Using elderly donors in liver transplantation.

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Transplant Proc. 2005 Jul-Aug.

Using elderly donors in liver transplantation.

Grazi

GL, Ravaioli

M, Zanello

M, Ercolani

G, Cescon

M, Varotti

G, Del

Gaudio M, Vetrone

G, Lauro

A, Ramacciato

G, Pinna

AD.

Liver & Multi-organ Transplant Unit, Bologna, Italy.

AIM: Elderly donors are half of the grafts available in our center for liver

transplantation. We retrospectively investigated their characteristics,

outcomes, and variables related to graft failure. MATERIAL AND METHODS: From

1996 to 2003, 540 (46.4%) of 1163 donors were older than 60 years of age and

236 grafts (43.4%) were transplanted, whereas the others were refused. The

clinical investigated variables were examined among this cohort. RESULTS: The median

age of donors increased from 37 to 62 years. Donors older than 60 years of age

were more often refused than younger ones (66% vs

44%); HCV-positive (9.9% vs 5.4%); HbcAb-positive (18.6% vs 12.6%),

and steatotic (35.7% vs

13.9%; P < .01). Among donors older than 60 years, the main parameter to

refuse the graft was the grade of steatosis. The

variables related to the graft loss from donors older than 60 years were as

follows: model for end stage liver disease (MELD) recipient >15 (65% vs 39%), cold ischemia time >10 hours (25% vs 13%), high blood losses (3987 +/- 4764 vs 2664 +/- 2043 mL), and year of

liver transplantation after 2000 (26% vs 46%; P <

..01). The 1-, 3-, and 5-year graft survival rates were significantly lower

among donors older than 60 years than other donors: 75%, 65%, and 62% versus

85%, 83%, and 78%, respectively (P < .001). CONCLUSION: Donors older than 60 years of age provided liver

transplants to half of our recipients. The graft survival rate of these organs

was lower than that of younger donors and to improve it the other risk

variables for poor outcome should be reduced, including MELD score of the

recipient and prolonged cold ischemia time.

PMID: 16182750 [PubMed - indexed for MEDLINE]

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