Robotic Surgery, Machine Perfusion and AI Converge at Landmark Liver Transplant Congress

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nors at 62 centres and found that RDH achieved the lowest blood loss, the shortest hospital stay and the lowest major complication rate—0.3 percent—compared with 3.7 percent for laparoscopic and 1.9 percent for open approaches. A single-centre analysis of 339 living left-lobe donors reported significantly lower blood loss with RDH (77 versus 316 millilitres) and a lower recipient morbidity rate of 40 percent versus 5

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9 percent. The A2ROBOT study confirmed safety across 88 robotic donor hepatectomies at four US centres, with 5.7 percent major morbidity and no donor mortality. Risk stratification featured prominently alongside these headline results. Portal vein complications, which occur in roughly 1.9 percent of right-lobe hepatectomies, were predicted by a main-to-left portal vein angle below 60 degrees, variant anatomy, absent

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falciform fixation and a body mass index above 30. Intraoperative hepatic artery flow below 55 millilitres per minute was strongly associated with small-for-size syndrome, while the FLAME model achieved an area under the curve of 0.81 for predicting early graft failure using four postoperative markers. In an open-label randomised trial of donor regeneration, ursodeoxycholic acid supplementation was found to enhance l

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patient survival at three months. Machine perfusion emerged as perhaps the most forward-looking theme of the meeting, with normothermic machine perfusion reframed from a preservation tool into an active therapeutic platform. Perfusate flavin mononucleotide (FMN) stood out as a landmark biomarker: De Goeij and colleagues demonstrated that FMN during abdominal normothermic regional perfusion predicted biliary complicat

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