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World J Transplant. Sep 18, 2026; 16(3): 117482
Published online Sep 18, 2026. doi: 10.5500/wjt.117482
Integrating robotic donor nephrectomy into contemporary living donor programmes: Evidence and practical considerations
Pranjal Kashiv, Manish Ramesh Balwani, Amit Pasari, Khushboo Saxena, Sanjay P Kolte, Vivek B Kute
Pranjal Kashiv, Department of Nephrology, All India Institute of Medical Sciences, Nagpur 441108, Maharashtra, India
Pranjal Kashiv, Amit Pasari, Department of Nephrology, Jawaharlal Nehru Medical College, Wardha 442001, Maharashtra, India
Manish Ramesh Balwani, Department of Nephrology, Saraswati Kidney Care Centre, Nagpur 440015, Maharashtra, India
Khushboo Saxena, Department of Nephrology, Institute of Kidney Diseases and Research Centre, Ahmedabad 380016, Gujarat, India
Sanjay P Kolte, Director Urology, Max Superspeciality Hospital, Nagpur 440030, Maharashtra, India
Sanjay P Kolte, Department of Urology, Jawaharlal Nehru Medical College, Wardha 442001, Maharashtra, India
Vivek B Kute, Department of Nephrology, Institute of Kidney Diseases and Research Centre, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad 380016, Gujarat, India
Author contributions: Kashiv P conceptualized the study, designed the methodology, collected data, performed analysis, and drafted the initial manuscript; Balwani MR and Pasari A provided critical supervision, conceptual guidance, and major revisions of the manuscript; Saxena K and Kolte SP, assisted in data collection, literature review, and preparation of figures and tables; Kute VB contributed to study design, interpretation of results, and final review of the manuscript for important intellectual content. All authors approved the final version and agree to be accountable for all aspects of the work.
AI contribution statement: No part of the scientific content of the manuscript (including the Abstract, Introduction, Materials and Methods, Results, Discussion, or Conclusions) was generated de novo by AI. All scientific concepts, clinical observations, data interpretations, and conclusions are the original work of the authors. AI tools were used only for linguistic polishing and grammatical correction. They did not contribute to data analysis, study design, translation, or substantive scientific writing. No AI tool participated in the design of the study or in the interpretation of its results. All scientific reasoning was performed entirely by the human authors.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Vivek B Kute, Professor, Department of Nephrology, Institute of Kidney Diseases and Research Centre, Dr HL Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad 380016, Gujarat, India.
drvivekkute@rediffmail.com
Received: December 9, 2025
Revised: January 1, 2026
Accepted: February 3, 2026
Published online: September 18, 2026
Processing time: 264 Days and 15.8 Hours
In this editorial, we comment on the study by Christou et al recently published in World Journal of Transplantation, which presents a matched comparative analysis evaluating robot-assisted vs hand-assisted laparoscopic donor nephrectomy within a contemporary United Kingdom living-donor programme. Their work directly addresses a central question in the current evolution of minimally invasive donor surgery - the robotic platforms offer incremental advantages in precision, operative consistency, or ergonomic sustainability without compromising donor safety or graft function. The authors demonstrate that both techniques achieve comparable perioperative recovery, complication profiles, and early allograft outcomes. Although modest variations were observed in warm ischaemia time, postoperative stay, and workflow dynamics, these differences lacked clinical significance and did not influence donor or graft results. Importantly, the progressive reduction in console time with accumulating experience reflects the characteristic learning-curve trajectory seen across early robotic adoption, underscoring how proficiency stabilises as teams internalise the platform’s ergonomics and procedural choreography. Beyond the procedural metrics themselves, the study offers practical insight into how robotics may be integrated into mature donor programmes: As a complementary modality that supports technical reproducibility, preserves donor safety, and potentially enhances surgeon ergonomics. These findings therefore provide timely guidance for centres evaluating whether robotics can be incorporated alongside established laparoscopic pathways, balancing performance, training requirements, institutional resources, and long-term programme sustainability.
Core Tip: Robotic donor nephrectomy is increasingly explored as a refinement of minimally invasive living donor surgery. The matched analysis by Christou et al emonstrates that robot-assisted and hand-assisted laparoscopic donor nephrectomy achieve equivalent donor safety, graft outcomes, and perioperative recovery, with early differences in warm ischaemia time or workflow showing no clinical impact. Importantly, the robotic platform offers advantages in precision, visual control, and surgeon ergonomics, with performance improving rapidly along a compressed learning curve. These findings provide practical guidance for programmes considering robotics as a complementary modality that enhances reproducibility and long-term sustainability without compromising donor protection.
