title: Donor Age-Based Analysis of Liver Transplantation Outcomes: Short- and Long-Term Outcomes Are Similar Regardless of Donor Age.
abstract: BACKGROUND
  The shortage of donor organs has led to increasing use of extended criteria donors, including older donors. The upper limit of donor age that produces acceptable outcomes continues to be explored. In liver transplantation, with appropriate selection, graft survival and patient outcomes would be comparable regardless of age.
  
  
  METHODS
  We performed a retrospective analysis of 1,036 adult orthotopic liver transplantations (OLT) from a prospectively maintained database performed between January 1, 2000 and December 31, 2013. The study focus group was liver transplantations performed using grafts from older (older than 60 years) deceased donors. Deceased donor liver transplantations done during the same time period using grafts from younger donors (younger than 60 years) were analyzed for comparison. Both groups were further divided based on recipient age (less than 60 years and 60 years or older). Donor age was the primary variable. Recipient variables included were demographics, indication for transplantation, Model for End-Stage Liver Disease (MELD), graft survival, and patient survival. Operative details and postoperative complications were analyzed.
  
  
  RESULTS
  Patient demographics and perioperative details were similar between groups. Patient and graft survival rates were similar in the 4 groups. Rates of rejection (p = 0.07), bile leak (p = 0.17), and hepatic artery thrombosis were comparable across all groups (p = 0.84). Hepatitis C virus recurrence was similar across all groups (p = 0.10). Thirty-one young recipients (less than 60 years) received grafts from donors aged 70 or older. Their survival and other complication rates were comparable to those in the young donor to young recipient group.
  
  
  CONCLUSIONS
  Comparable outcomes in graft and patient survivals were achieved using older donors (60 years or more), regardless of recipient age, without increased rate of complications.
authors: Department of Surgery, Section of Abdominal Transplantation, Washington University School of Medicine, St Louis, MO. Electronic address: chapmanw@wustl.edu.
authors: William C
authors: WC
authors: Chapman
authors: Department of Surgery, Section of Abdominal Transplantation, Washington University School of Medicine, St Louis, MO.
authors: Neeta
authors: N
authors: Vachharajani
authors: Department of Surgery, Section of Abdominal Transplantation, Washington University School of Medicine, St Louis, MO.
authors: Kelly M
authors: KM
authors: Collins
authors: Department of Surgery, Section of Abdominal Transplantation, Washington University School of Medicine, St Louis, MO.
authors: Jackie
authors: J
authors: Garonzik-Wang
authors: Department of Surgery, Section of Abdominal Transplantation, Washington University School of Medicine, St Louis, MO.
authors: Yikyung
authors: Y
authors: Park
authors: Department of Surgery, Section of Abdominal Transplantation, Washington University School of Medicine, St Louis, MO.
authors: Jason R
authors: JR
authors: Wellen
authors: Department of Surgery, Section of Abdominal Transplantation, Washington University School of Medicine, St Louis, MO.
authors: Yiing
authors: Y
authors: Lin
authors: Department of Surgery, Section of Abdominal Transplantation, Washington University School of Medicine, St Louis, MO.
authors: Surendra
authors: S
authors: Shenoy
authors: Department of Surgery, Section of Abdominal Transplantation, Washington University School of Medicine, St Louis, MO.
authors: Jeffrey A
authors: JA
authors: Lowell
authors: Department of Surgery, Section of Abdominal Transplantation, Washington University School of Medicine, St Louis, MO.
authors: M B Majella
authors: MB
authors: Doyle
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D046148:Donor Selection / Q000379:methods*; D058625:End Stage Liver Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014019:Tissue Donors / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult