Fouzas I, Sgourakis G, Nowak K M, Lang H, Cicinnati V R, Molmenti E P, Saner F H, Nadalin S, Papanikolaou V, Broelsch C E, Paul A, Sotiropoulos G C
Department of General, Visceral, and Transplantation Surgery, University Hospital Essen, Essen, Germany; Organ Transplant Unit, Hippocration University Hospital, Thessaloniki, Greece.
Transplant Proc. 2008 Nov;40(9):3198-200. doi: 10.1016/j.transproceed.2008.08.061.
The purpose of this study was to evaluate our experience with orthotopic liver transplantation (OLT) using grafts from septuagenarians.
Seventeen adult patients underwent transplantation with grafts from donors 70 years of age or older during an 8-year period.
The median donor age was 73 years (range, 70-83). Eleven (64.7%) donors had experienced at least 1 hypotensive period and received vasoactive drugs. Median cold and warm ischemia times were 7.25 hours and 35 minutes, respectively. Two recipients underwent retransplantation because of dysfunction or primary nonfunction. Morbidity rate was 47% and hospital mortality rate was 23.5%. After a median follow-up of 34.5 months (range, 3-84 months), 5 additional patients died. Median patient survival was 17 months (range, 0-84 months). One-, 3-, 5-, and 7-year cumulative survival rates were 69.7%, 57.5%, 46.2%, and 23.3%, respectively. Only graft dysfunction (P = .042) was observed to be an independent predictor of survival upon multivariate analysis.
Although grafts from septuagenarians allow for expansion of the donor pool, long-term recipient survival is inferior to that encountered with younger donors.
本研究的目的是评估我们使用七十多岁供体的肝脏进行原位肝移植（OLT）的经验。
在8年期间，17例成年患者接受了70岁及以上供体的肝脏移植。
供体年龄中位数为73岁（范围70 - 83岁）。11例（64.7%）供体经历过至少1次低血压期并接受了血管活性药物治疗。冷缺血时间和热缺血时间中位数分别为7.25小时和35分钟。2例受者因移植物功能障碍或原发性无功能而接受再次移植。发病率为47%，医院死亡率为23.5%。中位随访34.5个月（范围3 - 84个月）后，又有5例患者死亡。患者生存时间中位数为17个月（范围0 - 84个月）。1年、3年、5年和7年累积生存率分别为69.7%、57.5%、46.2%和23.3%。多因素分析显示，仅移植物功能障碍（P = 0.042）是生存的独立预测因素。
尽管七十多岁供体的肝脏可扩大供体库，但受者长期生存情况不如年轻供体肝脏移植的受者。
