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

Background: Living liver donation is a major act with no direct clinical benefit to the donor. Understanding postoperative quality of life (QoL) is critical for donor counseling and program evaluation. This study prospectively assessed longitudinal QoL, body image, and well-being after robotic living donor hepatectomy (LDH) and their associations with donor and recipient factors.
Methods: All consecutive donors undergoing robotic LDH between March 2024 and January 2025 were enrolled. The SF-36, Body Image Scale (BIS), and Beck Depression Inventory (BDI) were administered preoperatively and at 3, 6, and 12 months post-donation. Donor demographics, operative data, donor-recipient relationship, and complications, as well as recipient disease characteristics, were analyzed using non-parametric tests and Spearman correlations.
Results: Among 214 robotic donors (mean age 36.4 ± 9.8 years, 54% male), physical function declined transiently at 3 months but normalized by 12 months. Emotional well-being and energy/fatigue improved significantly over time, while body-image disturbance was minimal. Older donors reported higher energy and emotional well-being; males had greater vitality and social functioning, whereas females expressed slightly higher body-image concerns. Recipient factors, including MELD score, HCC status, and morbidity, showed no significant associations with donor outcomes, except transient emotional effects following early recipient death.
Conclusion: Robotic donor hepatectomy yields excellent recovery and sustained psychosocial well-being. The minimal morbidity and superior cosmetic outcomes of the robotic approach contribute to favorable QoL, supporting its donor-centered benefits and safety in living liver donation.