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

Jiménez-Romero, Carlos; Clemares-Lama, Marta; Manrique-Municio, Alejandro; García-Sesma, Álvaro; Pulido, Jorge Calvo; Moreno‐González, E.

doi:10.1007/s00268-013-2085-7

Cited by 43 publications

(77 citation statements)

References 87 publications

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“…It also helps clarify the increased rates of initial poor function and period of prolonged cholestasis seen in older-donor grafts. 9,12,25,33 Our data do not allow for analysis of the impact of steatosis, as we avoid steatosis in older grafts.…”

Section: Discussionmentioning

confidence: 84%

“…8,9,16,17,25,[30][31][32][33] In a study of liver preservation injury, Briceno and coauthors 16 identified 5 variables from marginal donors (moderate to severe fatty infiltration, prolonged ICU hospitalization, prolonged CIT, high doses of inotropic drugs, and older donors) that could be strictly correlated with development of moderate to severe preservation injury, with good accuracy. Donor age and CIT were independent predictors of increasing liver preservation injury.…”

Section: Discussionmentioning

confidence: 97%

“…15 Although several reports have shown an association between increasing donor age and poorer patient and graft survival, others have refuted this association. 14,[22][23][24][25][26][27][28][29] Although large database studies have identified donor age as a significant risk factor for poor outcomes in recipients with hepatitis C, 14 multiple large single-center studies have not correlated with this finding. 22 In review of Scientific Registry of Transplant Recipients data between 1995 and 2001, including 3,463 patients Table 4.…”

Section: Discussionmentioning

confidence: 99%

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Donor Age-Based Analysis of Liver Transplantation Outcomes: Short- and Long-Term Outcomes Are Similar Regardless of Donor Age

Chapman¹,

Vachharajani²,

Collins³

et al. 2015

Journal of the American College of Surgeons

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Donor Age-Based Analysis of Liver Transplantation Outcomes: Short- and Long-Term Outcomes Are Similar Regardless of Donor Age

Chapman¹,

Vachharajani²,

Collins³

et al. 2015

Journal of the American College of Surgeons

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“…Moreover, the increased incidence of age-related risk factors in older donors, such as diabetes, hypertension, and dyslipidemia is responsible for a more severe hepatic steatosis and atherosclerotic disease (20)(21)(22) and may act in a synergistic way to further increase susceptibility to IRI (13).…”

Section: Agementioning

confidence: 99%

“…Grafts were perfused for a median of 126 min . Recipient median MELD score was 16 [16][17][18][19][20][21][22] but none has HCC. At 1 week after LT peak serum ALT and bilirubin levels were twofold lower in the DHOPE group than in the control group (median ALT: 966 vs. 1,858 UI/L respectively, P=0.006; median bilirubin 1.0 vs. 2.6 mg/dL, P=0.044).…”

Section: Hmpmentioning

confidence: 99%

Perfusion machines and hepatocellular carcinoma: a good match between a marginal organ and an advanced disease?

Ghinolfi

Rreka

Pezzati

et al. 2017

Transl. Gastroenterol. Hepatol.

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Hepatocellular carcinoma (HCC) accounts for 90% of primary liver cancers, is the second leading cause of cancer-related deaths and the leading cause of death in patients with cirrhosis. Liver transplantation (LT) represents the ideal treatment for selected patients as it removes both the tumor and the underlying cirrhotic liver with 5-year survival rates higher than 70%. Unfortunately, due to tumor characteristics, patient co-morbidities or shortage of organs available for transplant, only 20% of patients can undergo curative treatment. Ex situ machine perfusion (MP) is a technology recently introduced that might potentially improve organ preservation, allow graft assessment and increase the pool of available organs. The purpose of this review is to provide an update on the current role of ex situ liver MP in liver transplantation for HCC patients.

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Optimizing the Use of Geriatric Livers for Transplantation in the Eurotransplant Region

et al. 2019

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Acceptance criteria for liver allografts are ever more expanding because of a persisting wait‐list mortality. Older livers are therefore offered and used more frequently for transplantation. This study aims to analyze the use and longterm outcome of these transplantations. Data were included on 17,811 first liver transplantations (LTs) and information on livers that were reported for allocation but not transplanted from 2000 to 2015 in the Eurotransplant (ET) region. Graft survival was defined as the period between transplantation and date of retransplantation or date of recipient death. In the study period, 2394 (13%) transplantations were performed with livers ≥70 years old. Graft survival was 74%, 57%, and 41% at 1‐, 5‐, and 10‐year follow‐up, respectively. A history of diabetes mellitus in the donor (hazard ratio [HR], 1.3; P = 0.01) and positive hepatitis C virus antibody in the recipient (HR, 1.5; P < 0.001) are specific risk factors for transplantations with livers ≥70 years old. Although donor age is associated with a linearly increasing risk of graft loss between 25 and 80 years old, no difference in graft survival could be observed when “preferred” recipients were transplanted with a liver <70 or ≥70 years old (HR 1.1; CI 0.92‐1.23, P = 0.40) or with a donor <40 or ≥70 years old (HR 1.2; CI 0.96‐1.37, P = 0.13). Utilization of reported livers ≥70 years old increased from 42% in 2000‐2003 to 76% in 2013‐2015 without a decrease in graft survival ( P = 0.45). In conclusion, an important proportion of LTs in the ET region are performed with livers ≥70 years old. The risk of donor age on graft loss increases linearly between 25 and 80 years old. Livers ≥70 years old can, however, be transplanted safely in preferred patients and are to be used more frequently to further reduce wait‐list mortality.

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

Abstract: Because patient and graft survival rates are not affected by donor age, well-selected older donor livers can be safely used if they show good function and preharvesting conditions.

Cited by 43 publications

References 87 publications

Donor Age-Based Analysis of Liver Transplantation Outcomes: Short- and Long-Term Outcomes Are Similar Regardless of Donor Age

Donor Age-Based Analysis of Liver Transplantation Outcomes: Short- and Long-Term Outcomes Are Similar Regardless of Donor Age

Perfusion machines and hepatocellular carcinoma: a good match between a marginal organ and an advanced disease?

Optimizing the Use of Geriatric Livers for Transplantation in the Eurotransplant Region

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