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Live donor liver transplantation with older donors: Increased long‐term graft loss due to HCV recurrence
Author(s) -
Goldaraceicolas,
Barbas Andrew S.,
Galante Antonio,
Sapisochin Gonzalo,
AlAdra David,
Selzner Nazia,
Galvin Zita,
Cattral Mark S.,
Greig Paul D.,
Lilly Les,
Bhat Mamatha,
McGilvray Ian D.,
Ghanekar Anand,
Levy Gary,
Grant David R.,
Selzner Markus
Publication year - 2018
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13304
Subject(s) - medicine , surgery , incidence (geometry) , liver transplantation , hepatitis c virus , living donor liver transplantation , propensity score matching , hepatitis c , gastroenterology , transplantation , virus , immunology , physics , optics
Using our prospectively collected database all adult hepatitis C virus ( HCV )‐positive patients receiving an adult‐to‐adult LDLT between October 2000 and May 2014 were identified. Outcome of LDLT with grafts from younger (<50 years=128) vs older donors (≥50 years=31) was compared. Post‐transplant graft function, postoperative complications and incidence of HCV recurrence were evaluated. Long‐term graft and patient survival was calculated. No difference in graft function was observed between younger and older grafts. Overall complications were similar between both groups. The severity of complications determined by the Dindo‐Clavien score was similar. Graft loss from HCV recurrence was significantly less frequent in younger grafts (18% vs 62%, P = 0.001). Young vs older livers had a trend toward improved 1‐, 5‐, and 10‐year graft survival (89% vs 87%, 77% vs 69%, 70% vs 55%, P = 0.096), while patient survival was comparable between both groups (91% vs 90%, 78% vs 69%, 71% vs 60%, P = 0.25). In conclusion, LDLT with older vs younger grafts are more frequently associated with long‐term graft loss due to HCV recurrence. Differences in graft survival might be more prominent with prolonged (≥5‐year) follow‐up. Living donor‐recipient matching is particularly important for younger HCV ‐positive recipients.