1 Department of Transplantation Medicine, Section for Transplant Surgery, Oslo University Hospital, Oslo, Norway. 2 Biotechnology Centre of Oslo, University of Oslo, Oslo, Norway. 3 Centre for Molecular Medicine Norway, Nordic EMBL Partnership, University of Oslo, Oslo, Norway. 4 Department of Transplantation, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg, Sweden. 5 Division of Transplantation Surgery, Karolinska University Hospital Huddinge, Solna, Sweden. 6 Department of Surgical Sciences, Upper Abdominal Surgery, Uppsala Academic Hospital, Uppsala, Sweden. 7 Transplantation and Liver Surgery Clinic, Helsinki University Hospital, Helsinki, Finland. 8 Department of Surgical Gastroenterology and Transplantation, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark. 9 Division of Cancer medicine, Surgery and Transplantation, Department of Transplantation Medicine, Norwegian PSC Research Centre, Oslo University Hospital, Rikshospitalet, Oslo, Norway. 10 Institute for Clinical Medicine, University of Oslo, Oslo, Norway.
Transplantation. 2015 Dec;99(12):2534-42. doi: 10.1097/TP.0000000000000728.
The availability of donor organs limits the number of patients in need who are offered liver transplantation. Measures to expand the donor pool are crucial to prevent on-list mortality. The aim of this study was to evaluate the use of livers from deceased donors who were older than 75 years.
Fifty-four patients who received a first liver transplant (D75 group) from 2001 to 2011 were included. Donor and recipient data were collected from the Nordic Liver Transplant Registry and medical records. The outcome was compared with a control group of 54 patients who received a liver graft from donors aged 20 to 49 years (D20-49 group). Median donor age was 77 years (range, 75-86 years) in the D75 group and 41 years (range, 20-49 years) in the D20-49 group. Median recipient age was 59 years (range, 31-73 years) in the D75 group and 58 years (range, 31-74 years) in the D20-49 group.
The 1-, 3-, and 5-year patient/graft survival values were 87/87%, 81/81%, and 71/67% for the D75 group and 88/87%, 75/73%, and 75/73% for the D20-49 group, respectively. Patient (P = 0.89) and graft (P = 0.79) survival did not differ between groups. The frequency of biliary complications was higher in the D75 group (29.6/13%, P = 0.03).
Selected livers from donors over age 75 years should not be excluded based on age, which does not compromise patient or graft survival despite a higher frequency of biliary complications.
供体器官的可获得性限制了需要接受肝移植的患者数量。扩大供体池的措施对于防止名单内死亡至关重要。本研究旨在评估使用年龄超过 75 岁的已故供体的肝脏。
纳入 2001 年至 2011 年间接受首次肝移植的 54 例患者（D75 组）。从北欧肝移植登记处和病历中收集供体和受体数据。将结果与接受 20 至 49 岁供体肝脏移植的 54 例患者（D20-49 组）的对照组进行比较。D75 组供体年龄中位数为 77 岁（范围，75-86 岁），D20-49 组为 41 岁（范围，20-49 岁）。D75 组受体年龄中位数为 59 岁（范围，31-73 岁），D20-49 组为 58 岁（范围，31-74 岁）。
D75 组患者/移植物 1、3、5 年生存率分别为 87/87%、81/81%和 71/67%，D20-49 组分别为 88/87%、75/73%和 75/73%。两组患者（P=0.89）和移植物（P=0.79）生存率无差异。D75 组胆道并发症发生率较高（29.6/13%，P=0.03）。
不应因年龄而排除年龄超过 75 岁的供体的肝脏，尽管胆道并发症发生率较高，但这并不影响患者或移植物的生存率。
