Orthotopic liver transplantation (OLT) using grafts from donors older than 80 years have been reported. However, the long-term outcome of patients receiving livers from these donors is unknown.
In this study, doctors from Italy evaluated 12 patients who received OLTs between 1998 and 2003. Donors were over 80 years. More than a years worth of follow-up data were available.
The team found that hepatic insufficiency caused by hepatitis C virus (HCV)-related cirrhosis occurred in 42% of patients, and non-HCV-related diseases in 58%.
|Transplantation was uneventful in all cases.|
All donors had normal liver function, hemodynamic stability, and no parenchymal alterations.
The doctors found that OLT was uneventful in all cases, and no late vascular complications occurred.
One patient died 3 years after OLT for causes unrelated to hepatic dysfunction.
The team calculated 2 and 3-year actuarial survival rates as 100% and 75%, respectively.
All HCV-positive patients developed hepatitis recurrence requiring antiviral treatment.
However, non-HCV-positive patients had well-preserved liver function throughout the observation period.
By the end of follow-up, the team observed no clinical hepatic decompensation.
Biochemical signs of recurrent disease were noted in 3 patients.
Dr Matteo Cescon's team concluded, "Use of grafts for OLT from donors older than 80 years is safe because of their potentially normal functional recovery".
"A selection among available organs is mandatory to minimize other risk factors for poor outcome".
"Long-term patient and graft survival seem to be achievable, but the high rate and rapidity of HCV reinfection remain a major concern for HCV+ patients".