid-19 5 0 Viral infection Cytomegalovirus syndrome 3 0 Bacteremia of unknown origin Escherichia coli 5 1 Klebsiella pneumoniae 0 1 Bacteroides fragilis 1 0 Postsurgical site infection Klebsiella pneumonia 1 0 Streptococcus parasanguinis 1 0 Staphylococcus aureus 2 0 Enterococcus faecalis 2 0 Escherichia coli 2 0 Bacteroides fragilis 1 0 Candida albicans 1 0 Fungal infection Candidasis 2 0 Gastrointestinal infection Sapovirus 1 0 Clostridium difficille 2 0 Pneumonia, specifically from Covid-19, was noted in 5 instances (2.4%) within the OKT group. Additionally, viral infections like Cytomegalovirus syndrome were exclusive to the OKT group, occurring in 3 patients (1.4%). Occurrences of bacteremia of unknown origin in the OKT group included E. coli in 5 cases (2.4%) and K. pneumoniae and Bacteroides fragilis each in 1 case (0.5%). In the RAKT group, E. coli was the cause in 1 case (3.4%). Post-surgical site infections in the OKT cohort were caused by various organisms, including K. pneumoniae, Streptococcus parasanguinis, Staphylococcus aureus, Enterococcus faecalis, E. coli, B. fragilis, and Candida albicans, with individual incidences ranging from 0.5–1%. Fungal infections, represented by candidiasis, were found in 2 OKT patients (1%). In the In the OKT group, gastrointestinal infections were noted in a few cases: Sapovirus infection occurred in 1 patient (0.5%), while Clostridium difficile was identified in 2 patients (1.0%). Discussion Multiple studies have explored the feasibility, safety, and appropriateness of RAKT in ESRD patients [ 8 , 17 – 22 ]. Initially, research on RAKT primarily focused on its technical aspects, often overlooking comprehensive clinical outcome data. However, as RAKT's adoption increased, a richer dataset emerged, enhancing our understanding of its clinical outcomes and allowing for direct comparisons with traditional open methods. A range of studies has investigated the functional results and associated risks of both RAKT and OKT. For instance, research by J. Oberholzer and colleagues focused on the effectiveness of RAKT in obese patients, traditionally considered unsuitable for transplantation due to high BMIs averaging 42.6 ± 7.8 kg/m 2 . Comparing these patients with a similar cohort undergoing OKT, they found that renal function, measured by serum creatinine levels six months post-transplant, was similar in both groups (1.5 mg/dL ± 0.4 for RAKT vs. 1.6 mg/dL ± 0.6 for OKT, p = 0.47). Despite the six-month follow-up limitation, other metrics like graft survival, patient survival, rejection rates, and infection frequencies were comparable [ 19 ]. Additionally, a study by Volkan T. compared 40 RAKT and 40 OKT cases performed by the same surgeon [ 23 ]. The results indicated similar functional outcomes in both groups, with creatinine levels at six months post-transplantation being 0.95 ± 0.90 mg/dL for RAKT and 0.87 ± 0.73 mg/dL for OKT ( p = 0.638). A recent systematic analysis also found no significant differences in patient and graft survival across various KT methods (open, laparoscopic, robotic) [ 24 ]. While existing literature focuses on immunologically compatible patients, there's a gap in research exploring the impact of immunological risk on RAKT vs. OKT outcomes. T. Prudhomme and colleagues studied ABOi-RAKT in overweight patients, contrasting with ABOi-OKT. They observed longer cold ischemia times, operation durations, and rewarming intervals in the ABOi-OKT group ( p < 0.001). Additionally, the ABOi-RAKT group showed a 0% rate of delayed graft function, compared to 10.7% in ABOi-OKT ( p = 0.60), with similar graft survival rates observed in both groups [ 9 ]. Our research fills a gap by comparing clinical outcomes between ABOi-RAKT and ABOi-OKT in a broader demographic, not limited to overweight patients. We found comparable one-year BPAR-free survival rates (92.4% for RAKT vs. 93.1% for OKT, p = 0.99) and consistent eGFR trends over a year ( p = 0.20). These results suggest that, with proper desensitization methods, RAKT can be as effective as OKT in ABOi patients. Study limitations Our study faced several limitations that should be considered when reviewing the findings. Being a single-center retrospective study with unequal participant numbers in the two groups, it may have limited statistical power and potential biases. The imbalance in group sizes, influenced by non-random factors, could introduce additional biases. Despite using robust statistical methods to mitigate these issues, these limitations must be acknowledged. Another constraint is the limited timeframe for outcome assessment, due to the recent initiation of RAKT at our center. While short-term results are promising, further research over longer periods is essential. Conclusion In conclusion, RAKT demonstrates comparable functional outcomes to OKT in ABOi patients. Parameters like age, gender, BMI, preemptive transplantation status and retransplantation frequency showed no significant differences between the techniques. However, individual patient characteristics and surgical expertise should guide the choice of transplantation method. Future research should aim for more comprehensive studies with longer follow-up to solidify these initial findings. Declarations Funding This study was not supported by dedicated funding from any public, commercial, or non-profit organizations. Competing Interests The authors have no relevant financial or non-financial interests to disclose. Author contributions JMK, HK, YHK and SS were responsible for study design and manuscript preparation. JMK, HEK, YK and JHJ were responsible for data analysis. The first draft of the manuscript was written by JMK and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. Data availability statement The authors will provide the raw data supporting the findings of this article upon request, without any unwarranted delays or restrictions. 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Pediatr Transplant. 2011;15(5):502–4. Shishido S, Hyodo YY, Aoki Y, Takasu J, Kawamura T, Sakai KK, et al. Outcomes of pediatric ABO-incompatible kidney transplantations are equivalent to ABO-compatible controls. Transplant Proc. 2012;44(1):214-6. Montgomery JR, Berger JC, Warren DS, James NT, Montgomery RA, Segev DL. Outcomes of ABO-incompatible kidney transplantation in the United States. Transplantation. 2012;93(6):603–9. Hoznek A, Zaki SK, Samadi DB, Salomon L, Lobontiu A, Lang P, et al. Robotic assisted kidney transplantation: an initial experience. J Urol. 2002;167(4):1604–6. Prudhomme T, Del Bello A, Sallusto F, Lesourd M, Kamar N, Doumerc N. ABO-Incompatible Robotic-Assisted Kidney Transplantation in the Obese Recipient. Front Surg. 2020;7:49. Kwon H, Kim YH, Kim JY, Choi JY, Shin S, Jung JH, et al. The results of HLA-incompatible kidney transplantation according to pre-transplant crossmatch tests: Donor-specific antibody as a prominent predictor of acute rejection. Clin Transplant. 2019;33(5):e13533. Baek CH, Kim H, Yang WS, Han DJ, Park SK. Clinical significance of isoagglutinin titre with the current desensitization protocol in ABO-incompatible kidney transplantation. Nephrology (Carlton). 2019;24(6):654–60. Kim H, Choe W, Shin S, Kim YH, Han DJ, Park SK, et al. ABO-incompatible kidney transplantation can be successfully conducted by monitoring IgM isoagglutinin titers during desensitization. Transfusion. 2020;60(3):598–606. Lim SJ, Ko Y, Kim DH, Jung JH, Kwon H, Kim YH, et al. Robot-assisted Kidney Transplantation. J Vis Exp. 2021(173). Loupy A, Haas M, Solez K, Racusen L, Glotz D, Seron D, et al. The Banff 2015 Kidney Meeting Report: Current Challenges in Rejection Classification and Prospects for Adopting Molecular Pathology. Am J Transplant. 2017;17(1):28–41. Haas M, Loupy A, Lefaucheur C, Roufosse C, Glotz D, Seron D, et al. The Banff 2017 Kidney Meeting Report: Revised diagnostic criteria for chronic active T cell-mediated rejection, antibody-mediated rejection, and prospects for integrative endpoints for next-generation clinical trials. Am J Transplant. 2018;18(2):293–307. Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, 3rd, Feldman HI, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150(9):604–12. Giulianotti P, Gorodner V, Sbrana F, Tzvetanov I, Jeon H, Bianco F, et al. Robotic transabdominal kidney transplantation in a morbidly obese patient. Am J Transplant. 2010;10(6):1478–82. Boggi U, Vistoli F, Signori S, D'Imporzano S, Amorese G, Consani G, et al. Robotic renal transplantation: first European case. Transpl Int. 2011;24(2):213–8. Oberholzer J, Giulianotti P, Danielson KK, Spaggiari M, Bejarano-Pineda L, Bianco F, et al. Minimally invasive robotic kidney transplantation for obese patients previously denied access to transplantation. Am J Transplant. 2013;13(3):721–8. Abaza R, Ghani KR, Sood A, Ahlawat R, Kumar RK, Jeong W, et al. Robotic kidney transplantation with intraoperative regional hypothermia. BJU Int. 2014;113(4):679–81. Menon M, Abaza R, Sood A, Ahlawat R, Ghani KR, Jeong W, et al. Robotic kidney transplantation with regional hypothermia: evolution of a novel procedure utilizing the IDEAL guidelines (IDEAL phase 0 and 1). Eur Urol. 2014;65(5):1001–9. Tsai MK, Lee CY, Yang CY, Yeh CC, Hu RH, Lai HS. Robot-assisted renal transplantation in the retroperitoneum. Transpl Int. 2014;27(5):452–7. Tuğcu V, Şener NC, Şahin S, Yavuzsan AH, Akbay FG, Apaydın S. Robot-assisted kidney transplantation: comparison of the first 40 cases of open vs robot-assisted transplantations by a single surgeon. BJU Int. 2018;121(2):275–80. Wagenaar S, Nederhoed JH, Hoksbergen AWJ, Bonjer HJ, Wisselink W, van Ramshorst GH. Minimally Invasive, Laparoscopic, and Robotic-assisted Techniques Versus Open Techniques for Kidney Transplant Recipients: A Systematic Review. Eur Urol. 2017;72(2):205–17. