title: Live Donor Liver Transplantation With Older (≥50 Years) Versus Younger (<50 Years) Donors: Does Age Matter?
abstract: OBJECTIVE
  To compare the outcome of adult live donor liver transplantation (LDLT) with grafts from older versus younger donors.
  
  
  BACKGROUND
  Using older donor grafts for adult LDLT may help expand the donor pool. However, the risks of LDLT with older donors remain controversial, and many centers are reluctant to use live donors aged 45 years or older for adult LDLT.
  
  
  METHODS
  Outcomes of patients receiving a LDLT graft from donors aged 50 years or older (n = 91) were compared with those receiving a live donor graft from donors younger than 50 years (n = 378).
  
  
  RESULTS
  Incidences of biliary (LDLT <50: 24% vs LDLT ≥50: 23%; P = 0.89) and major complications (LDLT <50: 24% vs LDLT ≥50: 24%; P = 1) were similar between both groups of recipients. No difference was observed in 30-day recipient mortality (LDLT <50: 3% vs LDLT ≥50: 0%; P = 0.13). The 1- (90% vs 90%), 5- (82% vs 73%), and 10- (71% vs 58%) year graft survival was statistically similar between both groups (P = 0.075). Likewise, patient survival after 1- (92% vs 96%), 5- (83% vs 79%), and 10- (76% vs 69%) years was also similar (P = 0.686). Overall, donors rate of major complications (Dindo-Clavien ≥3b) within 30 days was low (n = 2.3%) and not different in older versus younger donors (P = 1). Donor median hospital stay in both groups was identical [LDLT <50: 6 (4-17) vs LDLT ≥50: 6 (4-14) days; P = 0.65]. No donor death occurred and all donors had full recovery and returned to baseline activity.
  
  
  CONCLUSIONS
  Right lobe LDLT with donors aged 50 years or older results in acceptable recipient outcome without increased donor morbidity or mortality. Potential live donors should not be declined on the basis of age alone.
authors.affiliation: *Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, Ontario, Canada †Department of Medicine, Toronto General Hospital, Toronto, Ontario, Canada.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Goldaracena
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Sapisochin
authors.forename: Vinzent
authors.initials: V
authors.lastname: Spetzler
authors.forename: Juan
authors.initials: J
authors.lastname: Echeverri
authors.forename: Moritz
authors.initials: M
authors.lastname: Kaths
authors.forename: Mark S
authors.initials: MS
authors.lastname: Cattral
authors.forename: Paul D
authors.initials: PD
authors.lastname: Greig
authors.forename: Les
authors.initials: L
authors.lastname: Lilly
authors.forename: Ian D
authors.initials: ID
authors.lastname: McGilvray
authors.forename: Gary A
authors.initials: GA
authors.lastname: Levy
authors.forename: Anand
authors.initials: A
authors.lastname: Ghanekar
authors.forename: Eberhard L
authors.initials: EL
authors.lastname: Renner
authors.forename: David R
authors.initials: DR
authors.lastname: Grant
authors.forename: Markus
authors.initials: M
authors.lastname: Selzner
authors.forename: Nazia
authors.initials: N
authors.lastname: Selzner
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015415:Biomarkers / Q000032:analysis; D005260:Female; D006085:Graft Survival; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016031:Liver Transplantation / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers