RT Journal Article
T1 Analyzing predictors of graft survival in patients undergoing liver transplantation with donors aged 70 years and over.
A1 Caso-Maestro, Oscar
A1 Jiménez-Romero, Carlos
A1 Justo-Alonso, Iago
A1 Calvo-Pulido, Jorge
A1 Lora-Pablos, David
A1 Marcacuzco-Quinto, Alberto
A1 Cambra-Molero, Félix
A1 García-Sesma, Alvaro
A1 Pérez-Flecha, Marina
A1 Muñoz-Arce, Carlos
A1 Loinaz-Segurola, Carmelo
A1 Manrique-Municio, Alejandro
K1 Aged donors
K1 Donor age
K1 Liver transplantation
K1 Marginal donors
K1 Old donors
AB To increase the number of available grafts. This is a single-center comparative analysis performed between April 1986 and May 2016. Two hundred and twelve liver transplantation (LT) were performed with donors ≥ 70 years old (study group). Then, we selected the first cases that were performed with donors  Graft and patient survivals were similar between both groups without increasing the risk of complications, especially primary non-function, vascular complications and biliary complications. We identified 5 risk factors as independent predictors of graft survival: recipient hepatitis C virus (HCV)-positivity [hazard ratio (HR) = 2.35; 95% confidence interval (CI): 1.55-3.56; P = 0.00]; recipient age (HR = 1.04; 95%CI: 1.02-1.06; P = 0.00); donor age X model for end-stage liver disease (D-MELD) (HR = 1.00; 95%CI: 1.00-1.00; P = 0.00); donor value of serum glutamic-pyruvic transaminase (HR = 1.00; 95%CI: 1.00-1.00; P = 0.00); and donor value of serum sodium (HR = 0.96; 95%CI: 0.94-0.99; P = 0.00). After combining D-MELD and recipient age we obtained a new scoring system that we called DR-MELD (donor age X recipient age X MELD). Graft survival significantly decreased in patients with a DR-MELD score ≥ 75000, especially in HCV patients (77% vs 63% at 5 years in HCV-negative patients, P = 0.00; and 61% vs 25% at 5 years in HCV-positive patients; P = 0.00). A DR-MELD ≥ 75000 must be avoided in order to obtain the best results in LT with donors ≥ 70 years old.
YR 2018
FD 2018
LK https://hdl.handle.net/10668/25473
UL https://hdl.handle.net/10668/25473
LA en
DS RISalud
RD Apr 17, 2025