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3939210","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":271739534,"identity":"38a2f022-ec27-457a-800c-8b698ab475e7","order_by":0,"name":"Jin-Myung Kim","email":"","orcid":"","institution":"Asan Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Jin-Myung","middleName":"","lastName":"Kim","suffix":""},{"id":271739535,"identity":"83106251-2980-4e04-b63d-f55c94873e51","order_by":1,"name":"Hye Eun Kwon","email":"","orcid":"","institution":"Asan Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Hye","middleName":"Eun","lastName":"Kwon","suffix":""},{"id":271739536,"identity":"e413dfda-20c4-467c-8870-ecd6981e77f8","order_by":2,"name":"Youngmin Ko","email":"","orcid":"","institution":"Asan Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Youngmin","middleName":"","lastName":"Ko","suffix":""},{"id":271739537,"identity":"c9d1d45a-2910-4d6d-ad1c-15a6bb236cba","order_by":3,"name":"Joo Hee Jung","email":"","orcid":"","institution":"Asan Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Joo","middleName":"Hee","lastName":"Jung","suffix":""},{"id":271739538,"identity":"91523e01-9a00-4758-b5e5-fb28ed3c0e5d","order_by":4,"name":"Hyunwook Kwon","email":"","orcid":"","institution":"Asan Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Hyunwook","middleName":"","lastName":"Kwon","suffix":""},{"id":271739539,"identity":"b782512e-8467-47f6-b44b-090c237b3262","order_by":5,"name":"Young Hoon Kim","email":"","orcid":"","institution":"Asan Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Young","middleName":"Hoon","lastName":"Kim","suffix":""},{"id":271739540,"identity":"a2ee34f7-d063-4a44-9f50-ef36e2584d13","order_by":6,"name":"Sung Shin","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAxUlEQVRIiWNgGAWjYFACHoYDDBVwngWDBHFazsB5EsRpYWBsI0WLfP/Zg4cL59lF8zewP3zwsU2CQXL2AfxaDG7kJRyeuS05d8YBHmPDmUAt0nwJBLRI8Bgc5t3GnLuBgYdNmheoRY6HoMPOALXMqQdqYX/+mygtDAdygFoaDgO1MJgxg7RIE9JicAOohefY8dwZh3mMJWeck+CR7CHsMOPPPDXVuf3t7Q8/fCizkZM4Q0ALAjBDKII+GQWjYBSMglFABAAAPHs6FPeL718AAAAASUVORK5CYII=","orcid":"","institution":"Asan Medical Center","correspondingAuthor":true,"prefix":"","firstName":"Sung","middleName":"","lastName":"Shin","suffix":""}],"badges":[],"createdAt":"2024-02-08 07:59:59","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3939210/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3939210/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":51024752,"identity":"57fff316-c14e-4909-828d-c722d8ecbc60","added_by":"auto","created_at":"2024-02-12 21:40:31","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":161529,"visible":true,"origin":"","legend":"\u003cp\u003eKaplan-Meir survival curve for biopsy-proven acute rejection free graft survival\u003c/p\u003e","description":"","filename":"Fig1.png","url":"https://assets-eu.researchsquare.com/files/rs-3939210/v1/03f7405a5109d7fe7b1a4418.png"},{"id":51024751,"identity":"a17b6f3c-0adc-4130-9eea-6fc54c25f3ae","added_by":"auto","created_at":"2024-02-12 21:40:31","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":61159,"visible":true,"origin":"","legend":"\u003cp\u003eTrends of eGFR values over follow-up periods up to 1 year after transplantation\u003c/p\u003e","description":"","filename":"Fig2.png","url":"https://assets-eu.researchsquare.com/files/rs-3939210/v1/ca69b49f63bd3f50df0f7fd0.png"},{"id":51125765,"identity":"f6a70c90-a9f0-441a-a69b-ce5c0907398c","added_by":"auto","created_at":"2024-02-14 15:24:12","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":586997,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3939210/v1/80b44c3b-425e-4d5f-a318-579491a60327.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Comparison of clinical outcomes between robot-assisted and open ABO-incompatible kidney transplantation","fulltext":[{"header":"Introduction","content":"\u003cp\u003eKidney transplantation (KT) has become the preferred treatment for end-stage renal disease (ESRD), offering patients enhanced survival, better quality of life, and independence from dialysis maintenance [\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The increasing incidence of ESRD has led to a heightened demand for donor kidneys, while their availability remains scarce. This disparity has resulted in extended waiting periods for those in need of KT. To mitigate this shortage, various strategies have been developed, including significant advancements in desensitization protocols. These protocols have effectively overcome immunological challenges, facilitating transplants across human leukocyte antigen (HLA) and ABO blood group incompatibilities.\u003c/p\u003e \u003cp\u003eHistorically, ABO incompatibility was considered a definitive barrier to KT due to the high risk of hyperacute rejection and poorer outcomes stemming from blood type mismatches [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Recent advances in immunosuppressive therapies and desensitization techniques, however, have enabled successful ABO-incompatible (ABOi) KT globally. As a result, ABOi KT is now widely recognized as a feasible option for ESRD treatment, yielding outcomes on par with ABO-compatible (ABOc) KT in both adults and children [\u003cspan additionalcitationids=\"CR6\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eRobot-assisted kidney transplantation (RAKT) has seen impressive progress since its first successful procedure in France in 2001 [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. This innovative method has transformed KT, offering superior precision, enhanced visualization, and benefits for surgeons and recipients alike. However, the application of RAKT in immunologically high-risk patients is less documented, and detailed studies comparing RAKT with traditional open KT (OKT) in these scenarios are essential to evaluate the feasibility and advantages of the robotic method.\u003c/p\u003e \u003cp\u003eIn a preliminary study by T. Prudhomme et al., the perioperative outcomes of ABOi-RAKT, ABOc-RAKT, and ABOi-OKT were examined in obese patients. The study highlighted the benefits of RAKT for this group, such as improved surgical visibility, lower infection rates, reduced wound complications, and less lymphocele formation compared to OKT. The findings indicated no significant difference in kidney graft survival rates two years post-transplant between the ABOi-RAKT and ABOi-OKT groups [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTo fully assess the safety and efficacy of RAKT in ABOi-KT, it's crucial to extend research beyond obese patients. Thus, our current study aims to compare perioperative and graft outcomes between ABOi-RAKT and -OKT across a more diverse patient population.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Patients\u003c/h2\u003e \u003cp\u003eThis retrospective, single-center study encompassed 210 patients who underwent ABOi-OKT and 29 who underwent ABOi-RAKT between October 2020 and February 2023. All RAKT procedures were performed by the same surgeon, while the OKT procedures were carried out by a team of experienced surgeons at our center. Notably, all transplants in this study were from living donors.\u003c/p\u003e \u003cp\u003ePrior to surgery, recipients underwent preoperative computed tomography to evaluate their vascular anatomy and detect potential atherosclerosis in the iliac vessels, critical for vascular anastomosis. Our center adhered to stringent protocols for preoperative donor evaluation, immunosuppressant regimens, postoperative care, and follow-up.\u003c/p\u003e \u003cp\u003e The study was approved by the Ethics Committee of Asan Medical Center (reference number: 2023-0085). Owing to the retrospective nature of the study, the requirement for informed consent was waived.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eDesensitization Protocol\u003c/h2\u003e \u003cp\u003eOur prior publications [\u003cspan additionalcitationids=\"CR11\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] provide a comprehensive overview of the desensitization procedures we have developed for managing ABO incompatibilities. These include using rituximab, an anti-CD20 monoclonal antibody, and therapeutic plasma exchange (TPE) to lower antibody levels. ABOi recipients receive a single rituximab dose (100\u0026ndash;200 mg) one week before commencing TPE, which continues until immunoglobulin M isoagglutinin levels are safely reduced (\u0026le;\u0026thinsp;1:4). If there is a rebound in isoagglutinin levels, reaching or exceeding a titer of 1:16, postoperative TPE is considered.