Outcomes of deceased donor liver transplantation from elderly donors
- Affiliations
-
- 1Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Abstract
- Background
Favorable outcomes achieved after deceased donor liver transplantation (DDLT) suggest that use of elderly donors may be an effective way to expand donor pool.
Methods
This was a retrospective analysis of adult DDLT using elderly donors. It was a double-arm study that compared post-
transplant outcomes to ascertain whether use of elderly donors (aged ≥76 years) has adverse effects on outcome of DDLT. The elderly study group included 14 donors aged ≥76 years and the elderly control group comprised 39 donors aged 66–75 years.
Results
Mean age of the elderly and control groups was 78.2±3.1 years and 68.9±2.7 years, respectively (P<0.001). Other clinical parameters were comparable between these two groups. The 1-, 3-, and 5-year graft survival rates in the elderly study group were 83.6%, 59.7%, and 59.7%, respectively, and those in the elderly control group were 79.4%, 68.1%, and 59.6%, respectively (P=0.97).
The overall 1-, 3-, and 5-year survival rates after donation from the elderly study group were 83.6%, 59.7%, and 59.7%, respectively, and those after donation from the control group were 79.3%, 72.1%, and 64.1%, respectively (P=0.74). Regarding overall patient survival, univariate analysis identified pretransplant requirement for ventilator support (P=0.021) and pretransplant renal replacement therapy (P=0.025) as statistically significant risk factors; however, neither was significant on multivariate analysis.
Conclusions
The data suggest that organs from elderly donors do not worsen posttransplant outcomes; thus, advanced age should not be an exclusion criteria criterion. Indeed, using such donors could be the key to increasing the supply of liver grafts.