Cadaveric liver transplant from older donors

Area of Science:

• Hepatology
• Transplantation Surgery
• Geriatric Medicine

Background:

• Donor age is a critical factor influencing organ transplant outcomes.
• The utility of older donor livers in orthotopic liver transplantation (OLT) requires careful evaluation.

Purpose of the Study:

• To investigate the impact of cadaveric donor age on patient and graft outcomes after OLT.
• To compare the results of OLT using older donor (OD) livers (≥60 years) versus younger donor (YD) livers (<60 years).

Main Methods:

• A retrospective analysis of 313 OLTs performed between 1997 and 2004.
• Patients were categorized into OD (n=51) and YD (n=262) liver recipients.
• Outcomes including graft function, survival, and complications were compared between groups.

Main Results:

• OD recipients showed a higher prevalence of blood group O (51% vs 33%) and fulminant hepatic failure (9.8% vs 5%).
• No significant differences were observed in initial poor graft function, primary non-functioning, graft loss, steatosis, or hepatic artery thrombosis between OD and YD groups.
• Graft and patient actuarial survival rates at 1, 3, and 5 years were comparable between OD and YD recipients (e.g., 5-year graft survival: 75% vs 77%).

Conclusions:

• Orthotopic liver transplantation can be successfully performed using selected livers from older deceased donors.
• Donor age alone should not be an absolute contraindication for liver donation, provided organs are carefully selected.