Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 11 (3), e4174

Recipient Outcomes With Younger Donors Undergoing Living Donor Liver Transplantation

Affiliations

Recipient Outcomes With Younger Donors Undergoing Living Donor Liver Transplantation

Faisal S Dar et al. Cureus.

Abstract

Introduction The 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). Methods This 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. Results Mean 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). Conclusion Opting for younger donors (≤ 35 years) for HCV-related ESLD patients lowers the risk of EAD and improves overall survival.

Keywords: allograft dysfunction; donors; liver transplantation; mortality.

Conflict of interest statement

This study was accepted for poster presentation in the Annual Meeting of the Americas Hepato-Pancreato-Biliary Association, held on March 29 – April 2, 2017 at Miami Beach, FL and was later published as an abstract in HPB journal. Bhatti AH, Dar FS, Ali R, et al. Outcomes with donors aged <35 years in living donor liver transplantation for hepatitis C. HPB , Volume 19 , S128 https://doi.org/10.1016/j.hpb.2017.02.286 2017

Figures

Figure 1
Figure 1. Estimated four-year overall survival in patients with HCV related end-stage liver disease with donor age cut-off of 35 years
HCV: hepatitis C virus

Similar articles

See all similar articles

References

    1. The travails of setting up a living donor liver transplant program: experience from Pakistan and lessons learned. Dar FS, Bhatti AB, Dogar AW, et al. Liver Transpl. 2015;21:982–990. - PubMed
    1. Differential effects of donor age in liver transplant recipients infected with hepatitis B, hepatitis C and without viral hepatitis. John RL, Jolene SS, Bettina JS, Alice HC, Robert DG, Russell HW. Am J Transplant. 2005;5:549–557. - PubMed
    1. Actual risk of using very aged donors for unselected liver transplant candidates: A European single-center experience in the MELD era. Bertuzzo VR, Cescon M, Odaldi F, et al. Ann Surg. 2016;265:388–396. - PubMed
    1. Characteristics associated with liver graft failure: the concept of a donor risk index. Feng S, Goodrich NP, Bragg-Gresham JL, et al. Am J Transplant. 2006;6:783–790. - PubMed
    1. How important is donor age in liver transplantation? Lué A, Solanas E, Baptista P, et al. World J Gastroenterol. 2016;22:4966–4976. - PMC - PubMed

LinkOut - more resources

Feedback