Older donors make up a growing proportion of the total donor pool.
In this study, researchers from Italy compared 30 orthotopic liver transplantations (OLTs) with octogenarian donors with 60 OLTs performed with donors who were under 40 years.
The researchers found that refusal was greater with older compared to younger donors (48% versus 14%).
They found that cold ischemia was shorter in the older group.
They also found that recipients with hepatocellular carcinoma and older age received octogenarian grafts more frequently.
|Long-term survival is lower in patients transplanted with octogenarian livers.|
|American Journal of Transplantation|
However, there were no differences in post-operative complications, and 6-month graft and patient survival.
In the long-term, the team found that survival was lower in patients transplanted with octogenarian donors.
The researchers established that hepatitis C-related mortality was greater in patients with octogenarian donors.
Dr Bruno Nardo and colleagues concluded, “Octogenarian livers can be used safely but a careful donor evaluation and a short cold ischemia are required to prevent additional risk factors”.
“However, hepatitis C recurrence is associated with a greater mortality in patients who received octogenarian grafts raising concerns whether to allocate these livers to HCV-positive recipients”.