title: Octogenarian Donors in Liver Transplantation.
abstract: BACKGROUND
  Due to the disparity between the number of patients on the list for liver transplantation and the availability of organs, the use of older donors has become necessary. The aim of this study was to investigate the outcomes of liver transplantation using octogenarian donors.
  
  
  METHODS
  From December 2003 to February 2016, 777 liver transplantations were performed at our institution, 33 of them (4.2%) with donors 80 years old and above. Our policy for the acceptance of these donors is based on preoperative liver function tests, donor hemodynamic stability, and intraoperative normal gross aspect. Octogenarian grafts were deliberately not assigned to retransplantations or to recipients with multiple previous surgical procedures or extensive portal thrombosis.
  
  
  RESULTS
  Mean donor age was 82.7 ± 2.1 years, with a range between 80 and 88. Only 12.1% suffered hemodynamic instability during the intensive care unit stay. Three donors (9.1%) had a history of diabetes mellitus. The mean Model for End-Stage Liver Disease score among recipients was 14.7 ± 5.6. Mean cold ischemia time was 302 ± 61 minutes. After a median follow-up of 18.5 months (range 7.5 to 47.5), no graft developed primary nonfunction. We observed hepatic artery thrombosis in 1 patient (3%) and biliary complications in 4 patients (12.5%). There was 1 case of ischemic-type biliary lesion, although it was related to hepatic artery thrombosis. Patient survival at 1 and 3 years was 90.3%, whereas graft survival was 92.6% and 86.4%, respectively.
  
  
  CONCLUSIONS
  Excellent mid-term results can be obtained after liver transplantation with octogenarian donors with strict donor selection and adequate graft allocation.
authors.affiliation: Hepatobiliary Surgery and Liver Transplantation Unit, Cruces University Hospital, Bilbao, Spain; Hepatobiliary Surgery and Liver Transplantation Unit, University of the Basque Country, Bilbao, Spain. Electronic address: mikel.gastacamateo@osakidetza.eus.
authors.forename: M
authors.initials: M
authors.lastname: Gastaca
authors.affiliation: Hepatobiliary Surgery and Liver Transplantation Unit, Cruces University Hospital, Bilbao, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Guerra
authors.affiliation: Pediatric Surgery, Cruces University Hospital, Bilbao, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Alvarez Martinez
authors.affiliation: Hepatobiliary Surgery and Liver Transplantation Unit, Cruces University Hospital, Bilbao, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Ruiz
authors.affiliation: Hepatobiliary Surgery and Liver Transplantation Unit, Cruces University Hospital, Bilbao, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Ventoso
authors.affiliation: Hepatobiliary Surgery and Liver Transplantation Unit, Cruces University Hospital, Bilbao, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Palomares
authors.affiliation: Hepatobiliary Surgery and Liver Transplantation Unit, Cruces University Hospital, Bilbao, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Prieto
authors.affiliation: Hepatobiliary Surgery and Liver Transplantation Unit, Cruces University Hospital, Bilbao, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Matarranz
authors.affiliation: Hepatobiliary Surgery and Liver Transplantation Unit, Cruces University Hospital, Bilbao, Spain; Hepatobiliary Surgery and Liver Transplantation Unit, University of the Basque Country, Bilbao, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Valdivieso
authors.affiliation: Hepatobiliary Surgery and Liver Transplantation Unit, Cruces University Hospital, Bilbao, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Ortiz de Urbina
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over / Q000706:statistics & numerical data*; D050377:Cold Ischemia; D046148:Donor Selection / Q000379:methods*; D005260:Female; D006085:Graft Survival; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D014019:Tissue Donors / Q000706:statistics & numerical data*; D019737:Transplants / Q000503:physiopathology / Q000600:supply & distribution; D016896:Treatment Outcome