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Impact of elderly donors for liver transplantation: A single‐center experience
Author(s) -
Kamo Naoko,
Kaido Toshimi,
Hammad Ahmed,
Ogawa Kohei,
Fujimoto Yasuhiro,
Uemura Tadahiro,
Mori Akira,
Hatano Etsuro,
Okajima Hideaki,
Uemoto Shinji
Publication year - 2015
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.24086
Subject(s) - medicine , liver transplantation , living donor liver transplantation , incidence (geometry) , young adult , transplantation , single center , surgery , retrospective cohort study , multivariate analysis , survival rate , abo blood group system , gastroenterology , physics , optics
Elderly donor grafts for liver transplantation (LT) are recognized to be marginal grafts. The present study investigated the impact of using elderly donors for LT. Between June 1990 and August 2012, 1631 patients received LT at Kyoto University Hospital. Out of 1631 patients, 1597 patients received living donor liver transplantation (LDLT), whereas the other 34 patients underwent deceased donor liver transplantation (DDLT). Seventy‐five grafts that were used came from individuals who were ≥60 years old. We retrospectively analyzed the recipients' survival rates according to donor age. The overall survival rates of the recipients of all LDLT ( P < 0.001), adult‐to‐adult LDLT ( P = 0.007), all DDLT ( P = 0.026), and adult‐to‐adult DDLT ( P = 0.011) were significantly lower for the elderly donor group versus the younger group and especially for those who were hepatitis C–positive. A multivariate analysis revealed that donor age, ABO incompatibility, and preoperative intensive care unit stay were independent risk factors for poor patient survival in adult‐to‐adult LDLT. However, no significant differences existed between the 2 groups among those who received adult‐to‐adult LDLT in and after April 2006. No significant association was found between donor age and incidence of acute cellular rejection. In conclusion, donor age was closely related to the survival rate for LDLT and DDLT, although the impact of donor age was not shown in the recent cases. Liver Transpl 21:591–598, 2015 . © 2015 AASLD.