Does the liver ever age? Results of liver transplantation with donors above 80 years of age.
BACKGROUND
Facing an increasing shortage of donor organs, donor criteria become more extended and so-called marginal organs are accepted for transplantation. For liver donation donor age above 70 years is accepted as a risk factor concerning primary dysfunction or nonfunction. Therefore, the aim of this study was to compare the early outcome of grafts older versus younger than 80 years of age.


METHODS
Between August 2002 and February 2004, 40 adult liver transplants were performed using triple immunosuppression with tacrolimus, MMF, and low-dose corticosteroids. Recipients with HCC received low-dose rapamycin after postoperative day 14. The outcome of grafts from donors under 80 years of age (n=35) was compared with those from donors 80 years old or more (n=5). For statistical analysis Mann-Whitney-U-Test and Fisher's Exact Test were used with P < .05 considered statistically significant.


RESULTS
The average donor age of our population was 54.4 +/- 17.3 years with five donors older than 80 years (80-83 years). These donors all had additional risk factors. The recipients of the latter grafts suffered from HCC and liver cirrhosis Child A (n=2) or from viral hepatitis (n=3). One recipient had advanced cirrhosis with severe complications. The outcomes of both groups were comparable concerning intraoperative and postoperative courses. All recipients of old liver grafts left the hospital with stable graft function.


CONCLUSIONS
Liver grafts over 80 years can be transplanted with good results, especially if given to recipients with malignancy and otherwise stable liver function.
Zapletal
Ch
Ch
Department of General and Vascular Surgery, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany. Christina.Zapletal@kgu.de
Faust
D
D
Wullstein
C
C
Woeste
G
G
Caspary
W F
WF
Golling
M
M
Bechstein
W O
WO
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D006801:Humans; D008099:Liver / Q000254:growth & development*; D016031:Liver Transplantation / Q000401:mortality / Q000502:physiology*; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology; D012307:Risk Factors; D016019:Survival Analysis; D014019:Tissue Donors / Q000706:statistics & numerical data; D016896:Treatment Outcome