title: Clinical outcomes of right-lobe split-liver versus orthotopic liver transplants from donors more than 70 years old.
abstract: Context-The imbalance between the organ supply and the number of potential transplant recipients led to consideration of expanded-criteria liver donors. Objective-To compare right-lobe split-liver transplants (RL-SLTs) with orthotopic liver transplants (OLTs) from donors more than 70 years old (OLT-O) and OLTs from donors less than 55 years old (OLT-Y). Methods-Seventy-one patients who received an RL-SLT were matched for age, sex, and Model for End-stage Liver Disease score with 71 patients who underwent OLT-O and 142 patients who underwent OLT-Y. Clinical outcomes were compared between groups. Results-Longer operation time was associated with RL-SLT (P< .001) as well as more blood loss (P= .03) and transfusions (P= .05). Postoperative morbidity was less in the OLT-Y group, with a lower rate of grades III to IV Clavien-Dindo complication (30%), compared with values in OLT-O (52%) and RL-SLT (38%). Kaplan-Meier analysis demonstrated better 1-year and 3-year survival rates in the OLT-Y group (97% and 92%, respectively), compared with 92% and 86.3%, respectively, in the RL-SLT group; and 84.5% and 73%, respectively, in the OLT-O group (P = .03). Kaplan-Meier analysis also demonstrated differences between the groups in terms of 1-year and 3-year graft survival rates, which were 92% and 86%, respectively, in OLT-Y; 77% and 66%, respectively, in the OLT-O, and 84.2% and 76.6%, respectively, in the RL-SLT group (P= .01). Conclusion-Even if OLT-Y guarantees better patient and graft survival, both RL-SLT and OLT-O can be used safely to expand the pool of liver donors, showing acceptable clinical results and complications rates.
authors: Hospital Henri-Mondor, Université de Paris Est-Creteil, Paris, France.
authors: Riccardo
authors: R
authors: Memeo
authors: Hospital Henri-Mondor, Université de Paris Est-Creteil, Paris, France.
authors: Nicola
authors: N
authors: de'Angelis
authors: Hospital Henri-Mondor, Université de Paris Est-Creteil, Paris, France.
authors: Chady
authors: C
authors: Salloum
authors: Hospital Henri-Mondor, Université de Paris Est-Creteil, Paris, France.
authors: Philipe
authors: P
authors: Compagnon
authors: Hospital Henri-Mondor, Université de Paris Est-Creteil, Paris, France.
authors: Alexis
authors: A
authors: Laurent
authors: Hospital Henri-Mondor, Université de Paris Est-Creteil, Paris, France.
authors: Cyrille
authors: C
authors: Feray
authors: Hospital Henri-Mondor, Université de Paris Est-Creteil, Paris, France.
authors: Cristoph
authors: C
authors: Duvoux
authors: Hospital Henri-Mondor, Université de Paris Est-Creteil, Paris, France.
authors: Daniel
authors: D
authors: Azoulay
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005602:France / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality; D016019:Survival Analysis; D014019:Tissue Donors