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eSurgical Techniques of RAKT\u003c/h2\u003e \u003cp\u003eIn our earlier publication [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], we have provided a thorough description of the surgical technique and the instruments used for RAKT. In brief, during the surgical procedure for RAKT, the patient was positioned at a 45-degree angle in the Trendelenburg position and securely fastened to the operating table. The initial steps involved exposing the iliac vessels and creating an extraperitoneal pouch, followed by the separation of the bladder to prepare for the ureteroneocystostomy. The graft, enclosed in a gauze jacket, was introduced into the abdominal cavity through the GelPOINT device. Regional hypothermia was induced by applying 200 to 250 cc of ice slush to cool the graft via the GelPOINT. Subsequently, a venotomy was made with Potts scissors, and the renal vein of the graft was joined to the external iliac vein in a continuous end-to-side manner. The external iliac artery was clamped, and an arteriotomy was created using robotic Potts scissors and the clamped artery was washed with heparinized saline. The renal artery was then connected to the external iliac artery in an end-to-side continuous manner. Once the anastomosis was confirmed to be secure, the blood supply to the kidney was restored and assessed for color and turgor. Throughout the entire anastomosis procedure, the pneumoperitoneum was reduced to 8 mm Hg to facilitate the detection of any bleeding. Following this, the kidney was placed into the extraperitoneal pouch, and the ureterovesical anastomosis was performed using a modified Lich-Gregoir technique. This involved creating two semi-continuous sutures with 4\u0026thinsp;\u0026minus;\u0026thinsp;0 Monocryl sutures over a previously inserted 6F, 14 cm Double-J stent. Finally, the detrusor muscle was closed using a continuous suture to establish an anti-reflux mechanism.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eClinical Outcomes\u003c/h2\u003e \u003cp\u003e We retrospectively reviewed patient records to collect clinical data. The primary endpoint was biopsy-proven acute rejection (BPAR). Allograft biopsies were evaluated based on Banff 2015 [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] and Banff 2017 criteria [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Graft survival was defined as the time from KT to graft removal or the resumption of dialysis. We included composite outcomes in our analysis, comprising BPAR, graft failure, and \u003cem\u003ede novo\u003c/em\u003e donor-specific antibody (DSA) occurrences.\u003c/p\u003e \u003cp\u003eKidney graft function was assessed by measuring the estimated glomerular filtration rate (eGFR) for up to one year post-KT, calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eWe presented continuous variables as median and range and categorical variables as numbers and percentages. Categorical variables were analyzed using the χ2 test or Fisher's exact test, depending on the sample size. Continuous variables were examined using the Student's \u003cem\u003et\u003c/em\u003e-test or Wilcoxon rank-sum test, based on their distribution.\u003c/p\u003e \u003cp\u003eRejection-free survival rates were analyzed using Kaplan-Meier curves and the log-rank test. Univariate and multivariate analyses using the Cox proportional hazards method were conducted to identify factors influencing graft survival and rejection events.\u003c/p\u003e \u003cp\u003eStatistical significance was set at a p-value of less than 0.05. All analyses were performed using IBM SPSS version 22.0 (IBM Corp., Armonk, NY, USA).\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\n\u003ch2\u003eBaseline Characteristics of Study Population\u003c/h2\u003e\n\u003cp\u003eThis study aimed to evaluate various parameters among 239 kidney transplant recipients, including 210 who received OKT and 29 who underwent RAKT. Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e outlines the baseline characteristics of the RAKT and OKT cohorts. The recipients' average age was 50.1 years, with no significant age difference between the groups (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.15). Gender distribution was also similar across both groups (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.63). The average body mass index (BMI) for the entire cohort was 23.36 kg/m\u003csup\u003e2\u003c/sup\u003e, with no significant difference between the RAKT and OKT groups (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.30).\u003c/p\u003e\n\u003cp\u003eA key finding was the variation in dialysis duration prior to transplantation between the two groups. The entire cohort had a median dialysis duration of 4 months, ranging from 0 to 10 months. The OKT group experienced a slightly longer median dialysis duration of 5 months (range: 0\u0026ndash;11 months) compared to 1 month (range: 0\u0026ndash;6 months) in the RAKT group, a statistically significant difference (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.02).\u003c/p\u003e\n\u003cp\u003eRetransplantation rates were similar between the two groups (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.14). The primary causes of ESRD included hypertension, diabetes mellitus (DM), glomerulonephritis (GN), and immunoglobulin A nephropathy (IgAN), with no significant differences in prevalence between the groups (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.76).\u003c/p\u003e\n\u003cp\u003eThe number of HLA mismatches was comparable between the RAKT and OKT groups (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.99). In comparing rituximab dosages, a higher proportion of RAKT recipients, 68.97%, received doses below 200mg, compared to 48.1% in the Open KT group. In contrast, only 31.03% of RAKT recipients received higher doses (\u0026ge;\u0026thinsp;200mg), against 51.9% in Open KT (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.04).\u003c/p\u003e\n\u003cp\u003eNo significant differences were found in the presence of pre-transplant DSA or \u003cem\u003ede novo\u003c/em\u003e DSA between the two groups (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.34 and \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.99, respectively), suggesting similar immunological profiles and antibody-mediated rejection risks. The use of induction immunosuppressants, such as basiliximab or thymoglobulin, was also comparable between the groups (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.79). The majority of recipients in both groups were treated with tacrolimus, with no significant difference in the use of calcineurin inhibitors (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.48).\u003c/p\u003e\n\u003cp\u003eDonor characteristics, including age, gender distribution, BMI, and comorbidities like DM and hypertension, showed no significant differences between the two groups. Additionally, donor renal function, evaluated by 24-hour creatinine clearance and urine protein levels, was similar in both groups.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003cdiv class=\"colspec\" align=\"char\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab1\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eBaseline characteristics of studied population between open KT and RAKT\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eVariables\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eTotal\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eOpen KT\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eRAKT\u003c/p\u003e\n\u003c/th\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003ep-value\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003en\u0026thinsp;=\u0026thinsp;239\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;210)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;29)\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eRecipient\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMean age, years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50.10\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11.81\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50.51\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11.97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e47.17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10.25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.154\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFemale gender, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e109\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e45.61\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e46.19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e12\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e41.38\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.626\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBody mass index, kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e23.36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.88\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e23.24\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.73\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24.23\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4.85\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.300\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePreemptive transplant, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e43\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e17.99\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e35\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e16.67\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e27.59\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.151\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDialysis duration in months, median (IQR)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u0026ndash;10\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u0026ndash;11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u0026ndash;6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.021\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eRetransplantation, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e7.53\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8.57\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.140\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCause of ESRD\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.763\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHTN, n( %)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e23\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9.62\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e20\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9.52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10.34\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDM, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e70\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e29.29\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e60\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e28.57\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e34.48\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGN, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10.04\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e20\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9.52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13.79\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIgAN, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e45\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18.83\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e39\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18.57\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e20.69\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFSGS, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.93\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.86\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.45\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePCKD, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6.28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e7.14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eUnknown, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e40\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e16.74\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e37\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e17.62\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10.34\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eOthers, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6.28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6.19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNumber of HLA mismatch (ABDR), median (IQR)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u0026ndash;5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u0026ndash;5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u0026ndash;5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.993\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.64\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.56\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.64\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.57\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.66\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHLA-incompatible KT, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e32\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13.39\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e14.29\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.388\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eRituximab dose (desensitization)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.035\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;200mg, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e121\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50.63\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e101\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e48.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e20\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e68.97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026gt;=200mg, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e118\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e49.37\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e109\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e51.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e31.03\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIgM titer, median (IQR)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e64\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e32\u0026ndash;128\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e64\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e32\u0026ndash;128\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e32\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e16\u0026ndash;64\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.094\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e117.80\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e298.48\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e125.69\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e316.79\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e60.69\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e65.74\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePre-transplant DSA, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e49\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e20.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e45\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e21.43\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13.79\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.340\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ede novo DSA, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6.69\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6.67\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u0026gt;\u0026thinsp;.999\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eImmunosuppressants\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eInduction, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.795\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBasiliximab\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e199\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e83.26\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e174\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e82.86\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e86.21\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThymoglobulin\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e40\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e16.74\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e17.14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13.79\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCalcineurin inhibitor, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.479\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTacrolimus\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e234\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e97.91\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e206\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e98.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e96.55\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCyclosporine\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.09\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.45\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eDonor\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMean age, years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50.79\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11.30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e51.02\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11.06\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e49.14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e12.98\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.401\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFemale gender, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e143\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e59.83\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e123\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e58.57\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e20\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e68.97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.285\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBody mass index, kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24.34\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.23\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24.40\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e23.88\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.85\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.424\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eRelation to a recipient, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.317\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLiving-related\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e103\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e43.