Impact of age older than 60 years in living donor liver transplantation.
BACKGROUND
Living donor liver transplantation (LDLT) was extended to adults in recent years and more recently to older patients. The impact of donor age, analysis of preoperative risk factors for older LDLT recipients, and comparison of the complication rate between older and younger recipients were analyzed.


METHODS
Subjects included patients who underwent LDLT at Kyoto University Hospital from October 1996 to December 2005. Twenty-three donors were 60 years of age or older, and 411 were younger than 60 years of age. Fifty-two recipients were 60 years of age or older and 410 were younger than 60 years of age.


RESULTS
Postoperative recovery of liver function for donors and recipient/graft survival were not influenced by donor age. Hospital stay was longer in the donors 60 years of age or older than those younger than 60 years of age (P=0.02). The 5-year survival rates were 78.7% in recipients 60 years of age or older and 69.3% in younger recipients (P=0.26). Among preoperative risk factors for recipient survival rate, fulminant hepatic failure and preoperative status in the intensive care unit were significant (P<0.05). There were no significant differences in the incidence of postoperative complications for recipients.


CONCLUSIONS
Selected right lobe donors from individuals who were 60 years of age or older showed a similar postoperative course compared with younger donors. Moreover, LDLT is feasible for patients 60 years of age or older who do not require care in the intensive care unit or do not have fulminant hepatic failure.
Department of Transplant Surgery, Kyoto University Hospital, [corrected] Kyoto, Japan. kura3kaori@aol.com
Kaori
K
Kuramitsu
Hiroto
H
Egawa
Emmet B
EB
Keeffe
Mureo
M
Kasahara
Takashi
T
Ito
Seisuke
S
Sakamoto
Kohei
K
Ogawa
Fumitaka
F
Oike
Yasutugu
Y
Takada
Shinji
S
Uemoto
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D016031:Liver Transplantation / Q000379:methods* / Q000401:mortality; D019520:Living Donors; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends