Kamal S. Yadav, Nikhitha Shetty, Fysal Valappil, Akash Selvathangam, Suchet Chaudhary, Ankur Gupta, Prashant Bhangui, Arvinder S. Soin
{"title":"Complex donor anatomy does not influence early donor or recipient outcomes after robotic donor hepatectomy at a high-volume center","authors":"Kamal S. Yadav, Nikhitha Shetty, Fysal Valappil, Akash Selvathangam, Suchet Chaudhary, Ankur Gupta, Prashant Bhangui, Arvinder S. Soin","doi":"10.1016/j.ajt.2025.04.017","DOIUrl":null,"url":null,"abstract":"<div><div><span><span><span>With evolving expertise, criteria to select donors for living robotic donor hepatectomy (RDH) have expanded. We studied the comparative donor and recipient outcomes in RDHs with standard grafts and complex grafts. We performed 360 right lobe RDH (RRDH) of 4296 living donor </span>liver transplantations, with 280 having >6 months follow-up. The first 53 cases were excluded as we used a different (cut-suture) technique for </span>hepatic duct<span> division. The subsequent 227 RRDHs were then divided into donors with standard (group S, n = 76) and complex grafts (group C, n = 151). Three donors in each group were converted to open midline incision. In groups S and C, 1 (1.3%) and 3 (1.9%) donors developed biliary complications (</span></span><em>P</em><span> = .741). Both recipient groups had similar early and late postoperative complications. Group C recipients had a nonsignificant higher incidence of late biliary complications (3 [3.9%] vs 17 [11.2%]; odds ratio, 3.09; 95% confidence interval, 0.88-10.88; </span><em>P</em> = .067). Early (<30 days) recipient mortality was similar with 4 (6.6%) in group S and 11 (7.3%) in group C (<em>P</em> = .755), all sepsis-related. The outcomes were similar among donors and recipients with both standard and complex grafts. With experience, RDH can be safely offered to “all-comer” donors and has the potential to become standard of care.</div></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"25 9","pages":"Pages 1987-1995"},"PeriodicalIF":8.2000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Transplantation","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1600613525002229","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
With evolving expertise, criteria to select donors for living robotic donor hepatectomy (RDH) have expanded. We studied the comparative donor and recipient outcomes in RDHs with standard grafts and complex grafts. We performed 360 right lobe RDH (RRDH) of 4296 living donor liver transplantations, with 280 having >6 months follow-up. The first 53 cases were excluded as we used a different (cut-suture) technique for hepatic duct division. The subsequent 227 RRDHs were then divided into donors with standard (group S, n = 76) and complex grafts (group C, n = 151). Three donors in each group were converted to open midline incision. In groups S and C, 1 (1.3%) and 3 (1.9%) donors developed biliary complications (P = .741). Both recipient groups had similar early and late postoperative complications. Group C recipients had a nonsignificant higher incidence of late biliary complications (3 [3.9%] vs 17 [11.2%]; odds ratio, 3.09; 95% confidence interval, 0.88-10.88; P = .067). Early (<30 days) recipient mortality was similar with 4 (6.6%) in group S and 11 (7.3%) in group C (P = .755), all sepsis-related. The outcomes were similar among donors and recipients with both standard and complex grafts. With experience, RDH can be safely offered to “all-comer” donors and has the potential to become standard of care.
期刊介绍:
The American Journal of Transplantation is a leading journal in the field of transplantation. It serves as a forum for debate and reassessment, an agent of change, and a major platform for promoting understanding, improving results, and advancing science. Published monthly, it provides an essential resource for researchers and clinicians worldwide.
The journal publishes original articles, case reports, invited reviews, letters to the editor, critical reviews, news features, consensus documents, and guidelines over 12 issues a year. It covers all major subject areas in transplantation, including thoracic (heart, lung), abdominal (kidney, liver, pancreas, islets), tissue and stem cell transplantation, organ and tissue donation and preservation, tissue injury, repair, inflammation, and aging, histocompatibility, drugs and pharmacology, graft survival, and prevention of graft dysfunction and failure. It also explores ethical and social issues in the field.