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Orthotopic Liver Transplantation in Rats
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Age and liver transplantation.

François Durand1, Josh Levitsky2, François Cauchy3

  • 1Hepatology & Liver Intensive Care; Hospital Beaujon, Clichy, France; INSERM U1149, France; University Paris Diderot, Paris, France.

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|December 22, 2018
PubMed
Summary

Liver transplant recipient and donor ages are rising. Careful selection ensures older recipients benefit, and elderly donors can yield excellent results with optimized matching.

Keywords:
AgeDeceased donor transplantationDonation after circulatory deathLiver transplantationLiving donor liver transplantationWaiting list mortality

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Area of Science:

  • Hepatology
  • Transplantation Medicine
  • Geriatric Medicine

Background:

  • Increasing average age of liver transplant donors and recipients over time.
  • Older patients face higher comorbidity, waitlist, and post-transplant mortality risks.
  • Long-term outcomes in elderly transplant recipients raise concerns about immunosuppression and graft aging.

Purpose of the Study:

  • To review trends in recipient and donor age in liver transplantation.
  • To discuss the implications of using older donors and recipients.
  • To explore age-matching strategies for optimizing liver transplant outcomes.

Main Methods:

  • Review of current literature on donor and recipient age trends.
  • Analysis of the impact of donor age on transplant outcomes.
  • Discussion of age-matching considerations in allocation policies.

Main Results:

  • Excellent outcomes are achievable with elderly donors, with no strict upper age limit for brain death donors.
  • Older donor age disproportionately affects younger recipients and those with high Model for End-Stage Liver Disease scores.
  • Age matching is crucial and requires adaptation for evolving allocation policies and treatments like direct-acting antivirals.

Conclusions:

  • Careful selection can provide similar transplant benefits for older recipients compared to younger ones.
  • Optimizing selection, procurement, and matching is key for successful outcomes with elderly donors.
  • Age matching strategies need continuous re-evaluation to improve liver transplant results.