Gianni Biancofiore1, Maria Bindi2, Davide Ghinolfi3, Quirino Lai3, Massimo Bisa2, Massimo Esposito2, Luca Meacci2, Roberto Mozzo2, Alicia Spelta2, Franco Filipponi3. 1. Anaesthesia and Critical Care for General and Transplantation Surgery, Azienda Ospedaliera-Universitaria Pisana, Italy. Electronic address: g.biancofiore@med.unipi.it. 2. Anaesthesia and Critical Care for General and Transplantation Surgery, Azienda Ospedaliera-Universitaria Pisana, Italy. 3. Hepatobiliary and Liver Transplant Surgery, University School of Medicine, Pisa, Italy.
Abstract
BACKGROUND: Use of grafts from very old donors for liver transplantation is controversial. AIM: To compare the perioperative course of patients receiving liver grafts from young ideal vs octogenarian donors. METHODS: Analysis of the perioperative course of patients receiving liver grafts from young, ideal (18-39 years) vs octogenarian (≥80years) deceased donors between 2001 and 2014. RESULTS: 346 patients were studied: 179 (51.7%) received grafts aged 18-39 years whereas 167 (48.3%) received a graft from a donor aged ≥80years. Intra-operative cardiovascular (p=0.2), coagulopathy (p=0.5) and respiratory (p=1.0) complications and incidence of reperfusion syndrome (p=0.3) were similar. Patients receiving a young graft required more fresh frozen plasma units (p≤0.03) but did not differ for the need of packed red cells (p=0.2) and platelet (p=0.3) transfusions. Median ICU stay was identical (p=0.4). Patients receiving octogenarian vs young grafts did not differ in terms of death or re-transplant (p=1.0) during the ICU stay. Similar cardiovascular, respiratory, renal, infectious and neurological postoperative complication rates were observed in the two groups. CONCLUSIONS: Octogenarian donors in liver transplantation grant an equivalent perioperative course to ideal young donors.
BACKGROUND: Use of grafts from very old donors for liver transplantation is controversial. AIM: To compare the perioperative course of patients receiving liver grafts from young ideal vs octogenarian donors. METHODS: Analysis of the perioperative course of patients receiving liver grafts from young, ideal (18-39 years) vs octogenarian (≥80years) deceased donors between 2001 and 2014. RESULTS: 346 patients were studied: 179 (51.7%) received grafts aged 18-39 years whereas 167 (48.3%) received a graft from a donor aged ≥80years. Intra-operative cardiovascular (p=0.2), coagulopathy (p=0.5) and respiratory (p=1.0) complications and incidence of reperfusion syndrome (p=0.3) were similar. Patients receiving a young graft required more fresh frozen plasma units (p≤0.03) but did not differ for the need of packed red cells (p=0.2) and platelet (p=0.3) transfusions. Median ICU stay was identical (p=0.4). Patients receiving octogenarian vs young grafts did not differ in terms of death or re-transplant (p=1.0) during the ICU stay. Similar cardiovascular, respiratory, renal, infectious and neurological postoperative complication rates were observed in the two groups. CONCLUSIONS: Octogenarian donors in liver transplantation grant an equivalent perioperative course to ideal young donors.
Authors: Richard W Laing; Hynek Mergental; Christina Yap; Amanda Kirkham; Manpreet Whilku; Darren Barton; Stuart Curbishley; Yuri L Boteon; Desley A Neil; Stefan G Hübscher; M Thamara P R Perera; Paolo Muiesan; John Isaac; Keith J Roberts; Hentie Cilliers; Simon C Afford; Darius F Mirza Journal: BMJ Open Date: 2017-11-28 Impact factor: 2.692
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