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[Liver transplantation from elderly donors].

A Mazziotti1, G L Grazi, M Cescon

  • 1Università di Bologna, Policlinico Sant'Orsola, Malpighi.

Chirurgia Italiana
|October 9, 1999
PubMed
Summary

Older liver donors (over 70) showed similar outcomes to younger donors in liver transplantation (OLT). However, careful evaluation for atherosclerosis complications in older donors is crucial to prevent severe post-operative issues.

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Area of Science:

  • Hepatology
  • Transplant Surgery
  • Geriatric Medicine

Background:

  • Liver transplantation (OLT) is a life-saving procedure.
  • The increasing demand for donor organs necessitates the consideration of older donors.
  • Donor age significantly impacts graft function and patient survival.

Purpose of the Study:

  • To compare the outcomes of OLT using livers from donors over 70 years of age versus donors under 40.
  • To identify potential risks and benefits associated with using elderly liver donors.
  • To inform donor selection criteria for OLT.

Main Methods:

  • Retrospective, case-controlled study.
  • Comparison of 17 OLTs from donors >70 years (Group A) with 17 OLTs from donors <40 years (Group B).

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  • Analysis of donor parameters, cold ischemic times, intra-operative support, 30-day mortality, primary graft dysfunction, rejection, complications, and long-term survival.

    • Main Results:

    • No significant differences in 30-day mortality, primary graft dysfunction, or retransplantation rates between groups.
    • Two arterial complications in Group A versus one in Group B (p=NS).
    • Similar two-year survival rates: 88.2% for Group A and 94.1% for Group B (p=NS).

    Conclusions:

    • Livers from donors over 70 years can be used for OLT with comparable outcomes to younger donors.
    • Vascular conditions like atherosclerosis in elderly donors require careful assessment due to potential severe postoperative complications.
    • Exclusion of candidates over 70 solely based on age may not be warranted, but thorough vascular evaluation is essential.