Effect of donor-recipient age matching in living donor liver transplantation

Background The use of a marginal donor, such as an elderly donor, in liver transplantation has been increasing in response to organ disparity; however, major risk factors for graft and patient survivals have been reported. Methods We retrospectively reviewed the medical records of 559 patients who underwent living-donor liver transplantation (LDLT) at our hospital from May 2003 to June 2013. Elderly donors were defined as those >50 years old, and elderly recipients were defined as those >60 years old. We evaluated the differences in survival according to donor and recipient ages. Furthermore, we compared post-transplantation outcomes according to donor-recipient age matching. Results The overall 5-year survival rate of the recipients was significantly lower in the elderly donor group than in the younger donor group (84.6% vs 58.2%; P <.001). However, no significant difference in survival rate was observed according to recipient age (P =.908). The survival rate of elderly recipients who received a graft from an elderly donor was significantly lower than those of the other groups (P <.001-.037). The mortality rate was significantly different among the groups (P <.001), and among the causes of death, surgical complications were most frequent cause in the elderly donor group (P <.001). Conclusions LDLT with the use of elderly donors >50 years of age could result in higher mortality rates than using younger donors. As such, elderly donor livers ideally should be matched with young recipients and attention concentrated on the surgical complications.