Long-term outcomes of the octogenarian donor liver recipient: The era of the new centurion

Sarah Schneider, Francia Díaz Jaime, Kristin Mara, Ross Dierkhising, Julie Heimbach, Kymberly D. Watt, Marina Berenguer

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Studies have suggested transplantation using older donor livers results in similar short-term outcomes as younger donor livers; however, little data exist on long-term patient/graft outcomes of the octogenarian liver recipient. Methods: Retrospective data were collected from 2 centers, (Valencia, Spain and Rochester, MN, USA) of all recipients of octogenarian donor liver allografts from 2000 to 2011 with follow-up to 2016. The aim was to compare long-term patient/graft survival as well as metabolic outcomes of the recipient with the octogenarian liver vs younger than 60 years donor. Results: 78 recipients of older liver allografts were compared to 78 matched controls. No difference in 10-year patient mortality was demonstrated (P = 0.074). Octogenarian livers were associated with 3-fold higher likelihood of graft failure (P = 0.002) but no increase in the risk of post-LT cardiovascular disease (P = 0.60), hypertension (P = 0.33), vascular complications (P = 0.53), or malignancy (P = 0.14). In multivariate analysis, elder livers remained a significant factor associated with rejection (P = 0.034) with a trend not reaching statistical significance for graft failure (P = 0.052). Conclusions: For appropriately selected recipients, receiving an octogenarian liver does not clearly influence patient survival but does impact early graft survival with a notable increase in early posttransplant rejection rates and re-transplantation. Over 1.5 decades, older allografts have not adversely affected metabolic outcomes.

Original languageEnglish (US)
Article numbere13629
JournalClinical Transplantation
Volume33
Issue number8
DOIs
StatePublished - 2019

Keywords

  • cardiovascular
  • donor age
  • elder
  • liver transplantation
  • metabolic
  • survival

ASJC Scopus subject areas

  • Transplantation

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