P100 Aims: Mortality on liver transplantation (LTx) waiting list is increasing dramatically, approaching 20-30% worldwide. The use of “expanded” older donors (>60yo) has become an accepted practice to try enlarging the donor pool. The use of very old donors (>70yo) remains scarce, due to possible underreporting of these donors by donor centers and reluctance to use these very old livers given the risk of poor outcome. We report the outcome of LTx using septuagenarian and octogenarian donors and explore the possible reasons for the underuse of this large potential donor pool. Methods: Between 05/2001 and 01/2004, 7 livers were procured from very old donors (70, 75, 78, 79, 81, 82, 82yo, mean=78.1yo) and found transplantable; 6 were female and 1 male. Cause of death was intracranial bleeding (ICB) (5) and trauma (2). Of note, 6 of 7 donors originated from the same center who follows the policy of routinely contacting the Tx center for all brain-death patients before making final assessment as to their suitability for donation (Spanish-like-system). Results: 7 patients {HCC (5), cryptogenic cirrhosis (1), postethyl (1); 3 females, 3 males; mean age 62 (54-69)} were successfully Tx. In a 7th patient, LTx was aborted due to the perioperative discovery of extra-hepatic malignancy (HCC). Mean cold and warm ischemia times were 8.5hrs (5h49-13h35) and 55.2’ (40-78), respectively. Graft function was immediate in all cases and peak transaminase was low: 784U/L (105-1489). Mean hospital stay was 24.5 days (14-29). Of the 6 LTx, 1 patient with a functioning graft died 2 months postTx (ICB). The other 5 are well. Patient and graft survival is 84%. Conclusions: ICB and brain-death is an important cause of mortality >70yo but this age category currently represents a very small percentage of the donors used for LTx (4%) probably due to a) underreporting by donor teams who erroneously believe that these very old patients are not suitable donors, and b) underuse by recipient teams who fear that these livers may not work. Extremely advanced age is not per se a contra-indication to liver donation and successful LTx. Information to donor teams and routine referral of all brain-death patients to Tx centers is pivotal to allow maximal use of this large donor pool that could substantially reduce the mortality on LTx waiting lists.