Robotic living donor hepatectomy is associated with superior outcomes for both the donor and the recipient compared with laparoscopic or open - A single-center prospective registry study of 3448 cases

Minimally invasive donor hepatectomy is an emerging surgical technique in living donor liver transplantation (LDLT). We examined outcomes across open, laparoscopic, and robotic LDLT using a prospective registry. We analyzed 3448 cases (1724 donor-recipient pairs) from January 2011 to March 2023 (NCT...

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Veröffentlicht in:American journal of transplantation 2024-11, Vol.24 (11), p.2080-2091
Hauptverfasser: Raptis, Dimitri A., Elsheikh, Yasser, Alnemary, Yasir, Marquez, Kris Ann H., Bzeizi, Khalid, Alghamdi, Saad, Alabbad, Saleh, Alqahtani, Saleh A., Troisi, Roberto I., Boehnert, Markus U., Malago, Massimo, Wu, Yao-Ming, Broering, Dieter C., Lepiesza, Agniesza, AlMudaiheem, Bedour A., Elmikkaoui, Bilal, Zakaria, Hazem, Vashist, Yogesh, Alshibi, Leen, Kareem, Sami A.
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container_end_page 2091
container_issue 11
container_start_page 2080
container_title American journal of transplantation
container_volume 24
creator Raptis, Dimitri A.
Elsheikh, Yasser
Alnemary, Yasir
Marquez, Kris Ann H.
Bzeizi, Khalid
Alghamdi, Saad
Alabbad, Saleh
Alqahtani, Saleh A.
Troisi, Roberto I.
Boehnert, Markus U.
Malago, Massimo
Wu, Yao-Ming
Broering, Dieter C.
Lepiesza, Agniesza
AlMudaiheem, Bedour A.
Elmikkaoui, Bilal
Zakaria, Hazem
Vashist, Yogesh
Alshibi, Leen
Kareem, Sami A.
description Minimally invasive donor hepatectomy is an emerging surgical technique in living donor liver transplantation (LDLT). We examined outcomes across open, laparoscopic, and robotic LDLT using a prospective registry. We analyzed 3448 cases (1724 donor-recipient pairs) from January 2011 to March 2023 (NCT06062706). Among donors, 520 (30%) were female. Adult-to-adult LDLT comprised 1061 (62%) cases. A total of 646 (37%) of the donors underwent open, 165 (10%) laparoscopic, and 913 (53%) robotic hepatectomies. Primary outcomes: donor overall morbidity was 4% (35/903) for robotic, 8% (13/165) laparoscopic, and 16% (106/646) open (P < .001) procedures. Pediatric and adult recipient mortality was similar among the 3 donor hepatectomy approaches: robotic 1.5% and 7.0%, compared with 2.3% and 8.3% laparoscopic, and 1.6% and 5.5% for open donor surgery, respectively (P = .802, P = .564). Secondary outcomes: pediatric and adult recipients major morbidity after robotic hepatectomy was 15% and 23%, compared with 25% and 44% for laparoscopic surgery and 19% and 31% for open surgery, respectively (P = .033, P < .001). Graft and recipient 5-year survival were 90% and 93% for pediatrics and 79% and 80% for adults, respectively. In conclusion, robotic LDLT was associated with superior outcomes when compared with the laparoscopic and open approaches. Both donors and, for the first time reported, recipients benefitted from lower morbidity rates in robotic surgery, emphasizing its potential for further advancing this field.
