Objective:

To investigate differences in surgical approaches to kidney transplantation based on surgeon training (urologist vs. general surgeon) in Germany, highlighting the implications for clinical practice.

Key Findings:

• Response rate was 89.5% with 34 centers participating (13 urological, 21 surgical).
• Pre-operative standards showed that 91% of urologists do not mandate nicotine cessation compared to 31% of general surgeons.
• 76% of urological centers perform open surgery, while 90% of surgical centers do the same; robotic-assisted laparoscopic transplants are more common in urology (23% vs. 5%).
• Post-operative care differs, with urological centers often managing care in the operating department (46%) compared to surgical centers (48% interdisciplinary).
• Patients in surgical centers are discharged earlier (6-8 days) compared to urological centers (10-14 days).

Interpretation:

The study highlights notable differences in pre-operative, perioperative, and post-operative practices between urology-led and surgical-led kidney transplant centers in Germany, suggesting potential areas for standardization that could improve patient outcomes.

Limitations:

• Incomplete questionnaires were included in the analysis, which may affect data reliability and the generalizability of the findings.
• The study is limited to Germany and may not reflect practices in other countries, potentially limiting the applicability of the results.

Conclusion:

The findings indicate significant variations in clinical standards for kidney transplantation based on the surgeon's specialty, emphasizing the need for potential standardization in practices to enhance patient care.