Older donors are a growing part of the total donor pool but no definite consensus exists on the limit of age for their acceptance. From November 1998 to January 2003, in a retrospective case-control multicenter study, we compared the outcome of 30 orthotopic liver transplantations (OLTs) with octogenarian donors and of 60 chronologically correlated OLTs performed with donors <40 years. The percentage of refusal was greater among older than younger donors (48.2 vs. 14.3%; p < 0.001). Cold ischemia was significantly shorter in the older than younger groups. Recipients with hepatocarcinoma and older age received octogenarian grafts more frequently. No differences were seen in post-operative complications and 6-month graft and patient survival. However, long-term survival was lower in patients transplanted with octogenarian donors (p = 0.04). Interestingly, the mortality related to hepatitis C recurrence was greater in patients with octogenarian donors. Accordingly, the long-term survival of HCV-positive patients who received older grafts was lower than those receiving younger grafts (p = 0.05). Octogenarian livers can be used safely but a careful donor evaluation and a short cold ischemia are required to prevent additional risk factors. However, hepatitis C recurrence is associated with a greater mortality in patients who received octogenarian grafts raising concerns whether to allocate these livers to HCV-positive recipients.

Liver transplantation from donors aged 80 years and over: Pushing the limit / B., Nardo; Masetti, Michele; L., Urbani; P., Caraceni; R., Montalti; F., Filipponi; F., Mosca; G., Martinelli; M., Bernardi; Ad, Pinna; A., Cavallari. - In: AMERICAN JOURNAL OF TRANSPLANTATION. - ISSN 1600-6135. - 4:(2004), pp. 1139-1147. [10.1111/j.1600-6143.2004.00472.x]

Liver transplantation from donors aged 80 years and over: Pushing the limit

MASETTI, Michele;
2004

Abstract

Older donors are a growing part of the total donor pool but no definite consensus exists on the limit of age for their acceptance. From November 1998 to January 2003, in a retrospective case-control multicenter study, we compared the outcome of 30 orthotopic liver transplantations (OLTs) with octogenarian donors and of 60 chronologically correlated OLTs performed with donors <40 years. The percentage of refusal was greater among older than younger donors (48.2 vs. 14.3%; p < 0.001). Cold ischemia was significantly shorter in the older than younger groups. Recipients with hepatocarcinoma and older age received octogenarian grafts more frequently. No differences were seen in post-operative complications and 6-month graft and patient survival. However, long-term survival was lower in patients transplanted with octogenarian donors (p = 0.04). Interestingly, the mortality related to hepatitis C recurrence was greater in patients with octogenarian donors. Accordingly, the long-term survival of HCV-positive patients who received older grafts was lower than those receiving younger grafts (p = 0.05). Octogenarian livers can be used safely but a careful donor evaluation and a short cold ischemia are required to prevent additional risk factors. However, hepatitis C recurrence is associated with a greater mortality in patients who received octogenarian grafts raising concerns whether to allocate these livers to HCV-positive recipients.
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Liver transplantation from donors aged 80 years and over: Pushing the limit / B., Nardo; Masetti, Michele; L., Urbani; P., Caraceni; R., Montalti; F., Filipponi; F., Mosca; G., Martinelli; M., Bernardi; Ad, Pinna; A., Cavallari. - In: AMERICAN JOURNAL OF TRANSPLANTATION. - ISSN 1600-6135. - 4:(2004), pp. 1139-1147. [10.1111/j.1600-6143.2004.00472.x]
B., Nardo; Masetti, Michele; L., Urbani; P., Caraceni; R., Montalti; F., Filipponi; F., Mosca; G., Martinelli; M., Bernardi; Ad, Pinna; A., Cavallari
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/310596
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