Transplantation of liver grafts from older donors: impact on recipients with hepatitis C virus infection.
BACKGROUND
Older donor allografts are being accepted for liver transplantation (LTx) due to shortage of organs. Hepatitis C virus (HCV) infection-related disease is presently the most common indication of LT in the United States. We studied the impact of donor age on patient and graft survivals in patients with HCV infection.


METHODS
One hundred fifty four consecutive HCV(+) LTx recipients (117 men, 37 women) were studied. The mean follow-up period was 41.0 +/- 30.2 months. The population was divided into four groups according to donor age: group I (< or =20 years); group II (21 to 40 years); group III (41 to 60 years); group IV (>60 years).


RESULTS
Thirty-two (20.8%) patients died during follow-up and 16 patients (10.4%) required retransplantation. The actuarial 7-year patient survivals for groups I, II, III, and IV were 87.1%, 73.7%, 69.3%, and 68.5%, respectively (P = .4). Patient survivals for donor age groups III + IV (n = 95) and groups I + II (n = 59) were 68.9% and 77.2%, respectively (P = .19). The 7-year graft survivals for groups I, II, III, and IV were 82.7%, 71.8%, 65.8%, and 62.5%, respectively (P = .17). Graft survivals for groups III + IV and groups I + II were 58.4% and 76.2%, respectively (P = .03).


CONCLUSIONS
Patient and graft survivals for HCV-positive liver transplant recipients in this study decreased progressively as the donor age increased. Patient and graft survivals were best for group I recipients. There were significant differences in graft survivals when recipients were grouped with a cutoff donor age of 40 years.
Jain
A
A
Department of Surgery, Division of Transplantation, University of Rochester Medical Centre, Rochester, New York 14642, USA. ashok_jain@urmc.rochester.edu
Orloff
M
M
Abt
P
P
Kashyap
R
R
Mohanka
R
R
Lansing
K
K
Bozorgzadeh
A
A
D000328:Adult; D000367:Age Factors; D002102:Cadaver; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006526:Hepatitis C / Q000635:transmission*; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality / Q000502:physiology / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000821:virology; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D014019:Tissue Donors