Older donor allografts are associated with poor patient survival after living donor liver transplantation for hepatitis B virus-related liver diseases.
OBJECTIVE
The significance of donor age in living donor liver transplantation (LDLT) for hepatitis B virus (HBV) infection has not been fully evaluated.


METHODS
We analyzed the data of 136 patients who underwent LDLT for HBV-related liver diseases from January 1999 to April 2004. The recipients were divided into an older donor group (donor age > or = 40) and a younger donor group (donor age < 40). Posttransplant clinical outcomes and survival were compared between two groups, and predictors of survival after LDLT were evaluated.


RESULTS
Baseline characteristics were not different between the two groups, except for more number of female donors and higher positive donor anti-HBc rate in the older group. The frequencies of acute rejection and early mortality after transplantation were similar in the two groups. The long-term survival rates for the older donor group were significantly lower than those of the younger donor group (1-, 3-, 5-year survival rate = 84%, 75%, 46% vs. 92%, 86%, and 83%, P = 0.03). Multivariate analysis showed that older donor age was the only independent risk factor associated with survival after LDLT (HR = 2.3; 95% CI = 1.1-5.6, P = 0.04).


CONCLUSIONS
Our study suggests that older donor allografts would be associated with poor patient survival after LDLT for HBV-related liver diseases.
Kim
Do Young
DY
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Choi
Moon Seok
MS
Lee
Joon Hyoek
JH
Koh
Kwang Cheol
KC
Paik
Seung Woon
SW
Yoo
Byung Chul
BC
Joh
Jae Won
JW
Lee
Suk Koo
SK
Rhee
Jong Chul
JC
D000328:Adult; D000367:Age Factors; D005260:Female; D006509:Hepatitis B / Q000601:surgery*; D006510:Hepatitis B Antibodies / Q000097:blood; D006512:Hepatitis B Core Antigens / Q000276:immunology; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D016019:Survival Analysis; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens