title: Impact of Donor Age on Recipient Survival in Adult-to-Adult Living-donor Liver Transplantation.
abstract: To investigate the influence of donor age on recipient outcome after living-donor partial liver transplantation (LDLT).
  
  
  
  Donor age is a well-known prognostic factor in deceased donor liver transplantation; however, its role in LDLT remains unclear.
  
  
  
  We retrospectively analyzed 315 consecutive cases of primary adult-to-adult LDLT in our center between April 2006 and March 2014. Recipients were divided into 5 groups according to the donor age: D-20s (n = 60); D-30s (n = 72); D-40s (n = 57); D-50s (n = 94); and D-60s (n = 32). The recipient survival and the association with various clinical factors were investigated.
  
  
  
  Recipient survival proportions were significantly higher in D-20s compared with all the other groups (P = 0.008, < 0.001, < 0.001, and = 0.006, vs D-30s, -40s, -50s, and -60s, respectively), whereas there was no association between recipient survival and their own age. There are 3 typical relationships between donors and recipients in adult-to-adult LDLT: from child-to-parent, between spouses/siblings, and from parent-to-child. The overall survival in child-to-parent was significantly higher than in spouses/siblings (P = 0.002) and in parent-to-child (P = 0.005), despite significantly higher recipient age in child-to-parent [59 (42-69) years, P < 0.001]. Contrastingly, parent-to-child exhibited the lowest survival, despite the youngest recipient age [26 (20-43) years, P < 0.001]. In addition, younger donor age exhibited significantly better recipient survival both in hepatitis C virus-related and in non-hepatitis C virus diseases. Univariate and multivariate analyses both demonstrated that donor age and graft-type (right-sided livers) are independent prognostic factors for recipient survival.
  
  
  
  Donor age is an independent, strong prognostic factor in adult-to-adult LDLT.
authors.affiliation: Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Toyonari
authors.initials: T
authors.lastname: Kubota
authors.affiliation: Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Hata
authors.affiliation: Department of Information and Computer Technology, Tokyo University of Science, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sozu
authors.affiliation: Organ Transplantation Unit, Kyoto University Hospital, Kyoto, Japan.|Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Ueda
authors.affiliation: Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Hirao
authors.affiliation: Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Okamura
authors.affiliation: Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Tamaki
authors.affiliation: Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshikawa
authors.affiliation: Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Kusakabe
authors.affiliation: Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Shoichi
authors.initials: S
authors.lastname: Kageyama
authors.affiliation: Organ Transplantation Unit, Kyoto University Hospital, Kyoto, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Anazawa
authors.affiliation: Organ Transplantation Unit, Kyoto University Hospital, Kyoto, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yoshizawa
authors.affiliation: Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Yagi
authors.affiliation: Organ Transplantation Unit, Kyoto University Hospital, Kyoto, Japan.
authors.forename: Noriyo
authors.initials: N
authors.lastname: Yamashiki
authors.affiliation: Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Okajima
authors.affiliation: Organ Transplantation Unit, Kyoto University Hospital, Kyoto, Japan.
authors.forename: Toshimi
authors.initials: T
authors.lastname: Kaido
authors.affiliation: Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
mesh_terms: D000328:Adult; D000367:Age Factors; D058625:End Stage Liver Disease / Q000150:complications / Q000601:surgery*; D006085:Graft Survival; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D016031:Liver Transplantation / Q000379:methods / Q000401:mortality*; D019520:Living Donors; D008875:Middle Aged; D009679:Nuclear Family; D012189:Retrospective Studies; D055815:Young Adult