PULSE
Robotic Donor Liver Surgery Challenges and learnings from the largest liver transplant center Liver transplantation is the only treatment option for patients suffering with acute or chronic liver failure. If you look at patients with kidney failure, an alternate option of dialysis is available but there is no substitute to maintain a failing liver for lengthy periods. They need a new liver.
Dr S Sudhindran Chief Transplant Surgeon, Department of Gastrointestinal Surgery and Solid Organ Transplantation, Amrita Institute of Medical Sciences, Kochi
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March 2021
A liver transplant is not a simple procedure, but it is a lifesaving intervention. In the last couple of years, survival rates after liver transplant have improved remarkably. Currently, over 80-90 per cent of people survive liver transplantation and enjoys a good quality-of-life. The survival rate is comparable with international standards. There are two primary options for liver donation. The first one is from a deceased donor where liver donation is from a patient who has undergone brain death. This form of donation is less common as we in India are already dealing with the lack of donated organs. The other form of donation is living donor transplant where the donation of part of the liver is from another person, mostly family or relative. This form of donation is popular because of the fact that the donor's body needs only about a third of the liver's volume for its daily function and the liver's unique ability to regenerate. After transplantation, the partial livers of both the donor and recipient will grow and remodel to form complete organs, usually within three months.
individual with no morbidity and you want to make sure that no harm comes to the donor. However, as in all surgeries, there are risks involved with the donor surgery too. These risk may be bleeding, infection, bile leakage from the cut surface of the liver and possible death. So we as surgeons need to minimise these risks. In addition, the probability of these risks occurring is more when the right lobe of the liver (comprising up to 60 per cent of total liver volume) is used for donation. When the recipient is a small adult, the left lobe of the liver from the donor might suffice and in such cases the complication rates are extremely low. For transplantation into children, even a smaller portion of the liver is required from the donor, diminishing the complication even further, although not totally eliminating them. We did a study to look at these risk factors. The occurrence of morbidity and mortality after living donor liver transplantation is much talked about but potentially life-threatening near miss events (during which a donor’s life may be in danger but after which there are no long-term sequelae) are rarely reported. Our study revealed that most complications are of low-grade severity but 4.1 per cent of patients had severe or life-threatening events. That’s why we look for better options so that we can improve the experience for the live liver donors.
Risks with donor surgery
Robotic liver transplant
Liver donor surgery is the most challenging surgery one can do because you are operating on a healthy
Robotic liver transplant in India is done for the live donor. In the recent past, minimally invasive surgery has gained
