Abstract
IntroductionThe impact of donor age on liver transplantation is well known. Data on an appropriate donor age cut-off for living donor liver transplantation (LDLT) with a background of hepatitis C (HCV) is generally limited. The objective of this study was to determine whether limiting donor age to less than 35 years improved outcomes in patients with HCV-related end-stage liver disease (ESLD).MethodsThis was a retrospective review of 169 patients who underwent LDLT for HCV-related ESLD. The patients were divided into two groups based on whether they received grafts from donors ≤ 35 (Group 1) or > 35 (Group 2) years of age. Kaplan Meier curves were used to determine survival. Uni and multivariate analysis were performed to determine independent predictors of mortality.ResultsMean donor age was 25.1 ± 5.2 and 40.1 ± 3.4 years (P < 0.0001). Early allograft dysfunction (EAD) was seen in 11.7% patients in Group 1 versus 29.6% in Group 2 (P = 0.02). A significant difference in mortality was present between the two groups, i.e., 33.3% versus 15.8% (P = 0.04). The estimated four-year overall survival (OS) was 78% and 64% (P = 0.03). Upon doing univariate analysis, the donor age (P = 0.04) and EAD (P = 0.006) were found to be significant variables for mortality. On multivariate analysis, EAD was the only independent predictor of mortality (Hazard ratio: 2.6; confidence interval: 1.1 - 5.8; P = 0.01).ConclusionOpting for younger donors (≤ 35 years) for HCV-related ESLD patients lowers the risk of EAD and improves overall survival.
Highlights
ObjectivesThe objective of this study was to determine whether limiting donor age to less than 35 years improved outcomes in patients with hepatitis C virus (HCV)-related end-stage liver disease (ESLD)
The impact of donor age on liver transplantation is well known
A significant difference in mortality was present between the two groups, i.e., 33.3% versus 15.8% (P = 0.04)
Summary
The objective of this study was to determine whether limiting donor age to less than 35 years improved outcomes in patients with HCV-related end-stage liver disease (ESLD). Would a younger donor age cut off (≤ 35 years) confer any outcome benefit for patients undergoing LDLT for HCV-related end-stage liver disease (ESLD)? The objective of this study was to determine if donor age < 35 years improves outcomes in transplanted patients with a HCV-positive ESLD Would a younger donor age cut off (≤ 35 years) confer any outcome benefit for patients undergoing LDLT for HCV-related end-stage liver disease (ESLD)? The objective of this study was to determine if donor age < 35 years improves outcomes in transplanted patients with a HCV-positive ESLD
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