Korean J Transplant.  2021 Jun;35(2):100-107. 10.4285/kjt.20.0051.

Outcomes of deceased donor liver transplantation from elderly donors

• Kim M
• Hwang S
• Ahn CS
• Kim KH
• Moon DB
• Ha TY
• Song GW
• Jung DH
• Park GC
• Yoon YI
• Kang WH
• Cho HD
• Na BG
• Kim SH
• Lee SG

• KMID: 2517292
• DOI: http://doi.org/10.4285/kjt.20.0051

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 posttransplant outcomes to ascertain whether use of elderly donors (aged ≥76 years) has adverse effects on outcome of DDLT. Elderly donor study group included 14 donors aged ≥76 years and elderly donor control group com-prised 39 donors aged 66–75 years.
Results
Mean donor age of the study 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 donor 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 elderly study group were 83.6%, 59.7%, and 59.7%, respectively, and those after donation from 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 results of this study suggest that using an elderly donor graft might not worsen the posttransplant outcomes significantly; thus, advanced age per se may not be an exclusion criterion for organ donation.

Keyword

Donor age; Elderly donor; Deceased donor liver transplantation; Octogenarian; Septuagenarian

Figure

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  Fig. 1 Distribution of ages of deceased donors for a 10-year study period in Korea.

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  Fig. 2 Comparison of graft (A) and overall patient (B) survival outcomes according to donor age.

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  Fig. 3 Comparison of the overall patient survival outcomes according to pretransplant ventilator support (A), pretransplant renal replacement therapy (B), Model for End-Stage Liver Disease (MELD) score with a cutoff of 31 (C), and retransplantation (D).

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