Liver transplants from elderly donors are safe

NEW YORK (Reuters Health) - Advanced donor age, per se, does not adversely affect the transplant recipient or the survival of the organ after liver transplantation, according to a report in the Journal of the American College of Surgeons.

Previous reports have indicated that the age of the donor — older than 60 years - contributes to decreased organ and patient survival, as well as a poorer quality of life for the recipient, the authors explain. They hypothesized, however, “that proper selection of donors older than age 60 and even over age 70″ can produce outcomes comparable to those obtained with younger donors.

Dr. William C. Chapman and colleagues from Washington University School of Medicine, St. Louis, Missouri, analyzed their experience with 741 adult-to-adult whole organ transplants — 91 donors were 60 years or older and 650 were younger than 60 years.

There was no significant difference in the number of second transplants performed or signs that another transplant was going to be needed between patients who received organs from younger and older donors, the authors report.

Overall survival rates did not significantly differ between the two groups of patients, the researchers note. Five-year survival, for example, was 67.6 percent in the patients who received organs from older donors compared with 75.5 percent in those who received organs from younger donors.

Similarly, organ survival was not significantly different between recipients of organs from younger and older donors, even when the donors were separated into three age groups - younger than 60 years, 60 to 69 years and 70 years or older.

Time between organ removable and transplant was significantly shorter for organs from older donors than for organs from younger donors, the report indicates.

“Our analysis was not able to identify any significant disadvantage in graft or patient survival based on donor age,” the authors noted.

Other donor risk factors, such as time from organ removal to transplant and variables associated with the recipient are all “important to ensure optimal outcomes” of transplants from older donors, they add.

Overall, the investigators conclude that “older donors represent an important and safe expansion of the donor pool.”

SOURCE: Journal of the American College of Surgeons, December 2008.


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