Elderly donor liver grafts are not associated with a higher incidence of biliary complications after liver transplantation: results of a national multicenter study

Clin Transplant. 2015 Jul;29(7):636-43. doi: 10.1111/ctr.12569. Epub 2015 Jun 17.

Abstract

Background: Liver transplantation with livers grafts from elderly donors has been associated with a higher risk of biliary complications. The aim of this study was to examine whether our national protocol could contribute to a lower incidence of biliary complications.

Methods: All adult recipients in the Netherlands transplanted with a liver from an elderly donor (≥ 65 yrs; n = 68) in the period January 2000-July 2011 were matched with recipients of a liver from a donor <65 yr (n = 136). Outcome parameters were 90-d, one-yr, and three-yr patient/graft survival rates, biliary complications (non-anastomotic stricture, anastomotic stricture, biliary leakage, and post-transplant cholangitis), and postoperative hepatic ischemic injury serum markers (AST/ALT).

Results: The median cold ischemia time (CIT) was 7:25 (h:min) in the group recipients of an elderly donor liver graft. Ninety-day, one-yr, and three-yr patient/graft survival rates were similar between the group with an elderly donor liver and their younger controls. Moreover, no differences were found in the incidence of biliary complications and postoperative levels of AST/ALT between the two groups.

Conclusion: Transplantation of livers from elderly donors (≥ 65 yr) is not associated with a higher incidence of biliary complications, in a national policy wherein the CIT is kept short.

Keywords: biliary complications; elderly donors; liver transplantation; survival.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biliary Tract Diseases / etiology*
  • Biliary Tract Diseases / mortality
  • Case-Control Studies
  • Female
  • Follow-Up Studies
  • Graft Rejection / epidemiology*
  • Graft Rejection / etiology
  • Graft Rejection / mortality
  • Graft Survival
  • Humans
  • Liver Diseases / surgery*
  • Liver Transplantation*
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Postoperative Complications*
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Tissue Donors*
  • Tissue and Organ Harvesting / methods*
  • Young Adult