Optimization of long-term graft survival after liver transplantation: the role of donor age
© Lai et al; licensee BioMed Central Ltd. 2011
Published: 24 August 2011
Nowadays, several solutions have been proposed for the minimization of both organ shortage and prolonged waiting times: the expansion of the donor pool using aged donors represents a possible solution . However, it is not completely clear if the use of “extreme” donors could cause unacceptable post-transplant adjunctive risks . Starting from these grounds, the aim of this study is to evaluate the impact of donor age on long-term graft survival.
Materials and methods
From January 2001 to April 2009, 188 consecutive liver transplantations were performed at our Department. The entire cohort was stratified in 4 subgroups according to donor age: Group 1 (1st-2nd decade, n=34), Group 2 (3rd-4th decade, n=51), Group 3 (5th-6th decade, n=75) and Group 4 (7th-8th decade, n=28). Donor, recipient and transplantation characteristics were compared in the 4 groups. ANOVA test and Kruskal-Wallis test were used for the comparison of continuous and categorical variables. Kaplan-Meier test was adopted for survival analysis: log-rank test was used for comparison among the groups’ survival rates.
In our experience, use of < 70 year-aged donors seems to be safe, while very aged (over 70) donors give poor long-term survival rates, despite similar initial post-transplantation results. We could speculate that grafts procured by very aged donors could be easier targets of viral recurrence, late ischemia-reperfusion damage and chronic rejection. A better allocation system for these organs may be improved, preferring HCC recipients who exceed transplant criteria to HCV ones .
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