INTERNATIONAL TRENDS IN ORGAN DONATION

B.E. Wellge, L. Fischer, E.G. Achilles, J. Pollok, M. Koch, M. Sterneck, B. Nashan, T.Y. Tsui
Hepatobiliary Surgery And Solid Organ Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg/GERMANY

Body: INTRODUCTION: Individuals greater than 70 years old represent an increasing portion of yearly deceased donor organ pool in orthotopic liver transplantation (OLT). Donor age has been suggested as an independent risk factor for early graft dysfunction. Using elderly donor grafts, particularly those older than 70 years old remain controversial. METHODS: We analyzed perioperative data and outcomes of primary OLT with donor age greater than 70 and compared with those matched control OLT (ratio: 1 to 2, based on recipients age, donor/recipient BMI, etiology of liver disease and lab MELD score) who received liver grafts from donor age less than 50 years in the same time frame in our center. After excluding age as factor the donor risk index resulting in similar risk of graft failure is 1.3 (1.17-1.37) for the old-donor group and 1.22 (1.0-1.39) for control group. Results are shown as median and range. RESULTS: 13 patients with donor age greater than 70 could be included. Median follow-up was 19 months (6-99). The median donor age is 73 (70-87) years in the old-donor group and 37.5 (14-50) years old in control group. There is no difference in perioperative data of two groups. Interestingly, there is no statistical difference in terms of biochemistry at posttransplant week one, month 6 and month 12. The old-donor group revealed no higher incidence of acute rejection rate (15.4 vs. 19.2%), biliary complications (7.7 vs. 7.7%), vascular complications (7.7 vs. 3.8%) or HCV re-infection (50 vs. 75%). In addition, there is no significant difference in graft survival (30 d: 84.5 vs 92.3%, 12 mo 75 vs. 86.9%). PNF occurred in two patients in the old-donor and one in the control group, whereas DGF was observed present in 2 patients of the young donor group. CONCLUSION: Our data suggest that OLT with donor aged 70 or above could be safely done in properly selected recipients.

Disclosure: All authors have declared no conflicts of interest.