title: Use of octogenarian donors for liver transplantation: a survival analysis.
abstract: Use of very old donors in liver transplantation (LT) is controversial because advanced donor age is associated with a higher risk for graft dysfunction and worse long-term results, especially for hepatitis C virus (HCV)-positive recipients. This was a retrospective, single-center review of primary, ABO-compatible LT performed between 2001 and 2010. Recipients were stratified in four groups based on donor age (<60 years; 60-69 years; 70-79 years and ≥80 years) and their outcomes were compared. A total of 842 patients were included: 348 (41.3%) with donors <60 years; 176 (20.9%) with donors 60-69 years; 233 (27.7%) with donors 70-79 years and 85 (10.1%) with donors ≥80 years. There was no difference across groups in terms of early (≤30 days) graft loss, and graft survival at 1 and 5 years was 90.5% and 78.6% for grafts <60 years; 88.6% and 81.3% for grafts 60-69 years; 87.6% and 75.1% for grafts 70-79 years and 84.7% and 77.1% for grafts ≥80 years (p = 0.065). In the group ≥80 years, the 5-year graft survival was lower for HCV-positive versus HCV-negative recipients (62.4% vs. 85.6%, p = 0.034). Based on our experience, grafts from donors ≥80 years may provide favorable results but require appropriate selection and allocation policies.
authors.affiliation: Hepatobiliary Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Ghinolfi
authors.forename: J
authors.initials: J
authors.lastname: Marti
authors.forename: P
authors.initials: P
authors.lastname: De Simone
authors.forename: Q
authors.initials: Q
authors.lastname: Lai
authors.forename: D
authors.initials: D
authors.lastname: Pezzati
authors.forename: L
authors.initials: L
authors.lastname: Coletti
authors.forename: D
authors.initials: D
authors.lastname: Tartaglia
authors.forename: G
authors.initials: G
authors.lastname: Catalano
authors.forename: G
authors.initials: G
authors.lastname: Tincani
authors.forename: P
authors.initials: P
authors.lastname: Carrai
authors.forename: D
authors.initials: D
authors.lastname: Campani
authors.forename: M
authors.initials: M
authors.lastname: Miccoli
authors.forename: G
authors.initials: G
authors.lastname: Biancofiore
authors.forename: F
authors.initials: F
authors.lastname: Filipponi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D016019:Survival Analysis; D014019:Tissue Donors
keywords: Clinical research/practice; donors and donation: deceased; donors and donation: extended-criteria; liver disease; liver transplantation/hepatology; organ procurement and allocation