3 years ago

Right Lobe Living Donors Ages 55 and Older in Liver Transplantation.

Shim JR, Park SJ, Kim SH, Lee EC
Insufficient is the evidence for safe use of elderly donors in adult-to-adult living donor liver transplantation (LDLT). The aim of this study was to evaluate the outcomes of right lobe LDLT by donor age (≥55 vs. <55 years). All living donors who underwent right hepatectomy at the authors' institution between March 2008 and December 2015 were divided into 2 groups: group A with an age ≥ 55 and group B with an age < 55. The selection criteria for elderly donor were preservation of middle hepatic vein, remnant liver volume ≥30%, and no or mild fatty liver. The matching criteria of recipients for the elderly donor grafts were model for end-stage liver disease score<25, graft-to-recipient weight ratio>0.8%, and body mass index<25kg/m2 . Perioperative data, complications by the Clavien classification, and the outcomes with at least 12 months follow-up were compared. Forty-two donors were enrolled in group A and 498 in group B. No significant differences in operative parameters were observed between the two groups. The peak postoperative AST, ALT, and total bilirubin levels made no difference between the two groups. The peak INR level was significantly lower in group A than in group B (p=0.001). All donors recovered completely with no significant differences in overall complications between the two groups. All recipients of grafts from donors in group A showed good initial function with no significant differences in 1-year graft and patient survival or biliary complications between two groups. These results provide clinical evidence for feasibility of right hepatectomy in living donors aged ≥ 55 years without compromising donor safety or recipient outcomes. This article is protected by copyright. All rights reserved.

Publisher URL: https://www.ncbi.nlm.nih.gov/pubmed/28734130

DOI: PubMed:28734130

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