Differential influence of donor age depending on the indication for liver transplantation

• Verfasst von: Houben, Philipp [VerfasserIn]
• Verfasst von: Döhler, Bernd [VerfasserIn]
• Verfasst von: Weiss, Karl Heinz [VerfasserIn]
• Verfasst von: Mieth, Markus [VerfasserIn]
• Verfasst von: Mehrabi, Arianeb [VerfasserIn]
• Verfasst von: Süsal, Caner [VerfasserIn]
• Titel: Differential influence of donor age depending on the indication for liver transplantation
• Titelzusatz: a collaborative transplant study report
• Verf.angabe: Philipp Houben, Bernd Döhler, Karl H. Weiss, Markus Mieth, Arianeb Mehrabi, and Caner Süsal
• Jahr: 2020
• Umfang: 9 S.
• Fussnoten: Gesehen am 18.05.2020
• Titel Quelle: Enthalten in: Transplantation
• Ort Quelle: Hagerstown, Md. : Lippincott Williams & Wilkins, 1963
• Jahr Quelle: 2020
• Band/Heft Quelle: 104(2020), 4, Seite 779-787
• ISSN Quelle: 1534-6080
• DOI: doi:10.1097/TP.0000000000002970
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: octogenarian donors
• K10plus-PPN: 1698463332

Abstract

Background. Despite steadily increasing donor age, there are no general guidelines for the use of organs from elderly donors in liver transplantation. This study focuses on identifying the recipients who are less affected from an old-donor organ graft and conversely in whom a rather unfavorable outcome is expected because of high donor age. Methods. Forty-eight thousand two hundred sixty-one adult liver transplantations, performed between 2000 and 2017 and reported to the Collaborative Transplant Study, were analyzed. Results. The proportion of >= 65-year-old donors has risen to >33% in recent years. The donor age has an approximately linear influence on graft survival. On average, each year's rise in the donor age was associated with a 0.9% increase in the risk of graft loss (hazard ratio [HR], 1.009; P < 0.001). The impact of donor age was strong in patients with hepatitis C-related cirrhosis (HR, 1.013; P < 0.001), substantial in patients with alcoholic cirrhosis (HR, 1.007; P < 0.001) and rather weak in patients with hepatocellular carcinoma (HR, 1.003; P = 0.038). The increase in the risk of graft loss per year rise in donor age was 1.4% for 18 to 49 year olds, 1.0% for middle-aged, and only 0.4% for >= 60-year-old recipients (all P < 0.001). Conclusions. Consequently, older recipients and especially patients with hepatocellular carcinoma seem to be less affected by an increased donor age, whereas the donor age is an important factor in all other patient groups.