Graft function and outcome of older (≥60 years) donor livers
Livers from donors > or = 60 years of age are often considered inadequate for transplantation by many centers. With waiting times exceeding 1 year in our region, we have aggressively used livers from this donor age group. Between 1990 and 1994, 209 patients received 223 liver grafts at our instit...
Gespeichert in:
| Veröffentlicht in: | Transplantation 1996-04, Vol.61 (7), p.1062-1066 |
|---|---|
| Hauptverfasser: | , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1066 |
|---|---|
| container_issue | 7 |
| container_start_page | 1062 |
| container_title | Transplantation |
| container_volume | 61 |
| creator | WASHBURN, W. K JOHNSON, L. B LEWIS, W. D JENKINS, R. L |
| description | Livers from donors > or = 60 years of age are often considered inadequate for transplantation by many centers. With waiting times exceeding 1 year in our region, we have aggressively used livers from this donor age group. Between 1990 and 1994, 209 patients received 223 liver grafts at our institution. Of these, 29 (13%) were from donors > or = 60 years of age (group A) and 194 (87%) were from donors < 60 years of age (group B). The two groups were matched for recipient diagnosis and severity of disease. Group A and B donors had similar liver, renal, and hematologic studies prior to donation. Weight, sex, race and vasopressor requirement were also similar. Postoperative alanine aminotransferase, aspartate aminotransferase,and prothrombin time were not significantly different over the first 10 postoperative days. Group A grafts were significantly more cholestatic than group B grafts on postoperative days 6-10. The retransplantation rate for primary graft nonfunction was not significantly different from group A (6.7%) and group B (3.4%; P=0.04). Patient and graft survival rates at 1 year were 58.6 % and 44.8% for group A and 79.2% and 74.5% for group B (P |
| doi_str_mv | 10.1097/00007890-199604150-00013 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_78006701</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>15675144</sourcerecordid><originalsourceid>FETCH-LOGICAL-c420t-a270941cdba3b86b66d990bed0738f2a47610eb50e9c0ba8c23a28b9ebfdf2a53</originalsourceid><addsrcrecordid>eNqFkM9KxDAQh4Mo67r6CEIOInqoTpo2fy6CLLoKC170HJI0hUq3WZNW2EfwQXwxn8To1r06l4H5fTMhH0KYwBUBya8hFRcSMiIlg4KUkKUJoXtoSkpaZAwE7KMppCgjlPJDdBTja0JKyvkETQTLKRFsim4WQdc9rofO9o3vsO4q7Ife-pXDvsa-rVzAF18fnwzwxukQL3HlOx9w27y7EI_RQa3b6E7GPkMv93fP84ds-bR4nN8uM1vk0Gc65yALYiujqRHMMFZJCcZVwKmoc11wRsCZEpy0YLSwOdW5MNKZukpxSWfofHt3Hfzb4GKvVk20rm115_wQFRcAjCcB_4GkZLwkRZFAsQVt8DEGV6t1aFY6bBQB9eNY_TlWO8fq13FaPR3fGMzKVbvFUWrKz8ZcR6vbOujONnGHUWDpt5J-AwZwgys</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>15675144</pqid></control><display><type>article</type><title>Graft function and outcome of older (≥60 years) donor livers</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>WASHBURN, W. K ; JOHNSON, L. B ; LEWIS, W. D ; JENKINS, R. L</creator><creatorcontrib>WASHBURN, W. K ; JOHNSON, L. B ; LEWIS, W. D ; JENKINS, R. L</creatorcontrib><description>Livers from donors > or = 60 years of age are often considered inadequate for transplantation by many centers. With waiting times exceeding 1 year in our region, we have aggressively used livers from this donor age group. Between 1990 and 1994, 209 patients received 223 liver grafts at our institution. Of these, 29 (13%) were from donors > or = 60 years of age (group A) and 194 (87%) were from donors < 60 years of age (group B). The two groups were matched for recipient diagnosis and severity of disease. Group A and B donors had similar liver, renal, and hematologic studies prior to donation. Weight, sex, race and vasopressor requirement were also similar. Postoperative alanine aminotransferase, aspartate aminotransferase,and prothrombin time were not significantly different over the first 10 postoperative days. Group A grafts were significantly more cholestatic than group B grafts on postoperative days 6-10. The retransplantation rate for primary graft nonfunction was not significantly different from group A (6.7%) and group B (3.4%; P=0.04). Patient and graft survival rates at 1 year were 58.6 % and 44.8% for group A and 79.2% and 74.5% for group B (P<0.001 for both). Four of 12 deaths in the first year in group A were completely unrelated to graft function. If these are excluded, patient and graft survival rates were 68% and 52%, which are better but still significantly less than in group B. Initial graft function of older donor livers are similar to that of the matched younger group. However, patient and graft survival rates were significantly worse for the older donors, even when corrected for unrelated deaths. Livers should not be discarded based on age alone without inspection and/or biopsy to rule out significant steatosis. Prompt retransplantation for primary graft nonfunction of older donors are generally more cholestatic than those from the younger donor age group; however, many of them function quite well. At the present time, given the inability to identify donor variables associated with decreased recipient survival, we recommend cautious use of older liver grafts in healthier recipients.