Multicentric Study of Safety and Outcomes of Liver Transplant with Octogenarian Donors

Abstract

Introduction: To analyze results of liver transplants performed with donors older than 80 years old. Methods: Multicenter match-case retrospective cohort study including all liver transplants with octogenarian donors in Andalucia (Spain) from 2000 to 2017. In order to increase the strength of the comparison, selected controls were younger than 65 years and matched by the period of transplant (2000-2006, 2007-2012, and 2013-2017), recipient gender, transplant indication, and donor cause of death. Donor and recipient characteristics, organ retrieval, liver transplant, complications, and graft and patient survival were analyzed. Results: 196 patients were included (98 in each group). Donor medium age was 81,95 vs 50,32 in each group. There weren´t differences regarding donor and recipient characteristics and organ retrieval (including CIT), excepting donor gender (male 43,3% vs 72,2% favors younger group) as well height and weight. Primary liver dysfunction and complications were similar, however, an increased rate of early arterial complications was showed in the older group (12,9% (12) vs 4,2% (4) p=0,038). Graft survival at 1, 3 and 5 years was 78,3% vs 83,4%, 71,4% vs 77,9% and 61,8% vs 71,1% while patient survival at 1, 3 and 5 years was 78,4% vs 85,5%, 71,4% vs 79,9% and 72,9% vs 73,1% in the old vs young group respectively (p=0,105 and p=0,384). Re-Transplant rate resulted higher in the old group 11,6% (11) vs 3,2% (3), p=0,048. Conclusion: The use of octogenarian liver graft is safe. However, an increased re-transplant rate is present due to higher early arterial complications.