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e88\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e41.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e51.72\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLiving-unrelated\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e136\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e56.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e122\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e58.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e48.28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDM, donor\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e12\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.02\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.24\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.45\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u0026gt;\u0026thinsp;.999\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHTN, donor\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e73\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e30.54\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e66\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e31.43\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24.14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.424\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24-h creatinine clearance, mL/min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e111.20\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e26.68\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e111.17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e27.49\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e111.47\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e20.21\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.954\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24-h urine protein, mg/day\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e83.42\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e30.61\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e83.66\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e31.95\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e81.65\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18.48\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.624\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLeft kidney donation, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e142\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e59.41\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e127\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e60.48\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e51.72\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.368\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eOperative results\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCold ischemic time, min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e56.85\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e38.82\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e48.57\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e30.06\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e116.83\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e42.70\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAnastomosis time, min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24.04\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10.44\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e21.09\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6.40\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e45.41\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9.08\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eRewarming time, min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e58\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9.66\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eOperative time, min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e170.37\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e68.45\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e152.90\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e49.75\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e296.83\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e49.98\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHospitalization after KT, days\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9.96\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8.14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10.37\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8.52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e7.03\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.21\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eeGFR (CKD-EPI) one month after KT, ml/min/1.73/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e68.60\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e19.25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e68.23\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e19.55\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e71.28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e16.95\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.426\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eCKD-EPI, chronic kidney disease epidemiology collaboration; DM, diabetes mellitus; DSA, donor-specific antibody; eGFR, estimated glomerular filtration rate; ESRD, end-stage renal disease; FSGS, focal segmental glomerulosclerosis; GN, glomerulonephritis; HLA, human leukocyte antigen; HTN, hypertension; IQR, Interquartile Range; IgAN, immunoglobulin A nephropathy; PCKD, polycystic kidney disease;\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\n\u003ch2\u003ePerioperative Outcomes\u003c/h2\u003e\n\u003cp\u003eIn our study examining surgical outcomes, we observed significant differences between the OKT and RAKT groups. Our findings revealed that the cold ischemic time was notably shorter in the OKT group, averaging 48.57\u0026thinsp;\u0026plusmn;\u0026thinsp;30.06 minutes, compared to 116.83\u0026thinsp;\u0026plusmn;\u0026thinsp;42.70 minutes in the RAKT group (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). A similar trend was seen in anastomosis time, with the OKT group averaging 21.09\u0026thinsp;\u0026plusmn;\u0026thinsp;6.40 minutes, significantly less than the RAKT group's 45.41\u0026thinsp;\u0026plusmn;\u0026thinsp;9.09 minutes (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The overall operative time also differed significantly, being shorter for the OKT group (152.91\u0026thinsp;\u0026plusmn;\u0026thinsp;49.75 minutes) compared to the RAKT group (296.83\u0026thinsp;\u0026plusmn;\u0026thinsp;49.98 minutes, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Additionally, we observed a difference in the length of hospital stay post-transplantation, with the RAKT group averaging shorter stays (7.03\u0026thinsp;\u0026plusmn;\u0026thinsp;3.21 days) compared to the OKT group (10.37\u0026thinsp;\u0026plusmn;\u0026thinsp;8.52 days, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eUnivariate and Multivariate Analysis For A Composite of BPAR, graft failure, and\u003c/strong\u003e \u003cstrong\u003ede novo\u003c/strong\u003e \u003cstrong\u003eDSA\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e displays the results of both univariate and multivariate analyses, focusing on a composite outcome of BPAR, graft failure, and \u003cem\u003ede novo\u003c/em\u003e DSA. In the univariate analysis, the type of surgery did not significantly influence this composite outcome. However, HLA-incompatible kidney transplants were significantly associated with the outcome, demonstrating a hazard ratio (HR) of 3.75 (95% CI: 1.744\u0026ndash;8.074, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.0007). The multivariable analysis indicates that this association might be significant, with an HR of 2.889 (95% CI: 0.974\u0026ndash;8.564, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.0557), suggesting a potential differential impact of HLA incompatibility across transplant groups. Pre-transplant DSA also displayed a significant association in the univariate analysis (HR 3.092, 95% CI: 1.475\u0026ndash;6.482, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.0028), but this significance was not maintained in the multivariate analysis (HR 2.161, 95% CI: 0.842\u0026ndash;5.547, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.1091). Additionally, thymoglobulin induction was significantly associated with the composite outcome in the univariate analysis (HR 2.527, 95% CI: 1.15\u0026ndash;5.553, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.021), but this association was not significant in the multivariate analysis, indicating that thymoglobulin's effect might be influenced by additional variables. Lastly, no donor factors showed significant association with the composite outcome. Overall, these analyses suggest that factors such as HLA incompatibility and pre-transplant DSA have significant associations in univariate contexts, but their impacts become more nuanced in multivariate analyses.