Robotic kidney transplant: Hospital uses new technology for surgery

Team at work

Medical City Fort Worth

900 Eighth Ave.

Fort Worth 76104


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Even in death, Mariyah Brown joined with Jason Martinez in making history.

Brown, an 18-year-old college freshman, died unexpectedly during the Christmas holidays. However, her family, having known Martinez through their daughters playing select softball together, used her death as a way to save his life.

Martinez, 38, had been on a waiting list for a kidney transplant. Brown’s was a match, so the transplant was done.

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But it wasn’t a traditional transplant. Dr. George Rofaiel and his team performed robotic surgery at Medical City Fort Worth’s Transplant Institute, using a da Vinci Xi surgical robot to transplant the kidney.

It is believed to be the first surgery of its kind in the Southwest, Rofaiel said.

“I was lying in bed Christmas night and I got a phone call from our friend Robbie Brown,” Martinez said. “She said, ‘Our daughter is passing, but we want to bring happiness to your family.’ I didn’t have any words. This family thought of me at the worst time in their life, when they were losing their child.”

Martinez admits feeling awkward at first.

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“I was just taken aback. I didn’t have any words,” he said. “Do I say yes? Do I say no? You’re an extension of my family. Our daughters played together. I said yes.”

Indeed he did, and the transplant took place on Dec. 28. The next day he was on his way to a speedy recovery.

“The next day I was a little sore, but there was no pain at all,” Martinez said recently. “Then, when I got out, it was off-the-wall energy, cooking, cleaning. Yesterday I went on a three-mile walk.”

The transplant team used a pioneering robotic surgery procedure performed by only about 10 surgeons and facilities in the world. Medical City Fort Worth is believed to be the first in Texas and the southwestern United States to perform the procedure, Rofaiel said.

Benefits for the patient include a faster recovery, less chance of infection, less pain and a smaller incision, according to Rofaiel.

“If you were to tell someone they’d have a transplant and be home the next morning, they’d say you were crazy,” Rofaiel said.

“The robotic system enabled us to avoid the typical 10-inch incision made in the lower abdomen, just above the groin, which exposes the layers of the abdominal wall,” Rofaiel explained. “In that location, there’s a particular risk for herniation and infections after surgery, as well as for lymphoceles, or fluid, collecting.

“Some of these complications simply don’t happen with the robotic procedure, like the lymphoceles. We can go into a different location – the upper abdomen –using an incision that’s one-third the size. We can avoid infections and hernias, allowing for faster recovery.

“In this case, Jason was able to go home less than 72 hours after the surgery, taking only Tylenol for pain.”

Martinez battled diabetes and high blood pressure for years and was on dialysis for a year. The Transplant Institute team helped him work to get healthy enough for the transplant.

One step in that journey was bariatric surgery performed by Dr. Jay Patel at Medical City Fort Worth, which helped Martinez lose 100 pounds and also brought his diabetes and hypertension under control. In May 2016, he was officially listed for a transplant.

“Kidney transplant patients often have other health issues besides just the failing kidneys,” said Dr. Sridhar Allam, medical director of Medical City Fort Worth’s kidney transplant program. “Our team looks at the entire picture for the patient, working to help resolve issues that might keep them from being eligible for a transplant.”

Rofaiel has since performed a second robotic kidney transplant. He hopes use of the procedure will grow rapidly in coming years.

“I think it’s going to become a major part of what we do. My goal is for us in 2018 to do about 25 to 30 percent of all of our transplants this way. It’s accelerated pretty quickly in the last two years.”

More than 99,000 people are on the waiting list in the United States for a kidney, according to the United Network for Organ Sharing (UNOS). Overall organ transplants performed in the United States in 2016 reached a record high for the fourth consecutive year, according to preliminary data reported by UNOS. For the year, 33,606 transplants were reported, representing an 8.5 percent increase over the 2015 total and an increase of 19.8 percent since 2012.

With so much need, there are people like the Browns to help, even in the most devastating of personal times.

“Mayriah cared for everyone around her for her whole life,” said her father, Robbie Brown. “I just knew this was something she would want to do, and the very first person who came to mind was Jason. We’ve known him a few years, and he had shared his story with me and what he was going through. I knew he was a good person and we wanted to help him.

“The donation honors Mayriah’s life, and that’s helping us to get through this. The last I heard, her organs were saving up to seven lives.”

Martinez said that while Brown’s death was heartbreaking, her posthumous help was a miracle.

“God put the Browns in my life for a reason,” Martinez said. “We’re a family now. We’re tied together.”