Quality of Life After Robotic Living Donor Hepatectomy: A 1-Year Prospective Analysis of Donor and Recipient Determinants.

Abstract

Living liver donation is a major operation performed without direct medical benefit to the donor. Prospective data on longitudinal donor-reported outcomes after minimally invasive donor hepatectomy remain limited, particularly for robotic approaches offered without donor selection. This prospective observational cohort study included all consecutive living liver donors undergoing robotic donor hepatectomy between April 2024 and March 2025. The robotic approach was offered to all donors without preselection. Donors completed the Short Form-36 (SF-36), Body Image Scale (BIS), and Beck Depression Inventory (BDI) questionnaires preoperatively and at 3, 6, and 12 months post-donation. Longitudinal changes relative to baseline were assessed using Wilcoxon signed-rank tests. Associations with donor demographics, perioperative variables, and recipient disease severity were evaluated using Spearman correlation and nonparametric group comparisons. A total of 214 donors were analyzed (mean age 36.4 y, 54% male). Physical Functioning, Role-Physical, Bodily Pain, and General Health declined at 3 months but recovered and returned to baseline by 12 months. Emotional Well-Being and Energy/Fatigue improved beyond baseline by 6 months and remained elevated at 12 months. Body image disturbance and depressive symptoms remained low throughout follow-up. Older donor age was modestly associated with better psychosocial outcomes. Donor complications and early recipient mortality were associated with transient reductions in selected domains without sustained impact. No consistent associations were observed with graft type, donor-recipient relationship, or recipient disease severity. Robotic living donor hepatectomy is associated with excellent physical and psychosocial recovery during the first postoperative year, supporting its donor-centered benefits.