Impact of the elderly donor on an abdominal organ transplantation program

Abstract

Older donors have become widespread in recent years. Given that they have comorbidities, the treatment of theses donors is crucial. Our aim was to analyze the influence of the elderly donor (≥65 years) on the subsequent evolution of liver and kidney recipients. Retrospective study including all liver and kidney transplants performed at the Marques de Valdecilla University Hospital with grafts generated from local donors in brain death. Period: 2014–2017. Two groups were considered, depending on the age of the donor (≥ or <65 years). There were 37 older donors (from 100 donors in brain death). Fourteen liver transplants were performed with old grafts that were characterized by a lower Model for End-stage Liver Disease (MELD) score (13.5 [interquartile range (IQR): 10–14] vs. 19 [IQR: 16–22], p: 0.004). The values of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were higher over time in the older graft recipients. 18 renal transplants were performed with grafts from older donors. This group were older (62 vs. 57, p: 0.001) and had longer hospital stay (25 vs. 17 days; p: 0.023). There were no significant differences in the development of primary graft disfunction or graft loss. Liver transplant survival and kidney survival were similar in both groups. The use of elderly donors has not influenced the clinical evolution of liver and kidney transplants in our series. Older donors should no longer be considered suboptimal, because they offer a possibility for certain patients on the waiting list.