Wang Kai, Jiang Wen-Tao, Deng Yong-Lin, Pan Cheng, Shen Zhong-Yang
Department of Transplant Surgery, Tianjin First Center Hospital, Key Laboratory of Organ Transplantation of Tianjin, Tianjin 300192, China.
Hepatobiliary Pancreat Dis Int. 2015 Feb;14(1):50-5. doi: 10.1016/s1499-3872(15)60334-4.
Donor shortage is the biggest obstacle in organ transplantation. Living donor liver transplantation (LDLT) has been considered as a valuable approach to shortening waiting time. The objectives of this study were to investigate the feasibility of utilizing donors older than 50 years in LDLT and to evaluate the graft function and recipient survival.
All LDLT cases (n=159) were divided into the older (donor age≥50 years, n=10) and younger (donor age<50 years, n=149) donor groups. Donor graft and recipient condition pre-, intra- and post-operation were compared between the two groups. In particular, graft functions and recipient survivals were analyzed.
The median donor age was 58.5 (52.5-60.0) years in the older donor group and 25.0 (23.0-32.0) in the younger donor group. There was no significant difference in cold ischemic time, anhepatic phase and operation time between the older and younger donor groups (P>0.05). However, the volume of red blood cell transfused in operation was greater in the older donor group than in the younger donor group (1900 vs 1200 mL, P=0.023). The 1-, 3- and 5-year graft survival rates were 90%, 80% and 80% for the older donor group, and 92%, 87% and 87% for the younger donor group, respectively (P=0.459). The 1-, 3- and 5-year survival rates were 100%, 90% and 90% for recipients with older grafts, and 93%, 87% and 87% for those with younger grafts, respectively (P=0.811).
It is safe for a LDLT recipient to receive liver from donors older than 50 years, and there is no significant adverse effect on graft function and long-term patients' survival.
供体短缺是器官移植中的最大障碍。活体供肝移植（LDLT）被认为是缩短等待时间的一种有价值的方法。本研究的目的是探讨在LDLT中使用年龄超过50岁的供体的可行性，并评估移植物功能和受体生存率。
将所有LDLT病例（n = 159）分为老年供体组（供体年龄≥50岁，n = 10）和年轻供体组（供体年龄<50岁，n = 149）。比较两组供体移植物及受体术前、术中和术后的情况。特别分析了移植物功能和受体生存率。
老年供体组供体年龄中位数为58.5（52.5 - 60.0）岁，年轻供体组为25.0（23.0 - 32.0）岁。老年和年轻供体组之间冷缺血时间、无肝期和手术时间无显著差异（P>0.05）。然而，老年供体组术中输注红细胞的量大于年轻供体组（1900 vs 1200 mL，P = 0.023）。老年供体组1年、3年和5年移植物生存率分别为90%、80%和80%，年轻供体组分别为92%、87%和87%（P = 0.459）。接受老年移植物受体的1年、3年和5年生存率分别为100%、90%和90%，接受年轻移植物受体分别为93%、87%和87%（P = 0.811）。
LDLT受体接受年龄超过50岁供体的肝脏是安全的，对移植物功能和患者长期生存无显著不良影响。
