How important is donor age in liver transplantation?
The age of liver donors has been increasing in the past several years because of a donor shortage. In the United States, 33% of donors are age 50 years or older, as are more than 50% in some European countries. The impact of donor age on liver transplantation (LT) has been analyzed in several studies with contradictory conclusions. Nevertheless, recent analyses of the largest databases demonstrate that having an older donor is a risk factor for graft failure. Donor age is included as a risk factor in the more relevant graft survival scores, such as the Donor Risk Index, donor age and Model for End-stage Liver Disease, Survival Outcomes Following Liver Transplantation, and the Balance of Risk. The use of old donors is related to an increased rate of biliary complications and hepatitis C virus-related graft failure. Although liver function does not seem to be significantly affected by age, the incidence of several liver diseases increases with age, and the capacity of the liver to manage or overcome liver diseases or external injuries decreases. In this paper, the importance of age in LT outcomes, the role of donor age as a risk factor, and the influence of aging on liver regeneration are reviewed.
Alberto Lué, Sara Lorente, M Trinidad Serrano, Liver Transplantation Unit, Department of Gastroenterology, University Hospital Lozano Blesa, 50009 Zaragoza, Spain.
Alberto
A
Lué
Alberto Lué, Sara Lorente, M Trinidad Serrano, Liver Transplantation Unit, Department of Gastroenterology, University Hospital Lozano Blesa, 50009 Zaragoza, Spain.
Estela
E
Solanas
Alberto Lué, Sara Lorente, M Trinidad Serrano, Liver Transplantation Unit, Department of Gastroenterology, University Hospital Lozano Blesa, 50009 Zaragoza, Spain.
Pedro
P
Baptista
Alberto Lué, Sara Lorente, M Trinidad Serrano, Liver Transplantation Unit, Department of Gastroenterology, University Hospital Lozano Blesa, 50009 Zaragoza, Spain.
Sara
S
Lorente
Alberto Lué, Sara Lorente, M Trinidad Serrano, Liver Transplantation Unit, Department of Gastroenterology, University Hospital Lozano Blesa, 50009 Zaragoza, Spain.
Juan J
JJ
Araiz
Alberto Lué, Sara Lorente, M Trinidad Serrano, Liver Transplantation Unit, Department of Gastroenterology, University Hospital Lozano Blesa, 50009 Zaragoza, Spain.
Agustin
A
Garcia-Gil
Alberto Lué, Sara Lorente, M Trinidad Serrano, Liver Transplantation Unit, Department of Gastroenterology, University Hospital Lozano Blesa, 50009 Zaragoza, Spain.
M Trinidad
MT
Serrano
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003661:Decision Support Techniques; D046148:Donor Selection; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008115:Liver Regeneration; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D019520:Living Donors / Q000600:supply & distribution; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011237:Predictive Value of Tests; D012307:Risk Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome; D055815:Young Adult
Aging; Graft survival; Liver regeneration; Liver transplantation; Old donor