Liver Transplantation With Old Grafts: A Ten-Year Experience

Area of Science:

• Hepatology
• Transplantation Surgery
• Geriatric Medicine

Background:

• Donor scarcity is a critical issue in liver transplantation.
• Investigating the utility of older donor grafts is essential to expand organ availability.
• This study examines liver transplant outcomes using grafts from donors aged 70 and 80+ years.

Purpose of the Study:

• To evaluate the feasibility and outcomes of using liver grafts from elderly donors (≥70 and ≥80 years old).
• To determine if advanced donor age impacts graft survival and patient outcomes.
• To assess the potential of older donors to alleviate organ shortages in liver transplantation.

Main Methods:

• A retrospective analysis of 380 liver transplantations from 2005-2014.
• Patients were grouped based on donor age: <40, 40-49, 50-59, 60-69, 70-79, and ≥80 years.
• Graft and patient survival rates were compared across donor age groups.

Main Results:

• Older donors (≥70 years) more frequently died from stroke, unlike younger donors who died from trauma.
• Recipients of grafts from older donors had higher rates of hepatocellular carcinoma.
• Crucially, patient survival did not significantly differ between groups, and donor age was not a predictor of graft loss.

Conclusions:

• Liver grafts from donors over 70 and 80 years old can yield excellent outcomes.
• Factors like transaminase peak, retransplantation, and cold ischemia time, rather than donor age, predict graft loss.
• Expanding the use of older donor grafts is a viable strategy to address donor organ shortages.