Improving the outcome of liver transplantation with very old donors with updated selection and management criteria

Matteo Cescon, Gian Luca Grazi, Alessandro Cucchetti, Matteo Ravaioli, Giorgio Ercolani, Marco Vivarelli, Antonietta D'Errico, Massimo Del Gaudio, Antonio Daniele Pinna

Research output: Contribution to journalArticle

Abstract

Advanced donor age is a risk factor for poor outcome in liver transplantation (LT). We reviewed 553 consecutive transplants according to donor age categories [group 1 (n = 173): 30%, and the lowest ischemia time. Five-year graft survival was significantly higher in group 1 (75%) versus groups 3 (60%) and 4 (62%; P = 0.01 and P = 0.001, respectively) and in group 5 (81%) versus groups 3 and 4 (P = 0.04 and P = 0.01, respectively). Donor age of 60-79 years, recipient hepatitis C virus-positive status, Model for End-Stage Liver Disease score ≥ 25, and emergency LT were predictors of poor survival. In hepatitis C virus-positive patients, 5-year graft survival was 72% in group 1, 85% in group 2,52% in group 3,65% in group 4, and 71% in group 5 (group 1 versus group 3, P = 0.04; group 2 versus group 3, P = 0.03). In conclusion, older donor grafts managed with routine graft biopsy and short ischemia time may work effectively, regardless of the severity of the recipient's liver disease.

Original languageEnglish
Pages (from-to)672-679
Number of pages8
JournalLiver Transplantation
Volume14
Issue number5
DOIs
Publication statusPublished - May 2008

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ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Cescon, M., Grazi, G. L., Cucchetti, A., Ravaioli, M., Ercolani, G., Vivarelli, M., D'Errico, A., Del Gaudio, M., & Pinna, A. D. (2008). Improving the outcome of liver transplantation with very old donors with updated selection and management criteria. Liver Transplantation, 14(5), 672-679. https://doi.org/10.1002/lt.21433