Liver Transplantation Outcomes Using Grafts From Donors Older Than the Age of 80 Years

Rabelo, Álvaro; Álvarez, Miguel; Méndez, Carlos San Miguel; Villegas, M.T.; MGraneroa, K.; Becerra, A.; Domínguez, Minia Campos; Raya, A. Molina; Expósito, Manuela; Suárez, Y. Fundora

doi:10.1016/j.transproceed.2015.10.004

Cited by 9 publications

(8 citation statements)

References 6 publications

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“…In fact, with the growing use of elderly donors due to the unacceptable death rate in waiting lists, more favorable results have been demonstrated in recent studies using organs from donors older than 60, 70, and even 80 years of age …”

Section: Patient and Graft Survival Using Octogenarian Donors In Livementioning

confidence: 99%

“…In fact, with the growing use of elderly donors due to the unacceptable death rate in waiting lists, more favorable results have been demonstrated in recent studies (28)(29)(30)(31)(32)(33)(34) using organs from donors older than 60, 70, (35)(36)(37)(38)(39)(40)(41) and even 80 years of age. (20,26,28,41) There remains, however, concerns about the higher risk for primary nonfunction, delayed graft function, and worst longterm graft survival with the use of these super-old septuagenarian and octogenarian donors.…”

Section: The Growing Gap Between Patients In Need Of Livermentioning

confidence: 99%

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Pushing the donor limits: Deceased donor liver transplantation using organs from octogenarian donors

Jaime

Berenguer

2017

Liver Transpl

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Section: Patient and Graft Survival Using Octogenarian Donors In Livementioning

confidence: 99%

Section: The Growing Gap Between Patients In Need Of Livermentioning

confidence: 99%

Pushing the donor limits: Deceased donor liver transplantation using organs from octogenarian donors

Jaime

Berenguer

2017

Liver Transpl

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“…3,33,52 The effects of blood flow on vessels, and particularly on endothelial cells, are mainly due to wall shear stress, which can involve a multitude of physical and molecular mechanisms. 34,35,[53][54][55] However, it is difficult to know if portal thrombosis is the consequence or the cause of NRH.…”

Section: Discussionmentioning

confidence: 99%

Nodular Regenerative Hyperplasia Is Not a Rare Condition After Liver Transplantation: Incidence, Predictive Factors, and Impact on Survival

et al. 2023

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“…It is unlikely a difference will be noted between two recipients of a donor only slightly above or below the investigated age cut-off (ie, a recipient of an 80-year-old allograft may be compared to the recipient of a 78-year-old allograft). [23][24][25][26][27][28] In addition without accounting for recipient characteristics, any comparison can be challenging. Comparing outcomes for a recipient with HCV or HCC to others may make any effect of the donor age irrelevant.…”

Section: Discussionmentioning

confidence: 99%

“…This is in contrast to the earliest published studies that showed poor initial function and worse overall graft and patient survival, 6,19,[28][29][30][31] but confirms the positive results of more recent studies. [23][24][25][26][27][28] This, however, should be taken in context, as although not statistically significant, the difference (2× increased of mortality) in survival may be clinically relevant, as the study is underpowered. A larger study using similarly matched controls would better answer this question.…”

Section: Discussionmentioning

confidence: 99%

Long‐term outcomes of the octogenarian donor liver recipient: The era of the new centurion

Schneider

Jaime

Mara

et al. 2019

Clinical Transplantation

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Over the last decade, the limited number of deceased donors has resulted in longer waiting times and increased mortality on the waitlist. 1,2 In order to tackle this growing demand and organ shortage, several efforts have been pursued to widen the donor pool. Grafts from living donation, split-liver grafts, donation after circulatory death (DCD), and extended criteria donors (ECDs) including elderly donors are increasingly being used. [3][4][5] The relationship between donor age and LT outcomes has been widely studied, with controversial results. Initial studies reported older donor age as one of the most important negative prognostic factors for patient and graft survival. 6 More recent data, however, confirmed the safety with good short-and medium-term outcomes of these grafts, when recipients were appropriately selected. 1,7 A Abstract Background: Studies have suggested transplantation using older donor livers results in similar short-term outcomes as younger donor livers; however, little data exist on long-term patient/graft outcomes of the octogenarian liver recipient. Methods: Retrospective data were collected from 2 centers, (Valencia, Spain and Rochester, MN, USA) of all recipients of octogenarian donor liver allografts from 2000 to 2011 with follow-up to 2016. The aim was to compare long-term patient/ graft survival as well as metabolic outcomes of the recipient with the octogenarian liver vs younger than 60 years donor.Results: 78 recipients of older liver allografts were compared to 78 matched controls. No difference in 10-year patient mortality was demonstrated (P = 0.074).Octogenarian livers were associated with 3-fold higher likelihood of graft failure (P = 0.002) but no increase in the risk of post-LT cardiovascular disease (P = 0.60), hypertension (P = 0.33), vascular complications (P = 0.53), or malignancy (P = 0.14).In multivariate analysis, elder livers remained a significant factor associated with rejection (P = 0.034) with a trend not reaching statistical significance for graft failure (P = 0.052).Conclusions: For appropriately selected recipients, receiving an octogenarian liver does not clearly influence patient survival but does impact early graft survival with a notable increase in early posttransplant rejection rates and re-transplantation. Over 1.5 decades, older allografts have not adversely affected metabolic outcomes. K E Y W O R D S cardiovascular, donor age, elder, liver transplantation, metabolic, survival 2 of 9 | SCHNEIDER Et al. report from the Scientific Registry of Transplant Recipient (SRTR) data once again questioned the utilization of the older donors,showing increased graft and patient mortality. 8,9 Many factors contribute to patient and graft outcomes, and most of these studies cannot separate outcomes specifically related to the donor organ received.The liver has a significant role in metabolic functions. In liver transplant recipients, the graft becomes the main organ for carbohydrate, protein, lipid, and drug metabolism, responsible for the maintenance of glucose hom...

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Liver Transplantation Outcomes Using Grafts From Donors Older Than the Age of 80 Years

Cited by 9 publications

References 6 publications

Pushing the donor limits: Deceased donor liver transplantation using organs from octogenarian donors

Pushing the donor limits: Deceased donor liver transplantation using organs from octogenarian donors

Nodular Regenerative Hyperplasia Is Not a Rare Condition After Liver Transplantation: Incidence, Predictive Factors, and Impact on Survival

Long‐term outcomes of the octogenarian donor liver recipient: The era of the new centurion

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