Recipient age affects long-term outcome and hepatitis C recurrence in old donor livers following transplantation

✍ Scribed by Markus Selzner; Arash Kashfi; Nazia Selzner; Stuart McCluskey; Paul D. Greig; Mark S. Cattral; Gary A. Levy; Les Lilly; Eberhard L. Renner; George Therapondos; Lesley E. Adcock; David R. Grant; Ian D. McGilvray

• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: English
• Weight: 269 KB
• Volume: 15
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.21828

✦ Synopsis

We studied the role of donor and recipient age in transplantation/ischemia-reperfusion injury (TIRI) and short-and long-term graft and patient survival. Eight hundred twenty-two patients underwent deceased donor liver transplantation, with 197 donors being Ն60 years old. We evaluated markers of reperfusion injury, graft function, and clinical outcomes as well as short-and long-term graft and patient survival. Increased donor age was associated with more severe TIRI and decreased 3-and 5-year graft survival (73% versus 85% and 72% versus 81%, P Ͻ 0.001) and patient survival (77% versus 88% and 77% versus 82%, P Ͻ 0.003). Hepatitis C virus (HCV) infection and recipient age were the only independent risk factors for graft and patient survival in patients receiving an older graft. In the HCV(ϩ) cohort (297 patients), patients Ն 50 years old who were transplanted with an older graft versus a younger graft had significantly decreased 3-and 5-year graft survival (68% versus 83% and 64% versus 83%, P Ͻ 0.009). In contrast, HCV(ϩ) patients Ͻ 50 years old had similar 3-and 5-year graft survival if transplanted with either a young graft or an old graft (81% versus 82% and 81% versus 82%, P ϭ 0.9). In conclusion, recipient age and HCV status affect the graft and patient survival of older livers. Combining older grafts with older recipients should be avoided, particularly in HCV(ϩ) patients, whereas the effects of donor age can be minimized in younger recipients.