title: Liver Transplantation With Older Donors: A Comparison With Younger Donors in a Context of Organ Shortage.
abstract: BACKGROUND
  Older liver grafts have been considered in the past decade due to organ shortage. The aim was to compare outcomes after liver transplantation with either younger or older donors.
  
  
  METHODS
  Patients transplanted in our center between 2004 and 2014 with younger donors (younger than 60 years; n = 253) were compared with older donors (older than 75 years; n = 157). Multiorgan transplantations, split grafts, or non-heart-beating donors were not included.
  
  
  RESULTS
  Donors in the older group were mostly women deceased from stroke, and only 3 patients had experienced cardiac arrest. Liver tests were significantly better in the older group than in the younger group. There was no difference regarding cold ischemia time, model for end-stage liver disease score, and steatosis. There was no significant difference regarding primary nonfunction and dysfunction, hepatic artery and biliary complications, and retransplantation rates. Graft survival was not different (65% and 64% in the older and younger groups, P = 0.692). Within the older group, hepatitis C infection, retransplantation, and emergency transplantation were associated with poor graft survival.
  
  
  CONCLUSIONS
  Provided normal liver tests and the absence of cardiac arrest in donors, older liver grafts (>75 years) may be safely attributed to non-hepatitis C-infected recipients in the setting of a first and nonurgent transplantation.
authors: 1 Department of Hepatobiliopancreatic Surgery, Hôpital Beaujon, UNITY Hospitalo-universitary Department, Assistance Publique Hôpitaux de Paris (AP-HP), Paris 7 University, Clichy, France.2 Department of Anesthesiology and Intensive Care, Hôpital Beaujon, UNITY Hospitalo-universitary Department, Assistance Publique Hôpitaux de Paris (AP-HP), Paris 7 University, Clichy, France.3 Department of Hepatology Hôpital Beaujon, UNITY Hospitalo-Universitary Department, Assistance Publique Hôpitaux de Paris (AP-HP), Paris 7 University, Clichy, France.
authors: Louise
authors: L
authors: Barbier
authors: Manuela
authors: M
authors: Cesaretti
authors: Federica
authors: F
authors: Dondero
authors: François
authors: F
authors: Cauchy
authors: Linda
authors: L
authors: Khoy-Ear
authors: Takeshi
authors: T
authors: Aoyagi
authors: Emmanuel
authors: E
authors: Weiss
authors: Olivier
authors: O
authors: Roux
authors: Safi
authors: S
authors: Dokmak
authors: Claire
authors: C
authors: Francoz
authors: Catherine
authors: C
authors: Paugam-Burtz
authors: Ailton
authors: A
authors: Sepulveda
authors: Jacques
authors: J
authors: Belghiti
authors: François
authors: F
authors: Durand
authors: Olivier
authors: O
authors: Soubrane
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006085:Graft Survival; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D014019:Tissue Donors; D009927:Tissue and Organ Procurement