Is Age an Exclusive Factor for Accepting Liver Donors?

Background: The aims of this study were to assess the viability of livers from older donors ≥80 years of age and to study the evolution of both the graft and the recipient during a minimum follow-up period of 6 months.

Methods: This was a retrospective study (January 2011 to July 2019), including older liver donors, offered by the National Transplant Organization to the Transplant Coordination Team of our hospital. We compared livers excluded exclusively because of donor's age to those that were implanted. The following variables were studied: age, sex, body mass index, cardiovascular risk factors, toxic habits, comorbidities, natremia, use of vasoactive drugs, development of diabetes insipidus, use of antibiotics and length of stay in the intensive care unit. We also conducted a 6-month minimum follow-up of recipients, assessing graft and patient survival.

Results: During the period, 130 livers were offered. Of these, 102 (78%) livers were rejected. In 62 (47%), the reason for rejection was age exclusively. Twenty-eight (21%) livers ≥80 years of age were implanted; 2 needed retransplantation. There were no statistically significant differences between livers that were rejected and implanted in the variables detailed above, except for the number of comorbidities, which were lower in the rejected group. During the follow-up period, 7 deaths were registered.

Conclusion: In our series, liver rejection due exclusively to age was frequent. Recipients of livers that came from older donors had an evolution that is similar to what has been previously described for younger livers. Patients an older age should be evaluated carefully as liver donors before excluding them based exclusively on age criteria.