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003cdiv class=\"colspec\" align=\"char\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003cdiv class=\"colspec\" align=\"char\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003cdiv class=\"colspec\" align=\"char\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab3\" style=\"width: 591px;\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eUnivariate and multivariate analysis of factors associated with a composite of graft failure, BPAR and \u003cem\u003ede novo\u003c/em\u003e DSA\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth style=\"width: 236px;\" rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eFactors\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 74px;\" colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth style=\"width: 77px;\" colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth style=\"width: 74px;\" colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth style=\"width: 77px;\" colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth style=\"width: 151px;\" colspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eUnivariable\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 151px;\" colspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eMultivariable\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003eHR\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 43px;\" align=\"left\"\u003e\n\u003cp\u003e95%CI\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 31.5625px;\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth style=\"width: 45.4375px;\" align=\"left\"\u003e\n\u003cp\u003ep-value\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003eHR\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 43px;\" align=\"left\"\u003e\n\u003cp\u003e95%CI\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth style=\"width: 46px;\" align=\"left\"\u003e\n\u003cp\u003ep-value\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eOpen KT\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.7105\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.961\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eRAKT\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e0.797\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.241\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.636\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e0.97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.292\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.229\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eRecipient\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eMean age, years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e0.998\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.968\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.028\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.8786\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eFemale gender, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e1.309\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.632\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.712\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.4688\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eBody mass index, kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e1.069\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.985\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.161\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003ePreemptive transplant, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e0.894\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.341\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.344\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.8199\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eDialysis duration, months\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e0.995\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.974\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.016\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.6424\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eRetransplantation, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003eNA\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eNumber of HLA mismatch (ABDR), (range)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e1.196\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.94\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.521\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.1453\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eHLA-incompatible KT, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e3.753\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.744\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e8.074\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e0.0007\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e2.889\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.974\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e8.564\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.056\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eRituximab dose (desentization)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.4621\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026lt;200mg, n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026gt;200mg, n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e0.758\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.362\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.587\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eIgM titer (IQR)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.999\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.6989\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003ePre-transplant DSA, n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e3.092\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.475\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e6.482\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e0.0028\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e2.161\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.842\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e5.547\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.109\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eImmunosuppressants\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eInduction, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e0.021\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.671\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eBasiliximab\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eThymoglobulin\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e2.527\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e5.553\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e0.78\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.248\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.452\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eCalcineurin inhibitor, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.8085\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eTacrolimus\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eCyclosporine\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e1.28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.174\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e9.435\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eDonor\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eMean age, years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e0.992\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.96\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.025\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.6489\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eFemale gender, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e0.695\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.335\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.44\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.3277\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eBody mass index, kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e1.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.986\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.228\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.089\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eRelation to a recipient, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.1136\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eLiving-related\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eLiving-unrelated\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e1.889\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.859\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.154\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eDM, donor\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e0.583\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.079\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.286\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.5958\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eHTN, donor\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e0.96\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.424\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.172\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.9211\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003e24-h creatinine clearance, mL/min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e1.006\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.993\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.018\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.385\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003e24-h urine protein, mg/day\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e0.984\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.967\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.073\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 236px;\" align=\"left\"\u003e\n\u003cp\u003eLeft kidney donation, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n\u003cp\u003e1.524\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.694\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31.5625px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.348\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 45.4375px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.2935\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"width: 46px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eDM, diabetes mellitus; DSA, donor-specific antibody; HLA, human leukocyte antigen; HTN, hypertension; IQR, Interquartile Range; RAKT, robot-assisted kidney transplantation.