How can we utilize livers from advanced aged donors for liver transplantation for hepatitis C?

Tadahiro Uemura, Lucas Nikkel, Christopher S. Hollenbeak, Varun Ramprasad, Eric Schaefer, Zakiyah Kadry

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Advanced age donors have inferior outcomes of liver transplantation for Hepatitis C (HCV). Aged donors grafts may be transplanted into young or low model for end stage liver disease (MELD) patients in order to offset the effect of donor age. However, it is not well understood how to utilize liver grafts from advanced aged donors for HCV patients. Using the UNOS database, we retrospectively studied 7508 HCV patients who underwent primary liver transplantation. Risk factors for graft failure and graft survival using advanced aged grafts (donor age > 60 years) were analyzed by Cox hazards models, donor risk index (DRI) and organ patient index (OPI). Recipient's age did not affect on graft survival regardless of donor age. Advanced aged grafts had significant inferior survival compared to younger aged grafts regardless of MELD score (P < 0.0001). Risk factors of HCV patients receiving advanced aged grafts included donation after cardiac death (DCD, HR: 1.69) and recent hospitalization (HR: 1.43). Advanced aged grafts showed significant difference in graft survival of HCV patients with stratification of DRI and OPI. In conclusion, there was no offsetting effect by use of advanced aged grafts into younger or low MELD patients. Advanced aged grafts, especially DCD, should be judiciously used for HCV patients with low MELD score.

Original languageEnglish (US)
Pages (from-to)671-679
Number of pages9
JournalTransplant International
Volume25
Issue number6
DOIs
StatePublished - Jun 1 2012

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Hepatitis C
Liver Transplantation
Tissue Donors
Transplants
Liver
End Stage Liver Disease
Graft Survival
Proportional Hazards Models
Hospitalization
Databases
Survival

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

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title = "How can we utilize livers from advanced aged donors for liver transplantation for hepatitis C?",
abstract = "Advanced age donors have inferior outcomes of liver transplantation for Hepatitis C (HCV). Aged donors grafts may be transplanted into young or low model for end stage liver disease (MELD) patients in order to offset the effect of donor age. However, it is not well understood how to utilize liver grafts from advanced aged donors for HCV patients. Using the UNOS database, we retrospectively studied 7508 HCV patients who underwent primary liver transplantation. Risk factors for graft failure and graft survival using advanced aged grafts (donor age > 60 years) were analyzed by Cox hazards models, donor risk index (DRI) and organ patient index (OPI). Recipient's age did not affect on graft survival regardless of donor age. Advanced aged grafts had significant inferior survival compared to younger aged grafts regardless of MELD score (P < 0.0001). Risk factors of HCV patients receiving advanced aged grafts included donation after cardiac death (DCD, HR: 1.69) and recent hospitalization (HR: 1.43). Advanced aged grafts showed significant difference in graft survival of HCV patients with stratification of DRI and OPI. In conclusion, there was no offsetting effect by use of advanced aged grafts into younger or low MELD patients. Advanced aged grafts, especially DCD, should be judiciously used for HCV patients with low MELD score.",
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How can we utilize livers from advanced aged donors for liver transplantation for hepatitis C? / Uemura, Tadahiro; Nikkel, Lucas; Hollenbeak, Christopher S.; Ramprasad, Varun; Schaefer, Eric; Kadry, Zakiyah.

In: Transplant International, Vol. 25, No. 6, 01.06.2012, p. 671-679.

Research output: Contribution to journalArticle

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