title: Surgical strategy in abdominal organs retrieval from elderly donors.
abstract: BACKGROUND
  There are no literature data on surgical problems that can be encountered during harvesting of grafts from elderly donors. The aim of our study was to report our experience during liver harvesting from donors over 70 years old and during transplantations of these grafts.
  
  
  METHODS
  From April 1986 to December 2001, 686 OLT in 599 patients were performed at the Liver Transplant Unit of the S. Orsola Hospital in Bologna. In particular we harvested 68 livers from donors with mean age of 75.4+/-4.5 years (range 70-87). The cause of brain death was a spontaneous cerebral haemorrhage in 58 cases and trauma in 10 cases. Thirteen donors were previously submitted to cardiovascular surgery. Three subjects had an abdominal aorta aneurysm 5, 6 and 7 cm large respectively, involving the iliac arteries, not diagnosed before the harvesting procedure. In 60 donors atherosclerosis was present.
  
  
  RESULTS
  Out of 68 transplanted patients with donor over 70 years of age we observed 13 arterial complications (19.1%): 7 hepatic artery thrombosis, 3 hepatic artery stenosis, 1 iliac graft thrombosis, 1 splenic artery stump rupture and 1 hepatic artery rupture both leading to fatal hemoperitoneum. A primary non-function occurred in 4 cases treated with retransplantation. The 1- and 3-year graft survival was 74 and 56.2%, respectively; the 1 and 3-years patient survival was 85.8 and 72.5% respectively.
  
  
  CONCLUSIONS
  Harvesting technique from old donors is not so different from standard procedure: however it is fundamental surgeon's experience to optimize organ retrieval from these donors.
authors.affiliation: Department of Transplant, Resuscitation and Surgical Disciplines, S. Orsola Hospital, University of Bologna, Bologna, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Nardo
authors.forename: F
authors.initials: F
authors.lastname: Catena
authors.forename: R
authors.initials: R
authors.lastname: Montalti
authors.forename: L
authors.initials: L
authors.lastname: Puviani
authors.forename: G
authors.initials: G
authors.lastname: Cavallari
authors.forename: P
authors.initials: P
authors.lastname: Beltempo
authors.forename: R
authors.initials: R
authors.lastname: Bertelli
authors.forename: E
authors.initials: E
authors.lastname: Piazzese
authors.forename: V
authors.initials: V
authors.lastname: Pacilè
authors.forename: A
authors.initials: A
authors.lastname: Cavallari
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008099:Liver / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000379:methods*