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\n\u003ch2\u003eComparison of Biopsy-Proven Acute Rejection-Free Graft Survival and Renal Function Between RAKT and OKT Recipients\u003c/h2\u003e\n\u003cp\u003eTo illustrate the comparison in BPAR-free graft survival between RAKT and OKT recipients, we utilized Kaplan-Meier curves, as shown in Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e. Both groups demonstrated comparable BPAR-free graft survival throughout the observation periods. Specifically, the RAKT group exhibited a BPAR-free survival rate of 92.4% at both 1 and 2 years. In contrast, the OKT group recorded rates of 93.1% at 1 year and 91.9% at 2 years. However, the difference in BPAR-free survival between the two groups was not statistically significant (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.99).\u003c/p\u003e\n\u003cp\u003eFigure \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e depicts the overall trend in eGFR values, determined via the CKD-EPI Creatinine Equation. The patterns observed between the RAKT and OKT groups were notably similar (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.20). Specifically, the mean eGFR values were 64.41 ml/min/1.73m\u003csup\u003e2\u003c/sup\u003e for the RAKT group and 65.75 ml/min/1.73m\u003csup\u003e2\u003c/sup\u003e for the OKT group.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\n\u003ch2\u003eInfectious Complications\u003c/h2\u003e\n\u003cp\u003eTable\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e offers a detailed comparative analysis of the etiologies behind post-transplant infections necessitating hospital admission. It is essential to approach the data with an understanding that the numerical differences in infection incidences are influenced by the varying sample sizes of the two groups, and not necessarily indicative of a higher infection risk in either group. In the realm of urinary tract infections, the OKT group showed a diverse range of causative organisms. Escherichia coli (E.coli) was the most common, identified in 20 cases (9.5%), followed by Klebsiella pneumoniae (K. pneumoniae) in 11 cases (5.2%). Other organisms such as Klebsiella aerogenes, Enterococci, and Proteus mirabilis were also reported, with incidences of 2.4%, 3.3%, and 1% respectively. For the RAKT group, incidences were notably lower, with E. coli and K. pneumoniae appearing in 2 (6.9%) and 4 (13.8%) cases respectively.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab4\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eComparative Analysis of Post-Transplant Infection Etiologies between two groups\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eIncidences\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCauses\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEtiologies\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eOpen KT\u003c/p\u003e\n\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;210)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eRAKT\u003c/p\u003e\n\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;29)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"9\" align=\"left\"\u003e\n\u003cp\u003eUrinary tract infection\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEscherichia coli\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e20\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eKlebsiella aerogenes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eKlebsiella oxytoca\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eKlebsiella pneumoniae\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEnterococci\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eProteus mirabilis\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCitrobacter freundii\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMorganella morganii\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCandida albicans\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePneumonia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCovid-19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eViral infection\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCytomegalovirus syndrome\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBacteremia of unknown origin\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEscherichia coli\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eKlebsiella pneumoniae\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBacteroides fragilis\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePostsurgical site infection\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eKlebsiella pneumonia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eStreptococcus parasanguinis\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eStaphylococcus aureus\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEnterococcus faecalis\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEscherichia coli\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBacteroides fragilis\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCandida albicans\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFungal infection\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCandidasis\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGastrointestinal infection\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSapovirus\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eClostridium difficille\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003ePneumonia, specifically from Covid-19, was noted in 5 instances (2.4%) within the OKT group. Additionally, viral infections like Cytomegalovirus syndrome were exclusive to the OKT group, occurring in 3 patients (1.4%).\u003c/p\u003e\n\u003cp\u003eOccurrences of bacteremia of unknown origin in the OKT group included E. coli in 5 cases (2.4%) and K. pneumoniae and Bacteroides fragilis each in 1 case (0.5%). In the RAKT group, E. coli was the cause in 1 case (3.4%).\u003c/p\u003e\n\u003cp\u003ePost-surgical site infections in the OKT cohort were caused by various organisms, including K. pneumoniae, Streptococcus parasanguinis, Staphylococcus aureus, Enterococcus faecalis, E. coli, B. fragilis, and Candida albicans, with individual incidences ranging from 0.5\u0026ndash;1%.\u003c/p\u003e\n\u003cp\u003eFungal infections, represented by candidiasis, were found in 2 OKT patients (1%). In the In the OKT group, gastrointestinal infections were noted in a few cases: Sapovirus infection occurred in 1 patient (0.5%), while Clostridium difficile was identified in 2 patients (1.0%).\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eMultiple studies have explored the feasibility, safety, and appropriateness of RAKT in ESRD patients [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan additionalcitationids=\"CR18 CR19 CR20 CR21\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Initially, research on RAKT primarily focused on its technical aspects, often overlooking comprehensive clinical outcome data. However, as RAKT's adoption increased, a richer dataset emerged, enhancing our understanding of its clinical outcomes and allowing for direct comparisons with traditional open methods.