Case Study: Robotic Nephrectomy

A 62-year-old female underwent a successful living-donor kidney transplant at UPMC Harrisburg as a result of end state renal disease secondary to diabetes, along with multiple kidney stones. The patient’s 37-year-old son-in-law was her living donor. The female recipient was on hemodialysis for one year prior to kidney transplantation.

Danielle Ladie, MD, transplant surgeon and vice chair of the Department of Surgery at UPMC Harrisburg, performed a robotic nephrectomy in February 2024 to remove the living donor’s kidney for the transplant, using the multiport robotic surgery system, da Vinci Xi® by Intuitive. The UPMC Transplant Program at UPMC Harrisburg is the first program in central Pennsylvania to use this robotic system.

A robotic nephrectomy is a minimally invasive surgery where the kidney is removed from a donor to then be placed in the recipient. With this robotic system, the surgeon controls the robotic arm from a console to remove the donor kidney through small incisions. Robotic surgery enables smaller incisions in the lower abdomen, which decreases the risk of hernia and infection.

“We have found that this type of surgery allows the donor to get back to their daily activities very quickly,” says Dr. Ladie. “A donor typically only has to stay in the hospital for one night. The robot allows surgeons to be more meticulous and see inside their abdominal cavity in 3D. It also decreases the trauma on the donor, so they seem to heal much better and require less pain medication with this technology."

The donor did not require narcotic pain medication after surgery and only stayed one night in the hospital, then was discharged the next day. About two weeks post-surgery, the donor had a follow-up appointment with Dr. Ladie. Shortly after his appointment, the donor was able to return to his active lifestyle at the gym with some limitations. “The donor was back to doing things he loved very quickly,” says Dr. Ladie. “The living donation process has had very little effect on his life. The most important thing is that he truly saved someone's life, in his case, his mother-in-law’s life.”

Dr. Ladie states that this is a case that shows that a living donor doesn’t need to be a family member. “In this case, the donor and recipient weren’t related,” says Dr. Ladie. “A kidney can be donated to anybody, a friend, a neighbor, or even a stranger, as long as testing shows that they are compatible. The donor and recipient don’t even have to be the same blood type. Our team can also offer a kidney exchange, if needed.”

A paired kidney exchange allows a donor to save the life of their recipient even if they are not a direct match. It takes place when two incompatible donor and recipient pairs are compatible with each other, so they exchange kidneys to provide the appropriate match.

More than 90,000 people in the United States are currently on the waiting list for a kidney transplant. The wait time in the Harrisburg, Pa. region is about six years. “The recipient was able to have her transplant after only one year on the kidney transplant waiting list,” says Dr. Ladie. “Receiving a transplant from a living donor is going to extend and improve her quality of life.”

For more information on organ transplant services in central Pennsylvania, visit UPMC.com/CentralPaTransplant.