Comparison of Outcomes in Robotic vs. Laparoscopic vs. Open Living Donor Hepatectomy: A Single Center Prospective Registry Study
Trial Snapshot
- Phase
- Not Applicable
- Status
- Enrolling By Invitation
- Enrollment
- 3,448
- Locations
- 1
- Primary Endpoint
- Recipient overall morbidity rate
Study Overview
Brief Summary
This will be a study to examine the outcomes of open, laparoscopic, and robotic Living Donor Liver Transplantation (LDLT) procedures. The analysis will encompass 3,448 cases (1,724 donor-recipient pairs) from January 2011 to March 2023, documenting the transition between these surgical techniques, with a noted crossover in 2018.
Detailed Description
Background: Liver transplantation is a primary treatment for end-stage liver disease, enhancing survival rates and life quality. Living donor liver transplantation (LDLT) has gained prominence due to the scarcity of deceased donor organs. Historically, the open technique dominated living donor hepatectomies. However, advances in minimally invasive surgery (MIS) led to laparoscopic and later robotic procedures. With the introduction of robotic surgery, MIS for complex surgeries improved, offering better precision and ergonomics.
Objective: To compare the short and long-term outcomes of open, laparoscopic, and robotic LDLT, focusing on both donors and recipients.
Methods: Study Design: Retrospective analysis of data from a prospective liver transplant registry, examining three LDLT techniques.
Setting: King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Participants: All consecutive living donor and recipient pairs undergoing LDLT between January 2011 and March 2023. Exclusions include dual or domino LDLT.
Study Design
- Study Type
- Observational
- Observational Model
- Cohort
- Time Perspective
- Prospective
Eligibility Criteria
- Ages
- 1 Month to 75 Years (Child, Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •All donor and recipient pairs that underwent LDLT at the study institution
- •Between 01 January 2011 to 31 March 2023
- •Both adult-to-adult and adult-to-pediatric LDLT are included.
Exclusion Criteria
- •Dual and domino LDLT are excluded.
Outcomes
Primary Outcomes
Recipient overall morbidity rate
Time Frame: From date of liver transplantation until the date of hospital discharge assessed up to 90 days postoperatively.
Complication rate of any severity according to the Clavien-Dindo Classification
Donor overall morbidity rate
Time Frame: From date of donor hepatectomy until the date of first hospital discharge assessed up to 90 days postoperatively.
Complication rate of any severity according to the Clavien-Dindo Classification
Recipient in-hospital mortality rate
Time Frame: From date of liver transplantation until the date of death assessed up to 90 days post-transplant.
Recipient death up to 90 days of follow up
Secondary Outcomes
- Donor minimally invasive surgery conversion to open rate(Time from operation start until conversion to open in minutes assessed up to 720 min)
- Recipient Intensive Care Unit (ICU) stay in days(Total number of days hospitalised in ICU, from date of liver transplant until the date of discharge from ICU assessed up to 90 days postoperatively.)
- Graft survival rates(From date of liver transplantation until the date of re-transplantation or recipient death or last follow up assessed up to 120 months post-transplant)
- Donor hospital stay in days(From date of donor hepatectomy until the date of first hospital discharge assessed up to 90 days postoperatively.)
- Recipient hospital stay in days(From date of liver transplant until the date of first hospital discharge assessed up to 90 days postoperatively.)
- Recipient survival rates(From date of liver transplantation until the date of recipient death or last follow up assessed up to 120 months post-transplant)