The growing imbalance between the number of cadaveric organ donors and reci
pients has led to an increasing use of high-risk donors as an option to exp
and the donor pool. The aim of this study was to evaluate our experience wi
th the use of older liver (donor > 50 yr of age) allografts.
The medical records, postreperfusion biopsies and laboratory results were r
eviewed of the 393 patients who underwent orthotopic liver transplantation
between 1986 and 1997. The outcome of the 61 patients who received older li
vers (OL) was compared to that of the other 332 recipients.
Increasing use of OL was evident from 1992 onwards. Recipients of OL were o
lder than recipients of younger livers (YL, p < 0.001) and more commonly ha
d underlying chronic viral hepatitis (CVH) or fulminant hepatic failure (p
< 0.051. Patient and allograft survival were only slightly less in recipien
ts of OL versus YL (p = NS), Although postperfusion biopsies showed more da
mage in OL than YL allografts (p ( 0.05), this was not associated with incr
eased primary graft failure. OL allografts can be transplanted with accepta
ble results into recipients without the concern of early allograft loss.
Summary of Article: This report of one centre's experience with 61 recipien
ts of older donor liver allografts identifies recipient factors that may al
so have a negative impact on allograft outcome. These factors include a dia
gnosis of either CVH or fulminant hepatic failure at the time of transplant
ation. Postreperfusion biopsies of older donor allografts tend to show more
damage, but this is not associated with primary non-function.