title: Robot-assisted radical prostatectomy in patients with previous renal transplantation.
abstract: OBJECTIVE
  To evaluate the outcomes of robot-assisted radical prostatectomy (RARP) in patients with previous renal transplantation.
  
  
  METHODS
  We retrospectively identified all patients who had undergone RARP for localized prostate cancer between 2005 and 2008 at a single institution (N=228). Of these, three patients were renal transplant recipients. A four-arm robotic configuration was used in all patients. Port placement was modified in two of the three renal transplant recipients to avoid trauma to the renal allograft. Preoperative demographics, perioperative parameters, and postoperative outcomes were reviewed.
  
  
  RESULTS
  RARP was completed successfully in all three renal transplant recipients. As expected, the American Society of Anesthesiologists score (3.3 vs 2.4) and Charlson weighted index of comorbidity (4.7 vs 2.4) were greater in previous transplant patients. There were no major differences in mean age, Gleason score, body mass index, estimated blood loss, operative time, complications, or oncologic outcomes between the two groups. Each of the patients with renal allografts had an undetectable prostate-specific antigen level and was continent (needing no pads) at 13 months of follow-up.
  
  
  CONCLUSIONS
  RARP is feasible in patients with a previous renal transplant. Although technically more challenging, RARP can be performed in previous transplant patients with acceptable morbidity and oncologic outcomes similar to those of other prostate cancer patients.
authors.affiliation: Department of Urology, Loma Linda University, Loma Linda, CA 92354, USA.
authors.forename: Damien L
authors.initials: DL
authors.lastname: Smith
authors.forename: Forrest C
authors.initials: FC
authors.lastname: Jellison
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Heldt
authors.forename: Christopher
authors.initials: C
authors.lastname: Tenggardjaja
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Bowman
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Jin
authors.forename: Joshua
authors.initials: J
authors.lastname: Chamberlin
authors.forename: Paul D
authors.initials: PD
authors.lastname: Lui
authors.forename: D Duane
authors.initials: DD
authors.lastname: Baldwin
mesh_terms: D016022:Case-Control Studies; D003710:Demography; D006801:Humans; D007430:Intraoperative Care; D016030:Kidney Transplantation; D008297:Male; D011182:Postoperative Care; D011300:Preoperative Care; D011468:Prostatectomy / Q000379:methods*; D012371:Robotics