BACKGROUND: The shortage of donor organs has led to increasing use of extended criteria donors, including older donors. The upper limit of donor age that produces acceptable outcomes continues to be explored. In liver transplantation, with appropriate selection, graft survival and patient outcomes would be comparable regardless of age. STUDY DESIGN: We performed a retrospective analysis of 1,036 adult orthotopic liver transplantations (OLT) from a prospectively maintained database performed between January 1, 2000 and December 31, 2013. The study focus group was liver transplantations performed using grafts from older (older than 60 years) deceased donors. Deceased donor liver transplantations done during the same time period using grafts from younger donors (younger than 60 years) were analyzed for comparison. Both groups were further divided based on recipient age (less than 60 years and 60 years or older). Donor age was the primary variable. Recipient variables included were demographics, indication for transplantation, Model for End-Stage Liver Disease (MELD), graft survival, and patient survival. Operative details and postoperative complications were analyzed. RESULTS: Patient demographics and perioperative details were similar between groups. Patient and graft survival rates were similar in the 4 groups. Rates of rejection (p = 0.07), bile leak (p = 0.17), and hepatic artery thrombosis were comparable across all groups (p = 0.84). Hepatitis C virus recurrence was similar across all groups (p = 0.10). Thirty-one young recipients (less than 60 years) received grafts from donors aged 70 or older. Their survival and other complication rates were comparable to those in the young donor to young recipient group. CONCLUSIONS: Comparable outcomes in graft and patient survivals were achieved using older donors (60 years or more), regardless of recipient age, without increased rate of complications.
BACKGROUND: The shortage of donor organs has led to increasing use of extended criteria donors, including older donors. The upper limit of donor age that produces acceptable outcomes continues to be explored. In liver transplantation, with appropriate selection, graft survival and patient outcomes would be comparable regardless of age. STUDY DESIGN: We performed a retrospective analysis of 1,036 adult orthotopic liver transplantations (OLT) from a prospectively maintained database performed between January 1, 2000 and December 31, 2013. The study focus group was liver transplantations performed using grafts from older (older than 60 years) deceased donors. Deceased donor liver transplantations done during the same time period using grafts from younger donors (younger than 60 years) were analyzed for comparison. Both groups were further divided based on recipient age (less than 60 years and 60 years or older). Donor age was the primary variable. Recipient variables included were demographics, indication for transplantation, Model for End-Stage Liver Disease (MELD), graft survival, and patient survival. Operative details and postoperative complications were analyzed. RESULTS:Patient demographics and perioperative details were similar between groups. Patient and graft survival rates were similar in the 4 groups. Rates of rejection (p = 0.07), bile leak (p = 0.17), and hepatic artery thrombosis were comparable across all groups (p = 0.84). Hepatitis C virus recurrence was similar across all groups (p = 0.10). Thirty-one young recipients (less than 60 years) received grafts from donors aged 70 or older. Their survival and other complication rates were comparable to those in the young donor to young recipient group. CONCLUSIONS: Comparable outcomes in graft and patient survivals were achieved using older donors (60 years or more), regardless of recipient age, without increased rate of complications.
Authors: Dana Tomescu; Mihai Popescu; Lavinia Jipa; Ruxandra Fota; Daniela Ungureanu; Radu Zamfir; Carmen Orban; Simona Olimpia Dima; Irinel Popescu Journal: Rom J Anaesth Intensive Care Date: 2016-04
Authors: Nicholas Gilbo; Ina Jochmans; Mauricio Sainz-Barriga; Frederik Nevens; Schalk van der Merwe; Wim Laleman; Chris Verslype; David Cassiman; Len Verbeke; Hannah van Malenstein; Tania Roskams; Jacques Pirenne; Diethard Monbaliu Journal: Transplant Direct Date: 2019-03-26
Authors: Jacob D de Boer; Joris J Blok; Hein Putter; Jacob J E Koopman; Bart van Hoek; Undine Samuel; Marieke van Rosmalen; Herold J Metselaar; Ian P J Alwayn; Markus Guba; Andries E Braat Journal: Liver Transpl Date: 2019-02 Impact factor: 5.799
Authors: Michał Grąt; Karolina M Wronka; Waldemar Patkowski; Jan Stypułkowski; Karolina Grąt; Maciej Krasnodębski; Łukasz Masior; Zbigniew Lewandowski; Marek Krawczyk Journal: Dig Dis Sci Date: 2016-02 Impact factor: 3.199