title: Septuagenarian and octogenarian donors provide excellent liver grafts for transplantation.
abstract: BACKGROUND
  Wider utilization of liver grafts from donors ≥ 70 years old could substantially expand the organ pool, but their use remains limited by fear of poorer outcomes. We examined the results at our center of liver transplantation (OLT) using livers from donors ≥ 70 years old.
  
  
  METHODS
  From February 2003 to August 2010, we performed 450 OLT including 58 (13%) using donors ≥ 70 whose outcomes were compared with those using donors <70 years old.
  
  
  RESULTS
  Cerebrovascular causes of death predominated among donors ≥ 70 (85% vs 47% in donors <70; P < .001). In contrast, traumatic causes of death predominated among donors <70 (36% vs 14% in donors ≥ 70; P = .002). Unlike grafts from donors <70 years old, grafts from older individuals had no additional risk factors (steatosis, high sodium, or hemodynamic instability). Both groups were comparable for cold and warm ischemia times. No difference was noted in posttransplant peak transaminases, incidence of primary nonfunction, hepatic artery thrombosis, biliary strictures, or retransplantation rates between groups. The 1- and 5-year patient survivals were 88% and 82% in recipients of livers <70 versus 90% and 84% in those from ≥ 70 years old (P = .705). Recipients of older grafts, who were 6 years older than recipients of younger grafts (P < .001), tended to have a lower laboratory Model for End-Stage Liver Disease score (P = .074).
  
  
  CONCLUSIONS
  Short and mid-term survival following OLT using donors ≥ 70 yo can be excellent provided that there is adequate donor and recipient selection. Septuagenarians and octogenarians with cerebrovascular ischemic and bleeding accidents represent a large pool of potential donors whose wider use could substantially reduce mortality on the OLT waiting list.
authors.affiliation: Department of Abdominal Transplant Surgery, University Hospitals Leuven, Leuven, Belgium.
authors.forename: T
authors.initials: T
authors.lastname: Darius
authors.forename: D
authors.initials: D
authors.lastname: Monbaliu
authors.forename: I
authors.initials: I
authors.lastname: Jochmans
authors.forename: N
authors.initials: N
authors.lastname: Meurisse
authors.forename: B
authors.initials: B
authors.lastname: Desschans
authors.forename: W
authors.initials: W
authors.lastname: Coosemans
authors.forename: M
authors.initials: M
authors.lastname: Komuta
authors.forename: T
authors.initials: T
authors.lastname: Roskams
authors.forename: D
authors.initials: D
authors.lastname: Cassiman
authors.forename: S
authors.initials: S
authors.lastname: van der Merwe
authors.forename: W
authors.initials: W
authors.lastname: Van Steenbergen
authors.forename: C
authors.initials: C
authors.lastname: Verslype
authors.forename: W
authors.initials: W
authors.lastname: Laleman
authors.forename: R
authors.initials: R
authors.lastname: Aerts
authors.forename: F
authors.initials: F
authors.lastname: Nevens
authors.forename: J
authors.initials: J
authors.lastname: Pirenne
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D046148:Donor Selection; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome; D014850:Waiting Lists; D055815:Young Adult