Format

Send to:

Choose Destination
See comment in PubMed Commons below
HPB (Oxford). 2011 Mar;13(3):212-20. doi: 10.1111/j.1477-2574.2010.00275.x.

Liver grafts from selected older donors do not have significantly more ischaemia reperfusion injury.

Author information

  • 1Department of Surgery, Transplant Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. pnmartins@partners.org

Abstract

BACKGROUND:

There is a general concern that aged organs are more susceptible to ischaemia. In the light of recent proposals to change the liver allocation system by expanding regional sharing, it is feared that increased cold ischaemia time of grafts from older donors may reduce graft survival. The aim of this study was to correlate donor age and the patterns of ischaemia reperfusion injury and synthetic function early after liver transplantation.

METHODS:

We performed a retrospective study of first transplants using a single-centre electronic database. Patterns of liver injury (based on transaminases and post-reperfusion biopsy), synthetic function (international normalized ratio [INR]), and graft and patient survival in recipients receiving liver grafts from donors aged ≥ 65 years (group 1, n= 50) were compared with equivalent patterns in a matched cohort of recipients transplanted with grafts from donors aged <65 years (group 2, n= 50).

RESULTS:

There was no significant difference in transaminase levels from day 0 to day 6 after transplantation. When groups 1 and 2 were subdivided into two subgroups based on the duration of graft cold ischaemia time (<8 h and ≥ 8 h), there was no statistical difference in transaminase levels during the first 7 days. There were two cases (4%) of primary non-function in group 1 and one (2%) in group 2. Initial poor function did not differ significantly between the groups (26% vs. 24%; P= 0.81). In addition, there was no difference in histological changes in post-reperfusion biopsies (21% vs. 34%; P= 0.078) and rate of acute rejection episodes in the first year (30% vs. 32%; P= 0.99). There was no significant difference between groups 1 and 2 in 1-year patient and graft survivals (78% vs. 90% [P= 0.17]; 88% vs. 94% [P= 0.48], respectively).

CONCLUSIONS:

Judiciously selected livers from aged donors are not associated with major increased susceptibility to ischaemia reperfusion injury.

© 2011 International Hepato-Pancreato-Biliary Association.

PMID:
21309940
[PubMed - indexed for MEDLINE]
PMCID:
PMC3048974
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Blackwell Publishing Icon for PubMed Central
    Loading ...
    Write to the Help Desk