title: Long-term results using old liver grafts for transplantation: sexagenerian versus liver donors older than 70 years.
abstract: BACKGROUND
  The most practical measure to augment the available number of liver grafts and thus reduce waiting list mortality is to increase the donor age limit. We hypothesized that with careful selection of old liver donors without age limit it should be possible to obtain good patient and graft survival.
  
  
  METHODS
  The present study comprises 351 adults who underwent liver transplantation. They were divided into three groups according to the age of the liver donors: group 1: 226 recipients of donors <60 years; group 2: 75 recipients of donors between 60 and 70 years; and group 3: 50 recipients of donors >70 years. A comparative study among the groups was performed.
  
  
  RESULTS
  Patient survival rates at 1, 3, and 5 years were, respectively, 81.0, 76.1, and 71.1 % in group 1; 83.8, 74, and 72.2 % in group 2; and 76, 70.0, and 62.9 % in group 3 (P = NS). Graft survival at 1, 3, and 5 years was, respectively, 74.8, 69.0, and 64.1 % in group 1; 82.7, 71.4, and 69.6 % in group 2; and 71.4, 64.8, and 58.3 % in group 3 (P = NS). We analyzed the use of older grafts in recipients with HCV cirrhosis and did not find significant differences in patient and graft survival at 1, 3, and 5 years. In multivariate analysis increased donor body mass index and decreased recipient albumin were associated with lower patient and graft survival.
  
  
  CONCLUSIONS
  Because patient and graft survival rates are not affected by donor age, well-selected older donor livers can be safely used if they show good function and preharvesting conditions.
authors.affiliation: Department of General and Digestive Surgery, Hospital Doce de Octubre, Complutense University, 4ª Planta. Ctra Andalucía Km 5,4, 28041 Madrid, Spain. carlos.jimenez@inforboe.es
authors.forename: Carlos
authors.initials: C
authors.lastname: Jiménez-Romero
authors.forename: Marta
authors.initials: M
authors.lastname: Clemares-Lama
authors.forename: Alejandro
authors.initials: A
authors.lastname: Manrique-Municio
authors.forename: Alvaro
authors.initials: A
authors.lastname: García-Sesma
authors.forename: Jorge
authors.initials: J
authors.lastname: Calvo-Pulido
authors.forename: Enrique
authors.initials: E
authors.lastname: Moreno-González
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D064591:Allografts / Q000600:supply & distribution; D015992:Body Mass Index; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D000075202:Contraindications; D005260:Female; D006085:Graft Survival / Q000502:physiology; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000601:surgery / Q000821:virology; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D020127:Recovery of Function / Q000502:physiology; D012709:Serum Albumin / Q000032:analysis; D014019:Tissue Donors / Q000600:supply & distribution; D009927:Tissue and Organ Procurement / Q000458:organization & administration; D014850:Waiting Lists; D055815:Young Adult
chemical_list: D012709:Serum Albumin