The Kupffer Cell Number Affects the Outcome of Living Donor Liver Transplantation from Elderly Donors.
BACKGROUND
There have been no previous reports how Kupffer cells affect the outcome of living donor liver transplantation (LDLT) with an elderly donor. The aim of this study was to elucidate the influence of Kupffer cells on LDLT.


METHODS
A total of 161 adult recipients underwent LDLT. The graft survival, prognostic factors for survival, and graft failure after LDLT were examined between cases with a young donor (<50, n = 112) and an elderly donor (≥50, N = 49). The Kupffer cells, represented by CD68-positive cell in the graft, were examined in the young and elderly donors.


RESULTS
In a multivariable analysis, a donor older than 50 years, sepsis, and diabetes mellitus were significant predictors of graft failure after LDLT. The CD68 in younger donors was significantly more expressed than that in elderly donors. The group with a less number of CD68-positive cells in the graft had a significantly poor survival in the elderly donor group and prognostic factor for graft failure.


CONCLUSIONS
The worse outcome of LDLT with elderly donors might be related to the lower number of Kupffer cells in the graft, which can lead to impaired recovery of the liver function and may predispose patients to infectious diseases after LDLT.
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Japan.
Masaaki
M
Hidaka
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Japan.
Susumu
S
Eguchi
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Japan.
Mitsuhisa
M
Takatsuki
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Japan.
Akihiko
A
Soyama
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Japan.
Shinichiro
S
Ono
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Japan.
Tomohiko
T
Adachi
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Japan.
Koji
K
Natsuda
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Japan.
Tota
T
Kugiyama
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Japan.
Takanobu
T
Hara
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Japan.
Satomi
S
Okada
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Japan.
Hajime
H
Imamura
Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Japan.
Satoshi
S
Miuma
Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Japan.
Hisamitsu
H
Miyaaki