title: Does Matching Donor-Recipient Age Affect Long-Term Survival in Liver Transplantation?
abstract: BACKGROUND The characteristics of liver donors have changed over the last decade owing to the shortage of organs and high mortality on the waiting list, leading to wider use of extended-criteria donors, including older donors. The aim of this study was to evaluate the effect of matching donor-recipient age on morbidity at 1 year post-transplant and on long-term patient and graft survival. MATERIAL AND METHODS Retrospective study from a prospectively-obtained database including adult patients who had received a primary liver transplant (LT) from whole graft of brain-dead donors. Recipients were divided into 2 age groups: <60 years and ≥60 years. Both groups were sub-divided according to donor age (younger than 60 years and 60 years or older). A propensity score analysis was performed to further adjust for baseline differences between recipients and donors. RESULTS We analyzed 642 patients who had LT performed between January 2000 and December 2013. No differences were observed in 1-year morbidity (hospital stay, rejection, surgical complications, and retransplant) between groups. Although patient and graft survival was significantly impaired in the older donor/older recipient group on Kaplan-Meier analysis (p=0.004), the propensity score analysis showed that donor age ≥60 years did not increase the risk of death for recipients aged ≥60 (HR1.40, p 0.074) and <60 years (HR 1.47, p 0.070). CONCLUSIONS Older donor age did not negatively affect survival regardless of recipient age, and comparable outcomes were achieved without an increased rate of complications.
authors.affiliation: Department of HPB Surgery and Transplants, Hospital Universitario Vall d'Hebron, Universidad Autonoma de Barcelona, Barcelona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Dopazo
authors.affiliation: Department of HPB Surgery and Transplants, Hospital Universitario Vall d'Hebron, Universidad Autonoma de Barcelona, Barcelona, Spain.
authors.forename: Itxarone
authors.initials: I
authors.lastname: Bilbao
authors.affiliation: Hepatology Unit, Department of Internal Medicine, Hospital Vall d'Hebron, CIBERehd, Universidad Autonoma de Barcelona, Barcelona, Spain.
authors.forename: Lluis
authors.initials: L
authors.lastname: Castells
authors.affiliation: Department of HPB Surgery and Transplants, Hospital Universitario Vall d'Hebron, Universidad Autonoma de Barcelona, Barcelona, Spain.
authors.forename: Mireia
authors.initials: M
authors.lastname: Caralt
authors.affiliation: Department of HPB Surgery and Transplants, Hospital Universitario Vall d'Hebron, Universidad Autonoma de Barcelona, Barcelona, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Fernández de Sevilla
authors.affiliation: Department of HPB Surgery and Transplants, Hospital Universitario Vall d'Hebron, Universidad Autonoma de Barcelona, Barcelona, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Lázaro
authors.affiliation: Department of HPB Surgery and Transplants, Hospital Universitario Vall d'Hebron, Universidad Autonoma de Barcelona, Barcelona, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Charco
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D016208:Databases, Factual; D046148:Donor Selection; D005260:Female; D006084:Graft Rejection / Q000401:mortality*; D006085:Graft Survival; D006801:Humans; D007902:Length of Stay; D017093:Liver Failure / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors