Effect of donor age on graft outcome after liver transplantation

Grande, L; Matus, D; Manyalic, M.; Cabrer, C; Rodríguez-Montalvo, Carlos; Rimola, A.; Navasa, Miquel; García‐Valdecasas, Juan Carlos; Visa, Josep

doi:10.1016/s0041-1345(99)00427-3

Cited by 9 publications

(5 citation statements)

References 4 publications

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“…It is not surprising that increasing recipient age and diabetes status are predictors of poor renal function as these are well-known risk factors for renal dysfunction in the general population. Increasing donor age is also a proven risk factor for poor liver graft function and increased mortality after liver transplantation, 17,18 although this link between liver donor age and renal function after transplantation has not been reported previously to our knowledge. There was evidence for quicker liver function recovery after transplantation in those patients that achieved spontaneous return of renal function.…”

Section: Discussionmentioning

confidence: 71%

Pretransplant predictors of recovery of renal function after liver transplantation

et al. 2010

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The Model for End-Stage Liver Disease system has given priority on the liver transplant waiting list to candidates with renal failure. This study determined the predictors of spontaneous recovery of renal function after transplantation in 1041 liver transplant recipients on renal replacement therapy (RRT) at the time of transplant (from February 2002 to January 2007). Data from these patients were obtained from the US Organ Procurement and Transplantation Network and US Renal Data System databases. Univariate and multivariate survival models were constructed along with multivariate logistic regression models to find independent predictors of spontaneous renal recovery. Seven hundred seven recipients (67.9%) had spontaneous recovery of renal function after liver transplantation. Those recovering spontaneously had a significantly shorter course of RRT in the pretransplant time period (15.6 versus 36.6 days, P < 0.001). Recovery of renal function was observed in 70.8% and 11.5% of recipients on RRT for less than 30 days and more than 90 days, respectively. Other statistically significant pretransplant variables independently associated with recovery of renal function included recipient age, recipient pretransplant diabetes, and donor age. In conclusion, the duration of pretransplant RRT is highly predictive of spontaneous renal recovery post-transplant. Liver transplant candidates requiring less than 30 days of pretransplant RRT are likely to spontaneously recover renal function after liver transplantation, whereas those on RRT for more than 90 days are not. In the era of Model for End-Stage Liver Disease (MELD)-based liver allocation, there has been a preference for organ allocation to those patients with renal dysfunction, with the result that more than 30% of patients awaiting liver transplantation have decreased renal function, including a substantial number that require renal replacement therapy (RRT). 1,2 This has coincided with a rise in combined liver-kidney transplantation (CLKT) in the past 7 years. Impaired renal function at the time of transplantation has been shown to have a detrimental impact on morbidity and mortality after liver transplantation. 2,3 Despite imprecise methods for measuring renal dysfunction, 4 it is clear that the pretransplant degree of renal insufficiency has a major impact on post-transplant survival. 5 Specifically, the length of pretransplant renal dysfunction predicts post-transplant renal insufficiency. Campbell et al. 6 demonstrated that the duration of pretransplant Abbreviations: CI, confidence interval; CLKT, combined liver-kidney transplantation; INR, international normalized ratio; MELD, Model for End-Stage Liver Disease; N/A, not available; OR, odds ratio; RRT, renal replacement therapy; UNOS,

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Section: Discussionmentioning

confidence: 71%

Pretransplant predictors of recovery of renal function after liver transplantation

et al. 2010

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“…However, the use of older livers for transplantation is subject to debate because several authors [16][17][18][19] have reported a negative impact of increased donor age on survival after OLT. Other authors [12,14,[20][21][22][23][24], however, have demonstrated similar patient and graft survival rates with liver grafts older than 60 and even 70 years.…”

Section: Introductionmentioning

confidence: 84%

Long‐Term Results Using Old Liver Grafts for Transplantation: Sexagenerian Versus Liver Donors Older than 70 Years

et al. 2013

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“…The results of the studies which analyzed the effect of donor age in the outcome of liver transplantation in non HCV‐infected recipients are contradictory. Although few studies showed advanced donor age (with different age limits) as a factor associated with a poorer graft and patient survival rate [13–16], most of the authors did not consider advanced donor age per se as a contraindication for liver transplantation [17–23], however other factors such as steatosis, vascular conditions and others must be taken into account in this decision. Rifai et al [24] have found in a recent study that donor age influences liver graft histology independently of hepatitis C infection.…”

Section: Discussionmentioning

confidence: 99%

Advanced donor age increases the risk of severe recurrent hepatitis C after liver transplantation

et al. 2005

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Summary The association between donor age and the severity of recurrent hepatitis C and, whether there is any donor age above which severity of recurrence increases significantly, were analyzed. A total of 131 liver grafts of hepatitis C virus (HCV)‐infected recipients were selected for the study. Distribution of donor age was compared between grafts with and without severe recurrence. The risk of developing severe recurrence as well as the hepatitis‐free, severe hepatitis‐free and HCV‐related graft survival was compared between different donor age groups. Mean donor age was higher for grafts with severe recurrence (P = 0.007). The risk of developing severe recurrence within 2 years post‐transplant increased with donors aged ≥50 years (RR = 1.34) and donors aged ≥70 years (RR = 1.61). Five‐year severe hepatitis‐free survival rates decreased progressively when donor age was over 50 years (P < 0.001). The study shows 50 and 70 years as the donor age cut‐off points above which the evolution of HCV‐infected recipients worsens.

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Effect of donor age on graft outcome after liver transplantation

Cited by 9 publications

References 4 publications

Pretransplant predictors of recovery of renal function after liver transplantation

Pretransplant predictors of recovery of renal function after liver transplantation

Long‐Term Results Using Old Liver Grafts for Transplantation: Sexagenerian Versus Liver Donors Older than 70 Years

Advanced donor age increases the risk of severe recurrent hepatitis C after liver transplantation

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