Elderly living liver donors in Korea

 Introduction: Old donors have gradually been used as an alternative living liver donor to alleviate the organ shortage or avoid offspring donation. The aim of the present study is to determine the impact of elderly donors more than 60 years in living donor liver transplantation (LDLT) on donor safety and recipient outcomes compared with donors from fifty to fifty-nine years. Methods: We retrospectively identified 209 patients at nine centers from 2005 to 2017 in Korea. Results: Sixty group represented 10.0% (n = 21) of the patient donors. The incidence of male donor in the sixty group was higher than in the fifty group (61.9% vs. 37.8%; p = 0.039). Postoperative complications were more common in the sixty group. There was no in-hospital mortality and no mortality was reported during the observation period. There were no statistically significant differences in operation time, blood loss, intraoperative and postoperative transfusion rate, postoperative total bilirubin, and hospitalization between the two groups. In recipient operation, median blood loss, transfusion rates during operation, and postoperative bleeding control operations were more than in the fifty group. Postoperative total bilirubin and hospitalization in the sixty group were higher and longer in the fifty group. Cumulative patient survival rate in the fifty group was better than in the sixty group (p = 0.011). Sixty group was predisposing factor for recipient death in multivariate analysis. Conclusions: Present study suggests that highly selected elderly living donors (≥ 60 years) can safely donate, but their recipient outcomes are worse compared with the fifty group.