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24.04.2020 | original article | Ausgabe 5/2020

European Surgery 5/2020

Impact of the elderly donor on an abdominal organ transplantation program

Zeitschrift:
European Surgery > Ausgabe 5/2020
Autoren:
MD, PhD María Ángeles Ballesteros, MD, PhD Borja Suberviola, MD Lara Belmar Vega, MD Roberto Fernández-Santiago, MD Sandra Campos Fernández, MD, PhD Juan Carlos Ruiz San Millán, MD, PhD Eduardo Miñambres
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Summary

Background

Older donors have become widespread in recent years. Given that they have comorbidities, the treatment of theses donors is crucial. Our aim was to analyze the influence of the elderly donor (≥65 years) on the subsequent evolution of liver and kidney recipients.

Methods

Retrospective study including all liver and kidney transplants performed at the Marqués de Valdecilla University Hospital with grafts generated from local donors in brain death. Period: 2014–2017. Two groups were considered, depending on the age of the donor (≥ or <65 years).

Results

There were 37 older donors (from 100 donors in brain death). Fourteen liver transplants were performed with old grafts that were characterized by a lower Model for End-stage Liver Disease (MELD) score (13.5 [interquartile range (IQR): 10–14] vs. 19 [IQR: 16–22], p: 0.004). The values of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were higher over time in the older graft recipients. 18 renal transplants were performed with grafts from older donors. This group were older (62 vs. 57, p: 0.001) and had longer hospital stay (25 vs. 17 days; p: 0.023). There were no significant differences in the development of primary graft disfunction or graft loss. Liver transplant survival and kidney survival were similar in both groups.

Conclusion

The use of elderly donors has not influenced the clinical evolution of liver and kidney transplants in our series. Older donors should no longer be considered suboptimal, because they offer a possibility for certain patients on the waiting list.

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