doi_str_mv 10.1016/j.ajt.2024.04.020
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We examined outcomes across open, laparoscopic, and robotic LDLT using a prospective registry. We analyzed 3448 cases (1724 donor-recipient pairs) from January 2011 to March 2023 (NCT06062706). Among donors, 520 (30%) were female. Adult-to-adult LDLT comprised 1061 (62%) cases. A total of 646 (37%) of the donors underwent open, 165 (10%) laparoscopic, and 913 (53%) robotic hepatectomies. Primary outcomes: donor overall morbidity was 4% (35/903) for robotic, 8% (13/165) laparoscopic, and 16% (106/646) open (P &lt; .001) procedures. Pediatric and adult recipient mortality was similar among the 3 donor hepatectomy approaches: robotic 1.5% and 7.0%, compared with 2.3% and 8.3% laparoscopic, and 1.6% and 5.5% for open donor surgery, respectively (P = .802, P = .564). Secondary outcomes: pediatric and adult recipients major morbidity after robotic hepatectomy was 15% and 23%, compared with 25% and 44% for laparoscopic surgery and 19% and 31% for open surgery, respectively (P = .033, P &lt; .001). Graft and recipient 5-year survival were 90% and 93% for pediatrics and 79% and 80% for adults, respectively. In conclusion, robotic LDLT was associated with superior outcomes when compared with the laparoscopic and open approaches. 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Secondary outcomes: pediatric and adult recipients major morbidity after robotic hepatectomy was 15% and 23%, compared with 25% and 44% for laparoscopic surgery and 19% and 31% for open surgery, respectively (P = .033, P &lt; .001). Graft and recipient 5-year survival were 90% and 93% for pediatrics and 79% and 80% for adults, respectively. In conclusion, robotic LDLT was associated with superior outcomes when compared with the laparoscopic and open approaches. 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We examined outcomes across open, laparoscopic, and robotic LDLT using a prospective registry. We analyzed 3448 cases (1724 donor-recipient pairs) from January 2011 to March 2023 (NCT06062706). Among donors, 520 (30%) were female. Adult-to-adult LDLT comprised 1061 (62%) cases. A total of 646 (37%) of the donors underwent open, 165 (10%) laparoscopic, and 913 (53%) robotic hepatectomies. Primary outcomes: donor overall morbidity was 4% (35/903) for robotic, 8% (13/165) laparoscopic, and 16% (106/646) open (P &lt; .001) procedures. Pediatric and adult recipient mortality was similar among the 3 donor hepatectomy approaches: robotic 1.5% and 7.0%, compared with 2.3% and 8.3% laparoscopic, and 1.6% and 5.5% for open donor surgery, respectively (P = .802, P = .564). Secondary outcomes: pediatric and adult recipients major morbidity after robotic hepatectomy was 15% and 23%, compared with 25% and 44% for laparoscopic surgery and 19% and 31% for open surgery, respectively (P = .033, P &lt; .001). Graft and recipient 5-year survival were 90% and 93% for pediatrics and 79% and 80% for adults, respectively. In conclusion, robotic LDLT was associated with superior outcomes when compared with the laparoscopic and open approaches. 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fulltext fulltext
identifier ISSN: 1600-6135
ispartof American journal of transplantation, 2024-11, Vol.24 (11), p.2080-2091
issn 1600-6135
1600-6143
1600-6143
language eng
recordid cdi_proquest_miscellaneous_3053973447
source MEDLINE; Alma/SFX Local Collection
subjects Adult
Child, Preschool
complications
donor hepatectomy
Female
Follow-Up Studies
Graft Survival
Hepatectomy - methods
Hepatectomy - mortality
Humans
laparoscopic
Laparoscopy - methods
Laparoscopy - mortality
liver transplantation
Liver Transplantation - methods
Liver Transplantation - mortality
living donor
Living Donors
Male
morbidity
outcomes
Postoperative Complications - epidemiology
Prognosis
Prospective Studies
Registries
robotic
Robotic Surgical Procedures - methods
Robotic Surgical Procedures - mortality
survival
Tissue and Organ Harvesting - methods
Transplant Recipients - statistics & numerical data
Young Adult
title Robotic living donor hepatectomy is associated with superior outcomes for both the donor and the recipient compared with laparoscopic or open - A single-center prospective registry study of 3448 cases
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