Short-term Results of Liver Transplantation With Octogenarian Donors

Martín, L. Gajate; Grande, A; Roux, Daniel; Cibrián, C. González; Martín, Carlos; Rodríguez-Gandía, Miguel Ángel; Buenadicha, A. López

doi:10.1016/j.transproceed.2017.12.002

Cited by 8 publications

(6 citation statements)

References 41 publications

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“…The presented results of outcomes after transplantation with a liver from an older donor are in accordance with results from other regions, although these are reported with a high variance. Reported patient survival rates at 1 year vary from 70% to 90% and 5‐year patient survival rates from 50% to 80% . The sometimes very promising outcomes are apparently contradicting to the higher intrinsic risk of older donors .…”

Section: Discussionmentioning

confidence: 99%

“…Reported patient survival rates at 1 year vary from 70% to 90% and 5‐year patient survival rates from 50% to 80% . The sometimes very promising outcomes are apparently contradicting to the higher intrinsic risk of older donors . These results are therefore likely to be explained by the frequent single‐center design, relatively small numbers of included transplantations, different aging patterns in other countries, and differences in recipient and donor selection criteria.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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“…No discernible changes in gene expression were found in liver tissue when assayed by cDNA arrays (Zahn et al, 2007). Livers from octogenarian donors are acceptable for liver transplantation after careful selection (Cascales‐Campos et al, 2018; Gajate Martín et al, 2018), and liver cancer in patients over 90 years old can also be effectively treated by hepatectomy (Uwatoko et al, 2015). However, ageing is an inevitable process that is accompanied by a gradual reduction in liver volume and blood flow (Schmucker, 2005; Wynne et al, 1989).…”

Section: Introductionmentioning

confidence: 99%

Age‐related changes in metabolites in young donor livers and old recipient sera after liver transplantation from young to old rats

Han

Jia

et al. 2021

Aging Cell

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“…However, for high-risk recipients, careful evaluation and selection of appropriate donors are necessary to avoid adverse prognostic issues. Careful evaluation and selection, which involves avoiding factors such as hypernatremia, prolonged ICU stay, liver enzyme alterations and cardiac arrest, can render the usage of liver grafts from donors aged over 80 years in LT [37,38]. Therefore, age alone should not be an absolute contraindication for LT; rather, risk assessment should be stratified based on factors like MELD, facilitating the discerning selection of elderly liver donors for recipients.…”

Section: Donor-recipient Matchingmentioning

confidence: 99%

Current Understanding of Marginal Grafts in Liver Transplantation

Xiang,

Li,

Zeng

et al. 2024

Aging and disease

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End-stage liver disease (ESLD), stemming from a spectrum of chronic liver pathologies including chronic liver failure, acute cirrhosis decompensation and hepatocellular carcinoma, imposes a significant global healthcare burden. Liver transplantation (LT) remains the only treatment for ESLD. However, the escalating mortality on transplant waitlists has prompted the utilization of marginal liver grafts in LT procedures. These grafts primarily encompass elderly livers, steatotic livers, livers from donation after circulatory death, split livers and those infected with the hepatitis virus. While the expansion of the donor pool offers promise, it also introduces concomitant risks. These encompass graft failure, biliary and cardiovascular complications, the recurrence of liver disease and reduced patient and graft survival. Consequently, various established strategies, ranging from improved donorrecipient matching to surgical interventions, have emerged to mitigate these risks. This article undertakes a comprehensive assessment of the current landscape, evaluating the viability of diverse marginal liver grafts. Additionally, it synthesizes approaches aimed at enhancing the quality of such marginal liver grafts. The overarching objective is to augment the donor pool and ameliorate the risk factors associated with the shortage of liver grafts.

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Short-term Results of Liver Transplantation With Octogenarian Donors

Cited by 8 publications

References 41 publications

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

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

Age‐related changes in metabolites in young donor livers and old recipient sera after liver transplantation from young to old rats

Current Understanding of Marginal Grafts in Liver Transplantation

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