Liver transplantation with donors older than 75 years

Area of Science:

• Hepatology
• Transplant Surgery
• Geriatric Medicine

Background:

• Orthotopic liver transplantation (OLT) outcomes have improved, increasing demand for donor organs.
• Expanded donor criteria, including elderly donors, are utilized to address organ shortages.
• This study evaluates the use of older donors in OLT.

Purpose of the Study:

• To compare clinical outcomes and survival rates between liver grafts from donors aged ≥ 75 years and younger donors.
• To analyze donor and recipient characteristics in OLT using elderly donors.

Main Methods:

• Retrospective analysis of 174 consecutive OLTs performed between 2001 and 2009.
• Comparison of outcomes for 24 liver grafts from donors ≥ 75 years versus younger donors.
• Evaluation of donor/recipient factors, clinical evolution, and survival.

Main Results:

• Overall survival rates were similar between older (≥ 75 years) and younger donor groups (69% vs. 63% at 5 years).
• No significant differences in ICU stay, ischemia times, or transfusion requirements were observed.
• Older donor livers were associated with higher rates of poor initial graft function and increased reinterventions.

Conclusions:

• Donor age alone does not appear to confer a survival disadvantage in OLT.
• Careful selection of elderly donors is essential to minimize procedural risks.
• While elderly donors expand the donor pool, potential complications require vigilant management.