Short-term Results of Liver Transplantation With Octogenarian Donors.

Autor: Gajate Martín L; Department of Anesthesiology and Intensive Care, Madrid, Spain. Electronic address: gajate.luis@gmail.com., Martín Grande A; Department of Anesthesiology and Intensive Care, Madrid, Spain., Parise Roux D; Department of Anesthesiology and Intensive Care, Madrid, Spain., González Cibrián C; Department of Anesthesiology and Intensive Care, Madrid, Spain., Fernández Martín C; Department of Anesthesiology and Intensive Care, Madrid, Spain., Rodríguez Gandía MA; Department of Gastroenterology and Liver Diseases, Madrid, Spain., López Buenadicha A; Division of Liver Surgery and Liver Transplantation, Department of Surgery, Hospital Ramón y Cajal Liver Transplant Group, Ramon y Cajal University Hospital, Madrid, Spain.
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2018 Jan - Feb; Vol. 50 (1), pp. 184-191.
DOI: 10.1016/j.transproceed.2017.12.002
Abstrakt: Background: There are increasingly more patients awaiting liver transplantation while the number of donors has remained stable. It has been proven that grafts from donors older than 60 years have comparable results with those from younger donors. It is unclear whether this is so with donors older than 80 years old.
Material and Methods: This was a retrospective study of all adult liver transplantations at our institution between March 2011 and December 2015. We compared 1-, 3-, 6-, and 12-month graft survival rates from donors <80 years and ≥80 years. We also compared postoperative complications: infections, acute kidney injury, need for readmission in the intensive care unit, length of stay, mechanical ventilation, and specific graft complications. We considered differences in each age group regarding the presence of hepatitis C virus (HCV).
Results: Of 177 recipients, 38 received grafts from octogenarian donors (21.5%). Survival rates were very similar in the groups (97%, 93%, 91%, and 87% for donors <80 years and 95%, 92%, 87%, and 76% for donors ≥80 years). Although for younger grafts, 1-year survival rates were slightly lower for HCV+ patients (80% vs 89%; log-rank 0.205), this difference does not exist for elderly donors. The incidence of postoperative complications was similar in both groups.
Conclusions: Livers from octogenarian donors are acceptable for liver transplantation provided that thorough assessment and selection is made by avoiding other known poor prognosis factors. The presence of HCV did not affect survival rates.
(Copyright © 2017 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: