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DOES THE LIVER EVER AGE? RESULTS OF LIVER TRANSPLANTATION WITH DONORS ABOVE 80 YEARS OF AGE

2004; Wolters Kluwer; Volume: 78; Linguagem: Inglês

10.1097/00007890-200407271-00955

1534-6080

C Zapletal, D Faust, C. Wullstein, Guido Woeste, W. F. Caspary, M. Golling, Wolf O. Bechstein,

Renal Transplantation Outcomes and Treatments

P460 Aims: Facing an increasing shortage of donor organs, donor criteria become more and more extended and so-called marginal organs are accepted for transplantation. For liver donation donor age >70 years, hypotensive periods/catecholamine therapy of the donor or sodium > 150 mmol/l are accepted as risk factors concerning primary dys- or nonfunction of the graft. The aim of this study was to compare the outcome of grafts older versus younger than 80 years of age. Methods: Between 08/2002 and 02/2004 40 liver transplants in adult recipients were performed with grafts from braindead donors. Immunosuppression consisted of dual- or triple therapy based on Tacrolimus (trough level 12-15 ng/ml) and low-dose corticosteroids with or without MMF (1gr BID). Recipients with HCC additionally received low-dose Rapamycin (5-8 ng/dl) after POD 14 under reduction of MMF and Tacrolimus. Induction therapy was performed either with IL2-Receptorantagonist or Antithymocyteglobuline. Outcome of grafts < 80 years of age (n=35) was compared with grafts ≥ 80 Jahre (n=5). For statistical analysis Mann-Whitney-U-Test and Fisher’s Exakt-Test were used. P<0.05 was considered as statistically significant (*). Results: TABLE 1: Comparison of outcome of grafts older verses younger than 80 years of age after liver transplantation. (∗): p < 0.05FigureThe average donor age of our population was 54,4 ± 17,3 years. Among them 5 donors were older than 80 years (80-83 years). These donors all had additional risk factors including hypotensive episodes and catecholamine therapy. Recipients of the old grafts suffered from HCC in liver cirrhosis Child A (n=2) or from viral hepatitis (n=3). Just one of the recipients had a cirrhosis with severe complications (Child C, T2). Outcome of both group is comparable concerning intra- and postoperative course. All recipients of old liver grafts left the hospital with a stable graft function and had an uncomplicated course thereafter. Conclusions: Liver grafts > 80 years can be transplanted with good results, especially if they are given to recipients with malignancy and otherwise stable liver function.