\u003c/p\u003e \u003cp\u003eA range of studies has investigated the functional results and associated risks of both RAKT and OKT. For instance, research by J. Oberholzer and colleagues focused on the effectiveness of RAKT in obese patients, traditionally considered unsuitable for transplantation due to high BMIs averaging 42.6\u0026thinsp;\u0026plusmn;\u0026thinsp;7.8 kg/m\u003csup\u003e2\u003c/sup\u003e. Comparing these patients with a similar cohort undergoing OKT, they found that renal function, measured by serum creatinine levels six months post-transplant, was similar in both groups (1.5 mg/dL\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4 for RAKT vs. 1.6 mg/dL\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6 for OKT, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.47). Despite the six-month follow-up limitation, other metrics like graft survival, patient survival, rejection rates, and infection frequencies were comparable [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAdditionally, a study by Volkan T. compared 40 RAKT and 40 OKT cases performed by the same surgeon [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. The results indicated similar functional outcomes in both groups, with creatinine levels at six months post-transplantation being 0.95\u0026thinsp;\u0026plusmn;\u0026thinsp;0.90 mg/dL for RAKT and 0.87\u0026thinsp;\u0026plusmn;\u0026thinsp;0.73 mg/dL for OKT (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.638). A recent systematic analysis also found no significant differences in patient and graft survival across various KT methods (open, laparoscopic, robotic) [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWhile existing literature focuses on immunologically compatible patients, there's a gap in research exploring the impact of immunological risk on RAKT vs. OKT outcomes. T. Prudhomme and colleagues studied ABOi-RAKT in overweight patients, contrasting with ABOi-OKT. They observed longer cold ischemia times, operation durations, and rewarming intervals in the ABOi-OKT group (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Additionally, the ABOi-RAKT group showed a 0% rate of delayed graft function, compared to 10.7% in ABOi-OKT (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.60), with similar graft survival rates observed in both groups [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOur research fills a gap by comparing clinical outcomes between ABOi-RAKT and ABOi-OKT in a broader demographic, not limited to overweight patients. We found comparable one-year BPAR-free survival rates (92.4% for RAKT vs. 93.1% for OKT, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.99) and consistent eGFR trends over a year (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.20). These results suggest that, with proper desensitization methods, RAKT can be as effective as OKT in ABOi patients.\u003c/p\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eStudy limitations\u003c/h2\u003e \u003cp\u003eOur study faced several limitations that should be considered when reviewing the findings. Being a single-center retrospective study with unequal participant numbers in the two groups, it may have limited statistical power and potential biases. The imbalance in group sizes, influenced by non-random factors, could introduce additional biases. Despite using robust statistical methods to mitigate these issues, these limitations must be acknowledged. Another constraint is the limited timeframe for outcome assessment, due to the recent initiation of RAKT at our center. While short-term results are promising, further research over longer periods is essential.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn conclusion, RAKT demonstrates comparable functional outcomes to OKT in ABOi patients. Parameters like age, gender, BMI, preemptive transplantation status and retransplantation frequency showed no significant differences between the techniques. However, individual patient characteristics and surgical expertise should guide the choice of transplantation method. Future research should aim for more comprehensive studies with longer follow-up to solidify these initial findings.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was not supported by dedicated funding from any public, commercial, or non-profit organizations.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no relevant financial or non-financial interests to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eJMK, HK, YHK and SS were responsible for study design and manuscript preparation. JMK, HEK, YK and JHJ were responsible for data analysis. The first draft of the manuscript was written by JMK and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors will provide the raw data supporting the findings of this article upon request, without any unwarranted delays or restrictions. For additional questions or inquiries, please contact the corresponding author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest/Disclosure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no conflicts of interests or disclosures to report.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eLaupacis A, Keown P, Pus N, Krueger H, Ferguson B, Wong C, et al. A study of the quality of life and cost-utility of renal transplantation. Kidney Int. 1996;50(1):235\u0026ndash;42.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTomasz W, Piotr S. A trial of objective comparison of quality of life between chronic renal failure patients treated with hemodialysis and renal transplantation. Ann Transplant. 2003;8(2):47\u0026ndash;53.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTonelli M, Wiebe N, Knoll G, Bello A, Browne S, Jadhav D, et al. Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes. Am J Transplant. 2011;11(10):2093\u0026ndash;109.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMuramatsu M, Gonzalez HD, Cacciola R, Aikawa A, Yaqoob MM, Puliatti C. ABO incompatible renal transplants: Good or bad? World J Transplant. 2014;4(1):18\u0026ndash;29.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTyd\u0026eacute;n G, Kumlien G, Berg UB. ABO-incompatible kidney transplantation in children. Pediatr Transplant. 2011;15(5):502\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShishido S, Hyodo YY, Aoki Y, Takasu J, Kawamura T, Sakai KK, et al. Outcomes of pediatric ABO-incompatible kidney transplantations are equivalent to ABO-compatible controls. Transplant Proc. 2012;44(1):214-6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMontgomery JR, Berger JC, Warren DS, James NT, Montgomery RA, Segev DL. Outcomes of ABO-incompatible kidney transplantation in the United States. Transplantation. 2012;93(6):603\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHoznek A, Zaki SK, Samadi DB, Salomon L, Lobontiu A, Lang P, et al. Robotic assisted kidney transplantation: an initial experience. J Urol. 2002;167(4):1604\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePrudhomme T, Del Bello A, Sallusto F, Lesourd M, Kamar N, Doumerc N. 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Transpl Int. 2014;27(5):452\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTuğcu V, Şener NC, Şahin S, Yavuzsan AH, Akbay FG, Apaydın S. Robot-assisted kidney transplantation: comparison of the first 40 cases of open vs robot-assisted transplantations by a single surgeon. BJU Int. 2018;121(2):275\u0026ndash;80.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWagenaar S, Nederhoed JH, Hoksbergen AWJ, Bonjer HJ, Wisselink W, van Ramshorst GH. Minimally Invasive, Laparoscopic, and Robotic-assisted Techniques Versus Open Techniques for Kidney Transplant Recipients: A Systematic Review. Eur Urol. 2017;72(2):205\u0026ndash;17.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"robot-assisted kidney transplantation, ABO incompatible kidney transplantation, biopsy-proven acute rejection, immunologically high-risk patients, allograft outcomes","lastPublishedDoi":"10.21203/rs.3.rs-3939210/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3939210/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eRobot-assisted kidney transplantation (RAKT) is increasingly being adopted worldwide. Despite this growing interest, there remains a notable gap in the literature, especially concerning its effectiveness in immunologically high-risk patients compared to the conventional open kidney transplantation (OKT). This study is focused on exploring the viability and success of RAKT in comparison with OKT, particularly for recipients with ABO incompatibility (ABOi). A retrospective analysis was conducted on 239 living-donor transplants at a single center, comprising 210 OKT and 29 RAKT cases. Perioperative outcomes, graft survival, and renal function were assessed. A composite of biopsy-proven acute rejection (BPAR), graft failure, and the development of \u003cem\u003ede novo\u003c/em\u003e donor-specific antibodies (DSA) was analyzed through univariate and multivariate models. Both RAKT and OKT groups showed comparable one and two-year BPAR-free survival rates (RAKT: 92.4%, OKT: 93.1% and 91.9% respectively) and similar mean eGFR values (RAKT: 64.41 ml/min/1.73m\u0026sup2;, OKT: 65.75 ml/min/1.73m\u0026sup2;). OKT had a significantly shorter cold ischemic time and operative time but longer hospital stays compared to RAKT. Univariate and multivariate analyses indicate no significant difference in the composite outcome (BPAR, graft failure, \u003cem\u003ede novo\u003c/em\u003e DSA) between the two groups. RAKT presents as a safe and effective alternative to OKT in ABOi patients, with similar perioperative outcomes, graft survival rate, and renal function.\u003c/p\u003e","manuscriptTitle":"Comparison of clinical outcomes between robot-assisted and open ABO-incompatible kidney transplantation","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-02-12 21:40:27","doi":"10.21203/rs.3.rs-3939210/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"344ccda5-8050-441c-bb72-fd0b7ad4f860","owner":[],"postedDate":"February 12th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-02-14T15:16:03+00:00","versionOfRecord":[],"versionCreatedAt":"2024-02-12 21:40:27","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3939210","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3939210","identity":"rs-3939210","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}