Age Matching of Elderly Liver Grafts With Elderly Recipients Does Not Have a Synergistic Effect on Long-term Outcomes When Both Are Carefully Selected.
Journal
Transplantation direct
ISSN: 2373-8731
Titre abrégé: Transplant Direct
Pays: United States
ID NLM: 101651609
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
received:
25
01
2019
accepted:
06
02
2019
entrez:
18
4
2019
pubmed:
18
4
2019
medline:
18
4
2019
Statut:
epublish
Résumé
Older donors and recipients are increasingly considered for liver transplantation. Both donor and recipient age have a negative impact on outcomes. Large registry analyses show that older donors are frequently matched to older recipients. Whether age-related risks accumulate in a synergic negative effect on outcomes because of donor-recipient age matching is poorly understood. We investigated the impact of donor-recipient age interaction on patient and death-censored graft survival in multivariate Cox regressions in 849 transplants (January 2000 to December 2015). Donors 70 years or older did not affect long-term patient or graft survival. Recipient age independently increased the risk of death (hazard ratio [HR], 1.03; 95% confidence interval [CI], 1.02-1.05, Older livers can be safely used in older recipients without jeopardizing graft and patient survival if other risk factors are minimized.
Sections du résumé
BACKGROUND
BACKGROUND
Older donors and recipients are increasingly considered for liver transplantation. Both donor and recipient age have a negative impact on outcomes. Large registry analyses show that older donors are frequently matched to older recipients. Whether age-related risks accumulate in a synergic negative effect on outcomes because of donor-recipient age matching is poorly understood.
METHODS
METHODS
We investigated the impact of donor-recipient age interaction on patient and death-censored graft survival in multivariate Cox regressions in 849 transplants (January 2000 to December 2015).
RESULTS
RESULTS
Donors 70 years or older did not affect long-term patient or graft survival. Recipient age independently increased the risk of death (hazard ratio [HR], 1.03; 95% confidence interval [CI], 1.02-1.05,
CONCLUSIONS
CONCLUSIONS
Older livers can be safely used in older recipients without jeopardizing graft and patient survival if other risk factors are minimized.
Identifiants
pubmed: 30993187
doi: 10.1097/TXD.0000000000000883
pii: TXD50358
pmc: PMC6445659
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e342Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
Références
Heart Rhythm. 2015 Nov;12(11):2332-43
pubmed: 26142297
Am J Transplant. 2011 Jan;11(1):22-33
pubmed: 21070604
J Am Coll Surg. 2015 Jul;221(1):59-69
pubmed: 25872684
Diabetes Care. 2001 Apr;24(4):683-9
pubmed: 11315831
Clin Transplant. 2017 Dec;31(12):
pubmed: 29044682
J Am Coll Surg. 2008 Dec;207(6):847-52
pubmed: 19183530
J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146-56
pubmed: 11253156
Ann Surg. 2018 Mar;267(3):419-425
pubmed: 28885508
Am J Transplant. 2012 Oct;12(10):2789-96
pubmed: 22823098
Hepatology. 2016 Feb;63(2):574-80
pubmed: 26517301
Gastroenterology. 2016 Feb;150(2):441-53.e6; quiz e16
pubmed: 26522262
Transplant Proc. 2012 Nov;44(9):2861-7
pubmed: 23146543
Liver Transpl. 2010 Aug;16(8):943-9
pubmed: 20677285
Transplantation. 2018 Dec;102(12):2033-2037
pubmed: 29965955
Am J Transplant. 2006 Apr;6(4):783-90
pubmed: 16539636
J Am Coll Surg. 2010 Aug;211(2):271-8
pubmed: 20670867
Lancet. 2005 Sep 24-30;366(9491):1059-62
pubmed: 16182882
Am J Transplant. 2018 Aug;18(8):1986-1994
pubmed: 29380529
Transplantation. 2016 Nov;100(11):2410-2415
pubmed: 27780188
J Surg Res. 2002 Aug;106(2):246-53
pubmed: 12175974
Hepatology. 2007 Dec;46(6):1907-18
pubmed: 17918247
Liver Transpl. 2018 Mar;24(3):352-362
pubmed: 28885771
Am J Transplant. 2018 Mar;18(3):669-678
pubmed: 28960723
Liver Transpl. 2019 Feb;25(2):260-274
pubmed: 30317683
Ann Surg. 2017 Feb;265(2):388-396
pubmed: 28059967
Am J Transplant. 2012 Oct;12(10):2608-22
pubmed: 22958872
Transplant Proc. 2013 Sep;45(7):2700-6
pubmed: 24034027
Transpl Int. 2018 Dec;31(12):1293-1317
pubmed: 30259574
Am J Transplant. 2014 Sep;14(9):2062-71
pubmed: 25307037
Am J Transplant. 2008 Feb;8(2):419-25
pubmed: 18190658
Am J Transplant. 2008 Apr;8(4):839-46
pubmed: 18318783
N Engl J Med. 1996 Mar 14;334(11):693-9
pubmed: 8594428
Science. 2002 May 10;296(5570):1029-31
pubmed: 12004104
Arch Surg. 2007 Aug;142(8):775-81; discussion 781-4
pubmed: 17709732
Transplantation. 2018 Jul;102(7):1108-1114
pubmed: 29952924
Ann Surg. 2018 Aug;268(2):325-331
pubmed: 28549011
Hepatology. 2017 Aug;66(2):564-574
pubmed: 28422306
J Hepatol. 2012 Sep;57(3):675-88
pubmed: 22609307
Transplantation. 2016 Jan;100(1):153-8
pubmed: 26154390
Trends Endocrinol Metab. 2009 May;20(4):171-6
pubmed: 19359195
Curr Opin Immunol. 2010 Aug;22(4):507-13
pubmed: 20667703
J Surg Res. 2012 Dec;178(2):922-34
pubmed: 22647552