Liver grafts from older donors yielded good outcomes

Using selected organ donors aged 60 years or older had no deleterious short- or medium-term effects, according to a single-center review of 489 liver transplants done over a 10-year period.

The use of older donors did not raise the rates of graph failure or recipient mortality during a median follow-up of 55 months. Additional follow-up will determine the long-term effects of donor age, the investigators reported.

In the meantime, it appears that — contrary to previous reports — allowing liver donation from older donors is safe, said Washington University, St. Louis.

The investigators reviewed their experience with all 489 adults who had a liver transplant between 1997 and 2006 at the university, where transplants from older donors are allowed unless the liver shows severe steatosis. A total of 187 of these recipients had hepatitis C virus (HCV).

Graft survival and patient mortality were not significantly different when donors were aged 60 or older than when they were younger. These outcomes held true for recipients who needed transplantation due to HCV infection, as well as for recipients who were HCV negative.

Donor age also appeared to have no significant effect on the rate of recurrence of HCV in transplanted liver, or on the length of time until recurrence became evident.

“This study contradicts prior work in HCV-positive patients who had worse outcomes with older donors.” “The prior studies were larger,” “Though it is possible that single-center data are more accurate, fear there may be a power issue, where the sample size was too small to see a difference,” professor of medicine and surgery and chief of the division of abdominal organ transplantation at Columbia University College of Physicians and Surgeons, New York.