Comparable graft survival is achievable with the usage of donation after circulatory death liver grafts from donors at or above 70 years of age: A long-term UK national analysis

Emmanouil Giorgakis, Shirin E. Khorsandi, Amit K. Mathur, Lyle Burdine, Wayel Jassem, Nigel Heaton

Research output: Contribution to journalArticlepeer-review

Abstract

The aim of the study was to assess the UK donation after circulatory death (DCD) liver transplant experience from donors ≥70 years. Nationwide UK DCD retrospective analysis was conducted between 2001 and 2015 (n = 1163). Recipients were divided into group 1 vs. group 2 (donors 70≥ vs. <70 years, respectively). group 1 (n = 69, 5.9%) recipients were older (median 59 vs. 55 years, p =.001) and had longer waitlist time (128 vs. 84 days; p =.039). 94.2% of group 1 clustered in London and Birmingham, where the two busiest centers are located. group 1 allografts had higher UKDRI and UK DCD Risk Scores but similar WIT and CIT and were more likely to have been imported. Both groups had similar 1-, 3-, and 5-year graft survival (group 1, 90%, 81.4%, and 74% vs. group 2, 88.6%, 81.4%, and 78.6%, respectively; p =.54). Both groups had similar ICU stay length (p =.22), 3-month hepatic artery thrombosis rates (4.4% vs 4.0%; p =.9), and 12-month readmission rates for all biliary complications (20.3% vs 25.7%; p =.32). This study demonstrates that acceptable outcomes are achievable using older grafts in a highly selected cohort at experienced centers. Advanced age should not be an absolute contraindication to utilizing a DCD graft from donors aged ≥70 years.

Original languageEnglish (US)
JournalAmerican Journal of Transplantation
DOIs
StateAccepted/In press - 2020

Keywords

  • clinical research/practice
  • donors and donation: donation after circulatory death (DCD)
  • donors and donation: extended criteria
  • liver transplantation/hepatology
  • organ acceptance
  • organ allocation
  • organ procurement
  • organ procurement and allocation

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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