Donor age as a predictor of risk for short-term outcomes after liver transplant.
OBJECTIVE
To investigate an association between short-term mortality and donor age-associated worst outcomes in liver transplant.


METHODS
A total of 178 consecutive patients underwent a liver transplant between 1999 and 2007. Among these patients, there were 172 liver transplants (donor age, 32.04 +/- 16.66; range, 2-65 years) and 167 recipients. Mean recipient age was 39.16 +/- 21.61 years (range, 6 months to 71 years), and 90 were males (53.8%).


RESULTS
Among 172 transplants, 32.9% recipients died during follow-up (mean, 34.37 +/- 20.50 months). A lower mean recipient and graft survival occurred in donors older than 50 years (P = .01) and 30 years (P = .02) at 7-year patient survival. At 6- month and 1-year recipient survival, cutoffs were 50 and 55 years (P < .05). Log-rank test showed no statistical difference among recipients, and graft survival from donors older/younger 50 and 30 years 1.5 years after liver transplant (P < .565 and P < .259).


CONCLUSIONS
Donor age is a key factor in liver transplant that carries prognostic impact in the recipients. Our data suggest that its harmful effects are exclusively elicited during the short-term, postoperative phase. We recommend careful and distinct management of recipients receiving grafts from elderly donors up to 1.5 years after liver transplant. Changes in the current early postoperative management of this selected group are encouraged.
Macedo
Francisco Igor B
FI
Department of Surgery and Liver Transplantation, Oswaldo Cruz University Hospital, University of Pernambuco School of Medicine, Recife, Brazil. igormacedo1@hotmail.com
Miranda
Luiz Eduardo C
LE
Fernandes
Jordão L
JL
Pádua
Tiago C
TC
Figueroa
José N
JN
Neto
Olival Lucena F
OL
Lacerda
Cláudio M
CM
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D046148:Donor Selection; D005260:Female; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome; D055815:Young Adult