Session Name: Liver: Living Donor Liver Transplant and Partial Grafts
Session Date & Time: None. Available on demand.
*Purpose: Living donor adult-to-adult liver transplantation (LT) has emerged as a feasible alternative to deceased donors. Advances in hepatobiliary surgery have allowed the introduction of robotic approaches to potentially decrease morbidity and mortality of recipient patients. Recent reports have evaluated the safety of robotic living donor right hepatectomy (RLDRH). We aimed to evaluate the outcomes of LT recipients after RLDRH compared to laparoscopic (LADRH) and open (ODRH) living donor right hepatectomy
*Methods: A systematic search of several databases (e.g. MEDLINE) from inception to September 2020 was conducted. Experimental or observational comparative studies assessing the outcomes of LT recipients older than 18 years undergoing RLDRH versus ODRH or LADRH were included. CLARITY tool was used to assess the risk of bias of observational studies. Mean differences (MD) and relative risks (RR) and their 95% confidence interval (CI) were calculated with random-effects and restricted-maximum likelihood estimator for continuous and dichotomous outcomes
*Results: Four studies were included. These studies had unclear risk of bias. A total of 151 LT recipients received liver after RLDRH (mean age=56.5 ±0.3), 118 after LADRH (mean age=53.8 ±11.2) and 248 after ODRH (mean age=55.3 ±6.7). The mean MELD score in RLDRH was higher than that of LADRH and ODRH (18.8 ±4.9; 16.2 ±8.3; 17.2 ±6.4). The indications for surgery reported in two studies were mostly hepatocellular carcinoma n=135 and end stage liver disease n=97, nonalcoholic steatohepatitis n=44. Only one study comparing RLDRH to LADRH found no differences in Clavien-Dindo complication (CD) I-II (RR: 1.00 95%CI 0.53, 1.87), III-IV (RR: 0.66 95%CI 0.39, 1.11) and mortality (RR: 2.27 95%CI 0.14-35.59). Likewise, four studies comparing RLDRH to ODRH found no difference in CD I-II (RR: 1.34 95%CI 0.71, 2.55), III-IV (RR: 0.71 95%CI 0.43, 1.16) and mortality risk (RR: 1.20 95%CI 0.55, 2.62)
*Conclusions: RLDRH in recipient seems to be a safe approach with non-inferior outcomes compared to LADRH and ODRH. Experimental studies are needed to confirm this findings
To cite this abstract in AMA style:Lincango-Naranjo E, Garces-Delgado E, Solis-Pazmino P, Alexander-Leon H, Restrepo-Rodas G, Mancero-Montalvo R, Ponce CJ, Cadena-Semanate R, Vargas-Cordova R, Herrera-Cevallos G, Villarreal-Juris A, Vallejo S, Liu-Sanchez C, Prokop LP, Guerron AD, Ponce OJ, Moris D. Outcomes of Robotic Living Donor Right Hepatectomy in Liver Transplant Recipients: A Systematic Review and Meta-analysis [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/outcomes-of-robotic-living-donor-right-hepatectomy-in-liver-transplant-recipients-a-systematic-review-and-meta-analysis/. Accessed June 18, 2021.
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