title: Effect of donor-recipient age gradient on graft outcomes in deceased donor liver transplantation.
abstract: OBJECTIVE
  Donor age is a well-known factor influencing graft function after deceased donor liver transplantation (DDLT). However, the effect of donors older than recipients on graft outcomes remains unclear. This study investigated the relationship between the donor-recipient age gradient (DRAG) and posttransplant outcomes after DDLT.
  
  
  METHODS
  We included 164 adult recipients who underwent DDLT between May 1996 and April 2011. Patients were divided into 2 groups according to the value of DRAG: Negative (DRAG -20 to -1; n = 99) versus positive (DRAG 0-20; n = 65). Medical records were reviewed and laboratory data were retrospectively collected.
  
  
  RESULTS
  The median age of donors and recipients was 43 (range, 10-80) and 46 (range, 19-67) years, respectively. The mean follow-up time was 57.4 months. A positive DRAG had a negative effect on levels of alkaline phosphatase until 2 weeks after transplantation. However, the positive group showed a lower incidence of hepatitis B viral disease recurrence. The 1-, 3-, and 5-year graft survival rates were 80.4%, 76.8%, and 71.4% in the negative group, and 65.8%, 58.4%, and 56.3% in the positive group, respectively. The positive DRAG group showed significantly inferior graft survival compared with the negative DRAG group (P = .036).
  
  
  CONCLUSIONS
  This study demonstrated that donors older than recipients had a deleterious effect on graft outcomes. DRAG could be a meaningful determinant of graft survival among DDLT recipients.
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, seoul, Korea.
authors.forename: M
authors.initials: M
authors.lastname: Shin
authors.forename: J M
authors.initials: JM
authors.lastname: Kim
authors.forename: J B
authors.initials: JB
authors.lastname: Park
authors.forename: Ch H D
authors.initials: ChH
authors.lastname: Kwon
authors.forename: S-J
authors.initials: SJ
authors.lastname: Kim
authors.forename: J-W
authors.initials: JW
authors.lastname: Joh
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D005260:Female; D006085:Graft Survival; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D014019:Tissue Donors; D055815:Young Adult