title: Donors older than 70 years in liver transplantation.
abstract: BACKGROUND
  Expansion of donor criteria has become necessary with the increasing number of liver transplantation candidates, as aged donors who have been considered to yield marginal organs.
  
  
  METHODS
  Our database of 477 liver transplants (OLT) included 55 cases performed from donors at least 70 years old vs 422 with younger donors. We analyzed pretransplantation donor and recipient characteristics as well as evolution of the recipients.
  
  
  RESULTS
  The old donor group showed significantly lower ALT (23 +/- 17 vs 48.9 +/- 67; P = .0001) and LDH (444 +/- 285 vs 570 +/- 329; P = .01). There was a trend toward fewer hypotensive events in the aged donor group (27.2% vs 40.5%; P = .07). No steatosis (>10%) was accepted in the old donor group. Cold ischemia time was statistically shorter for the aged donors (297 +/- 90 minutes vs 346 +/- 139 minutes; P = .03). With these selected donors, the results were not different for primary nonfunction, arterial and biliary complications, hospitalization, acute reoperation or acute retransplantation, and hospital mortality when donors > or =70 years old were compared to younger donors. Functional cholestasis, neither related to rejection nor to biliary complications, was seen more frequently in old donor recipients (40% vs 22%; P = .03). No differences in 1, and 3 year survivals were observed between recipients of donors over 70 years old and these of younger organs: 93.8% and 90.6% vs 90.7% and 82.8%, respectively.
  
  
  CONCLUSIONS
  When using selected donors > or =70 years old the outcomes were comparable to those obtained with younger donors. Strict selection is necessary to achieve good long-term survival.
authors.affiliation: Liver Transplantation Unit, Hospital de Cruces, Bilbao, Spain. mgastaca@hcru.osakidetza.net
authors.forename: M
authors.initials: M
authors.lastname: Gastaca
authors.forename: A
authors.initials: A
authors.lastname: Valdivieso
authors.forename: J
authors.initials: J
authors.lastname: Pijoan
authors.forename: G
authors.initials: G
authors.lastname: Errazti
authors.forename: M
authors.initials: M
authors.lastname: Hernandez
authors.forename: J
authors.initials: J
authors.lastname: Gonzalez
authors.forename: J
authors.initials: J
authors.lastname: Fernandez
authors.forename: A
authors.initials: A
authors.lastname: Matarranz
authors.forename: M
authors.initials: M
authors.lastname: Montejo
authors.forename: A
authors.initials: A
authors.lastname: Ventoso
authors.forename: G
authors.initials: G
authors.lastname: Martinez
authors.forename: M
authors.initials: M
authors.lastname: Fernandez
authors.forename: J Ortiz
authors.initials: JO
authors.lastname: de Urbina
mesh_terms: D000367:Age Factors; D000368:Aged; D002423:Cause of Death; D005260:Female; D006085:Graft Survival; D006801:Humans; D008099:Liver; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000401:mortality / Q000502:physiology*; D008297:Male; D012086:Reoperation; D016019:Survival Analysis; D014019:Tissue Donors / Q000706:statistics & numerical data*; D016896:Treatment Outcome