Liver transplantation using livers from septuagenarian and octogenarian donors: an underused strategy to reduce mortality on the waiting list.
Shortage of liver grafts is the only limiting factor for application of liver transplantation and causes an increasing mortality on the waiting list. Very old donors (>70 to 80 years old) are rarely referred to transplant centers because of the assumption that these livers will not work properly. Alternatively, transplant teams may be reluctant to use these very old livers due to the risk of poor posttransplant outcome. We reviewed our experience with seven liver transplantations using very old donor livers. We found that the results in terms of graft function and patient survival are adequate. Interestingly, the majority of these donors originated from a single referring donor unit (of more than 20 units who belong to our donor network) that systematically refers all brain-dead donors to the transplant center, independent of the age of the potential donor. This implies that many of these donors are left undetected in other units. In conclusion, very old donors should be referred to transplant centers since results of transplantation with these grafts are favorable.
Pirenne
J
J
Abdominal Transplant Surgery Department--Transplant Coordination, University Hospitals Leuven, Leuven, Belgium. Jacques.Pirenne@uz.kuleuven.ac.be
Monbaliu
D
D
Van Gelder
F
F
Van Hees
D
D
Aerts
R
R
Verslype
C
C
Van Steenbergen
W
W
Ferdinande
P
P
Fevery
J
J
Nevens
F
F
Coosemans
W
W
Stockman
W
W
Lormans
P
P
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D015276:Health Care Rationing; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery; D008104:Liver Cirrhosis, Alcoholic / Q000601:surgery; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality / Q000502:physiology / Q000706:statistics & numerical data*; D008875:Middle Aged; D018579:Patient Selection; D016019:Survival Analysis; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome