Septuagenarian and octagenarian donors provide excellent liver grafts for transplantation

Darius, Tom;Monbaliu, Diethard;Aerts, Raymond;Jochmans, Ina;Pirenne, Jacques;et.al.
(2011) 15th Congress of the European Society for Organ Transplantation, ESOT and 22nd Annual Conference of the British Society for His — Location: Glasgow, United Kingdom (4.September.2011)

Files

2011ESOT-Darius-Septuagenarianandoctagenarian.pdf
  • Open Access
  • Adobe PDF
  • 51.27 KB
Download

Details

Authors
  • Darius, Tomorcid-logoUCLouvain
    Author
  • Monbaliu, Diethard
    Author
  • Aerts, Raymond
    Author
  • Jochmans, Ina
    Author
  • Pirenne, Jacques
    Author
Show more
Abstract
Background: Wider utilization of liver grafts from donors ≥70 yo could substantially expand the donor pool, but their use remains limited by fear of their poor outcome. We examined the results of liver transplantation (LTx) using livers from donors ≥70 yo at our center. Methods: From February 2003 to August 2010, 450 LTx were performed. Of those 58 (13%) were performed using donors ≥70 yo. Their outcome was compared to that of LTx using donors <70 yo. Results: Cerebrovascular causes of death predominated in donors ≥70 yo (85% versus 47% in donors <70 yo) (p<0,001) whereas traumatic causes of death predominated in donors <70 yo (36% versus 14% in donors ≥70 yo) (p=0,002). Unlike grafts/donors <70 yo, older grafts/donors had no additional risk factor (steatosis, high sodium, hemodynamic instability). Both groups were comparable for cold and warm ischemia times. No difference was noted in posttransplant peak transaminase, incidence of primary non-function, hepatic artery thrombosis, biliary strictures, and retransplantation between both groups. The 1 and 5-year patient survival were 90% and 80% in recipients of livers <70 yo versus 88% and 80% in recipients of livers ≥70 yo (p=0,74). Recipients of older grafts were 9 years older than recipients of younger grafts (p<0,001) and tended to have a lower laboratory MELD score (p=0,074). Conclusion: Short and middle-term survival following LTx with donors ≥70 yo can be excellent providing that donors and recipients are adequately selected. Septuagenarian and octogenarian victims of cerebrovascular ischemia and bleeding represent a large pool of potential donors whose wider use could substantially reduce the mortality on the waiting list.
Affiliations
  • University Hospitals Gasthuisberg, Leuven, BelgiumDepartement of Abdominal Transplant Surgery

Citations

  • APA
  • Chicago
  • FWB

Darius, T., Monbaliu, D., Aerts, R., Jochmans, I., Desschans, B., Coosemans, W., Roskams, T., Van Steenbergen, W., Verslype, C., Laleman, W., Nevens, F., & Pirenne, J. (2011). Septuagenarian and octagenarian donors provide excellent liver grafts for transplantation. Transplant International, 24(Suppl 2), 84. https://hdl.handle.net/2078.5/218200 (Original work published 2011)