Robotic Surgery in Urology: Prostate Cancer, Kidney Tumours and Bladder Cancer

Yes, blood group-incompatible transplants are done routinely, though they remain the second choice after a compatible donor. The recipient's antibody titre against the donor's blood group determines eligibility: titres up to 1:8 are essentially as good as a compatible transplant, and even up to 1:64 respond to one or two sessions of plasmapheresis. Higher titres, above 1:128, need immunoadsorption column filtration to bring the level down before proceeding. The success rate is good but runs slightly below a fully compatible transplant, with roughly one in 50 patients experiencing hyperacute rejection.

Yes, HLA incompatibility alone is not a major problem, even between spouses with no HLA match at all. What actually determines eligibility is the cross match: a negative CDC and flow cross match clears the way for transplant. If CDC is negative but flow is positive, donor-specific antibody testing by the single antigen bead method quantifies the real risk, an MFI reading up to roughly 1,500-2,000 is not a concern, while higher readings call for plasmapheresis first. The key requirement is simply that there should be no antibodies against that particular HLA antigen.

Whenever a brain-dead donor is identified anywhere in Delhi NCR, India's national organ transplant authority (NOTTO) is notified and coordinates two brain stem death declarations roughly two hours apart, made jointly by the primary caregiver and a neurointensivist or equivalent specialist. Once the family consents, NOTTO allocates the organ from its waiting list strictly by turn order across hospitals, no single centre can claim it outside that process. From the first declaration to organ harvest is roughly a 12-hour process, with the recipient's dialysis and cross-match run in parallel so the transplant can proceed within six to twelve hours of harvest.

This is antibody-mediated rejection (AMR), one of two categories of acute rejection alongside cell-mediated rejection (ACR), and a kidney biopsy is needed to tell them apart. Treatment usually starts with methylprednisolone pulses, escalating to anti-thymocyte globulin or plasmapheresis if that isn't enough. In over a decade, hyperacute rejection has not been seen in blood-compatible transplants at this centre, and most rejection today is reversible when caught and treated promptly, the real danger comes from delayed treatment, not from the rejection episode itself.

Donation has to come from love and compassion, never pressure. What actually works is reframing donation as a chance for the donor to become healthier: the thorough medical workup required for donor clearance means any underlying problem gets caught and treated, so donors go on to outlive their peer group rather than being harmed by donating. Where genuine pressure would otherwise be needed, keeping the recipient on dialysis while continuing to look for a willing donor is the ethical path, alongside broader deceased-donor campaigns to reduce reliance on living donors altogether.

Blood loss has dropped from around 700-800 ml under open surgery to about 100 ml, operating time is down to two-and-a-half to four hours, and most patients go home within three days and are catheter-free within two to three weeks.

Yes, robotic partial nephrectomy can address bilateral tumours in a single session, saving both kidneys. Dr. Rana cited a patient with bilateral kidney tumours and an adrenal mass, labelled metastatic elsewhere, who has remained tumour-free for five years after single-session robotic resection of all three lesions.