The impact of donor age on liver transplantation: Influence of donor age on early liver function and on subsequent patient and graft survival

Background. The urgent need to increase the organ donor pool has led to the expansion of criteria for donor selection. The aim of this study was to an alyze the influence of donor age on early graft function, subsequent graft loss, and mortality after liver transplantation (LT), Methods, Data on LT were evaluated retrospectively in a population-based co hort of 400 LTs in 348 patients. Of these, 21 (5%) were from donors >70 yea rs old.]Pretransplantation donor and recipient characteristics and the evol ution of recipients were analyzed. The influence of donor age as a risk fac tor was assessed using univariate and multivariate analyses. Results. Actuarial graft survival was 89% at 1 month after LT, 81% after 6 months, and 59% after 60 months. Multivariate analysis demonstrated that on ly donor age (>70 years old) was associated with a higher risk of long-term graft loss (relative risk [RR]=1.4, 95% confidence interval [CI]=1-1.9; P= 0.03) and mortality (RR=1.7, 95% CI=1.2-2.3; P=0.01), Graft survival of sep tuagenarian livers was 80% at 1 month after LT, 56% after 6 months, and 25% after 54 months, Actuarial survival analysis (Kaplan-Meier curves) also de monstrated worse evolution in recipients of livers from old donors (log-ran k test, P<0.001). Conclusions. Advanced donor age is associated with lower graft and recipien t survival.