Results of Liver Transplants From Donors Aged 70 Plus: Analysis of Andalusian Transplant Register

Pushing the donor limits: Deceased donor liver transplantation using organs from octogenarian donors

“…(10) In fact, multiple studies have clearly shown that older donor grafts are more susceptible to preservation injury and that older donor age is independently associated with higher rates of biliary complications, (11,12) hepatic artery thrombosis, (10) poor initial function, (13) and overall graft and patient survival (11,(14)(15)(16)(17)(18)(19) especially in hepatitis C virus (HCV)-infected recipients. (14,15,(19)(20)(21)(22) Findings from these single-center studies were further confirmed by large international registry studies. Thus, in an analysis of the European Liver Transplant Registry, donor age 60 years significantly increased the 3-month patient mortality.…”

“…In fact, multiple studies have clearly shown that older donor grafts are more susceptible to preservation injury and that older donor age is independently associated with higher rates of biliary complications, hepatic artery thrombosis, poor initial function, and overall graft and patient survival especially in hepatitis C virus (HCV)–infected recipients …”

“…For instance, because of the significant negative impact of old donor age on graft outcome in HCV‐positive patients, grafts from elderly donors were seldom used in the HCV population for some years. With the advent of the extremely efficacious direct‐acting antiviral (DAA) agents against HCV, this effect will probably no longer be observed.…”

“…Indeed, there is a clear association between posttransplant outcomes and variables such as the Model for End‐Stage Liver Disease (MELD) score, recipient age, and history of previous LT . On the basis of these associations, most authors implant octogenarian livers in older recipients who show stable clinical conditions or are perceived to be at a higher risk of death than predicted by their MELD scores (ie, hepatocellular carcinoma), avoiding recipients with a MELD score ≥ 25 or a Donor Age‐Model for End‐Stage Liver Disease (D‐MELD) score > 1400 (Table ) …”

Impact of elderly donors for liver transplantation: A single‐center experience

“…Because of the shortage of donor organs, many transplant centers have to accept marginal organs from older individuals to expand the donor pool. Franco et al reported that the overall patient outcomes and graft survival rates in a 70‐year‐old‐plus donor group were lower than those in the nonaged group. This directly resulted in proportionately increasing the rate of retransplantation.…”