Liver transplantation using elderly donors

A risk factor analysis

Dae Y. Kim, Jang Moon, Eddie R. Island, Akin Tekin, Susan Ganz, David Levi, Gennaro Selvaggi, Seigo Nishida, Andreas G. Tzakis

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Survival after liver transplantation is negatively impacted by use of elderly deceased donors, but excluding them would increase waiting times and waiting list mortality. We reviewed our experience with liver transplantation (LT) utilizing livers from deceased donors 65yr of age and older to identify those factors that impact graft survival. All adult patients (≥18yr old) who underwent primary LT using deceased donor livers from donors aged ≥65yr between February 1995 and November 2003 were included. With multivariate analysis we found four unfavorable characteristics significantly associated with higher post-transplant graft failure rate. These characteristics are hepatitis C as an etiology of liver disease, Model for End-Stage Liver Disease score >20, serum glucose level of donor >200mg/dL at the time of liver recovery, and skin incision to aortic cross-clamp time >40minutes in the donor surgery. The five-yr estimated graft survival rates having 0, 1, 2, 3, and 4 unfavorable characteristics were 100%, 82.0%, 81.7%, 39.3%, and 25.0%, respectively (p<0.05). Our data demonstrated good graft survival can be achieved in LT using elderly donor liver allografts with appropriate patient selection, donor blood glucose management and efficient liver recovery with minimal manipulation of the liver during donor surgery.

Original languageEnglish
Pages (from-to)270-276
Number of pages7
JournalClinical Transplantation
Volume25
Issue number2
DOIs
StatePublished - Mar 1 2011

Fingerprint

Liver Transplantation
Statistical Factor Analysis
Tissue Donors
Liver
Graft Survival
Transplants
End Stage Liver Disease
Waiting Lists
Hepatitis C
Patient Selection
Allografts
Blood Glucose
Liver Diseases
Multivariate Analysis
Survival Rate
Glucose
Skin
Survival
Mortality
Serum

Keywords

  • Elderly donor
  • Expanded criteria
  • Liver transplantation
  • Risk factor
  • Survival

ASJC Scopus subject areas

  • Transplantation

Cite this

Kim, D. Y., Moon, J., Island, E. R., Tekin, A., Ganz, S., Levi, D., ... Tzakis, A. G. (2011). Liver transplantation using elderly donors: A risk factor analysis. Clinical Transplantation, 25(2), 270-276. https://doi.org/10.1111/j.1399-0012.2010.01222.x

Liver transplantation using elderly donors : A risk factor analysis. / Kim, Dae Y.; Moon, Jang; Island, Eddie R.; Tekin, Akin; Ganz, Susan; Levi, David; Selvaggi, Gennaro; Nishida, Seigo; Tzakis, Andreas G.

In: Clinical Transplantation, Vol. 25, No. 2, 01.03.2011, p. 270-276.

Research output: Contribution to journalArticle

Kim, DY, Moon, J, Island, ER, Tekin, A, Ganz, S, Levi, D, Selvaggi, G, Nishida, S & Tzakis, AG 2011, 'Liver transplantation using elderly donors: A risk factor analysis', Clinical Transplantation, vol. 25, no. 2, pp. 270-276. https://doi.org/10.1111/j.1399-0012.2010.01222.x
Kim, Dae Y. ; Moon, Jang ; Island, Eddie R. ; Tekin, Akin ; Ganz, Susan ; Levi, David ; Selvaggi, Gennaro ; Nishida, Seigo ; Tzakis, Andreas G. / Liver transplantation using elderly donors : A risk factor analysis. In: Clinical Transplantation. 2011 ; Vol. 25, No. 2. pp. 270-276.
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