Premium
Liver transplantation using elderly donors: a risk factor analysis
Author(s) -
Kim Dae Y.,
Moon Jang,
Island Eddie R.,
Tekin Akin,
Ganz Susan,
Levi David,
Selvaggi Gennaro,
Nishida Seigo,
Tzakis Andreas G.
Publication year - 2011
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/j.1399-0012.2010.01222.x
Subject(s) - medicine , liver transplantation , surgery , liver disease , multivariate analysis , transplantation , etiology , gastroenterology
Kim DY, Moon J, Island ER, Tekin A, Ganz S, Levi D, Selvaggi G, Nishida S, Tzakis AG. Liver transplantation using elderly donors: a risk factor analysis.
Clin Transplant 2011: 25: 270–276. © 2010 John Wiley & Sons A/S. Abstract: Survival after liver transplantation is negatively impacted by use of elderly deceased donors, but excluding them would increase waiting times and waiting list mortality. We reviewed our experience with liver transplantation (LT) utilizing livers from deceased donors 65 yr of age and older to identify those factors that impact graft survival. All adult patients (≥18 yr old) who underwent primary LT using deceased donor livers from donors aged ≥65 yr between February 1995 and November 2003 were included. With multivariate analysis we found four unfavorable characteristics significantly associated with higher post‐transplant graft failure rate. These characteristics are hepatitis C as an etiology of liver disease, Model for End‐Stage Liver Disease score >20, serum glucose level of donor >200 mg/dL at the time of liver recovery, and skin incision to aortic cross‐clamp time >40 minutes in the donor surgery. The five‐yr estimated graft survival rates having 0, 1, 2, 3, and 4 unfavorable characteristics were 100%, 82.0%, 81.7%, 39.3%, and 25.0%, respectively (p < 0.05). Our data demonstrated good graft survival can be achieved in LT using elderly donor liver allografts with appropriate patient selection, donor blood glucose management and efficient liver recovery with minimal manipulation of the liver during donor surgery.