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

Outcomes of deceased donor liver transplantation from elderly donors

Affiliations
  • 1Division of Hepatobiliary Surgery and Liver Transplantation, Department 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 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
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