Transplant Surgery

EHR‑integrated AI risk prediction did not change SDM or outcomes in kidney transplant recipients

In a single‑center randomized trial (n=76, eGFR<30) EHR‑available AI risk estimates did not increase patient‑reported conversations about post‑graft‑loss options (14/36 vs 16/40). No differences were seen in secondary SDM, relationship, or distress measures across 12 months. Tool uptake was low and users reported workflow barriers, suggesting implementation failure rather than model ineffectiveness. 1

Instrumental‑variable analysis removes apparent MAG survival benefit after CABG in older Medicare patients

In 1,291,314 Medicare CABG patients, conventional risk‑adjusted analysis showed MAG median survival 10.74 vs 10.33 years for SAG. Using surgeon MAG rate as an instrumental variable, adjusted median survival was identical: 10.38 years for both groups. This contrast implies unmeasured confounding likely explains much of the observational MAG survival advantage. 2

Robot‑assisted kidney transplantation reduced early major and vascular complications numerically

In this randomized open‑label trial (robot n=54, open n=53) major surgical complications occurred in 13 (25%) open vs 7 (13%) robotic patients (risk difference −11%). Vascular complications were 19% open vs 9.4% robotic (risk difference −9.4%). Findings suggest possible short‑term morbidity reduction with robotic KTx but are limited by single‑centre design and modest sample size, and results were not statistically definitive. 3