</description><identifier>ISSN: 0041-1337</identifier><identifier>EISSN: 1534-6080</identifier><identifier>DOI: 10.1097/00007890-199604150-00013</identifier><identifier>PMID: 8623186</identifier><identifier>CODEN: TRPLAU</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Adult ; Age Factors ; Aged ; Biological and medical sciences ; Female ; Graft Survival ; Humans ; Liver Transplantation ; Liver, biliary tract, pancreas, portal circulation, spleen ; Male ; Medical sciences ; Middle Aged ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Tissue Donors ; Treatment Outcome</subject><ispartof>Transplantation, 1996-04, Vol.61 (7), p.1062-1066</ispartof><rights>1996 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c420t-a270941cdba3b86b66d990bed0738f2a47610eb50e9c0ba8c23a28b9ebfdf2a53</citedby><cites>FETCH-LOGICAL-c420t-a270941cdba3b86b66d990bed0738f2a47610eb50e9c0ba8c23a28b9ebfdf2a53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3066109$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8623186$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>WASHBURN, W. K</creatorcontrib><creatorcontrib>JOHNSON, L. B</creatorcontrib><creatorcontrib>LEWIS, W. D</creatorcontrib><creatorcontrib>JENKINS, R. L</creatorcontrib><title>Graft function and outcome of older (≥60 years) donor livers</title><title>Transplantation</title><addtitle>Transplantation</addtitle><description>Livers from donors > or = 60 years of age are often considered inadequate for transplantation by many centers. With waiting times exceeding 1 year in our region, we have aggressively used livers from this donor age group. Between 1990 and 1994, 209 patients received 223 liver grafts at our institution. Of these, 29 (13%) were from donors > or = 60 years of age (group A) and 194 (87%) were from donors < 60 years of age (group B). The two groups were matched for recipient diagnosis and severity of disease. Group A and B donors had similar liver, renal, and hematologic studies prior to donation. Weight, sex, race and vasopressor requirement were also similar. Postoperative alanine aminotransferase, aspartate aminotransferase,and prothrombin time were not significantly different over the first 10 postoperative days. Group A grafts were significantly more cholestatic than group B grafts on postoperative days 6-10. The retransplantation rate for primary graft nonfunction was not significantly different from group A (6.7%) and group B (3.4%; P=0.04). Patient and graft survival rates at 1 year were 58.6 % and 44.8% for group A and 79.2% and 74.5% for group B (P<0.001 for both). Four of 12 deaths in the first year in group A were completely unrelated to graft function. If these are excluded, patient and graft survival rates were 68% and 52%, which are better but still significantly less than in group B. Initial graft function of older donor livers are similar to that of the matched younger group. However, patient and graft survival rates were significantly worse for the older donors, even when corrected for unrelated deaths. Livers should not be discarded based on age alone without inspection and/or biopsy to rule out significant steatosis. Prompt retransplantation for primary graft nonfunction of older donors are generally more cholestatic than those from the younger donor age group; however, many of them function quite well. At the present time, given the inability to identify donor variables associated with decreased recipient survival, we recommend cautious use of older liver grafts in healthier recipients.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Female</subject><subject>Graft Survival</subject><subject>Humans</subject><subject>Liver Transplantation</subject><subject>Liver, biliary tract, pancreas, portal circulation, spleen</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Tissue Donors</subject><subject>Treatment Outcome</subject><issn>0041-1337</issn><issn>1534-6080</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkM9KxDAQh4Mo67r6CEIOInqoTpo2fy6CLLoKC170HJI0hUq3WZNW2EfwQXwxn8To1r06l4H5fTMhH0KYwBUBya8hFRcSMiIlg4KUkKUJoXtoSkpaZAwE7KMppCgjlPJDdBTja0JKyvkETQTLKRFsim4WQdc9rofO9o3vsO4q7Ife-pXDvsa-rVzAF18fnwzwxukQL3HlOx9w27y7EI_RQa3b6E7GPkMv93fP84ds-bR4nN8uM1vk0Gc65yALYiujqRHMMFZJCcZVwKmoc11wRsCZEpy0YLSwOdW5MNKZukpxSWfofHt3Hfzb4GKvVk20rm115_wQFRcAjCcB_4GkZLwkRZFAsQVt8DEGV6t1aFY6bBQB9eNY_TlWO8fq13FaPR3fGMzKVbvFUWrKz8ZcR6vbOujONnGHUWDpt5J-AwZwgys</recordid><startdate>19960415</startdate><enddate>19960415</enddate><creator>WASHBURN, W. K</creator><creator>JOHNSON, L. B</creator><creator>LEWIS, W. D</creator><creator>JENKINS, R. L</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>19960415</creationdate><title>Graft function and outcome of older (≥60 years) donor livers</title><author>WASHBURN, W. K ; JOHNSON, L. B ; LEWIS, W. D ; JENKINS, R. L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c420t-a270941cdba3b86b66d990bed0738f2a47610eb50e9c0ba8c23a28b9ebfdf2a53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Female</topic><topic>Graft Survival</topic><topic>Humans</topic><topic>Liver Transplantation</topic><topic>Liver, biliary tract, pancreas, portal circulation, spleen</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Tissue Donors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>WASHBURN, W. K</creatorcontrib><creatorcontrib>JOHNSON, L. B</creatorcontrib><creatorcontrib>LEWIS, W. D</creatorcontrib><creatorcontrib>JENKINS, R. L</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>WASHBURN, W. K</au><au>JOHNSON, L. B</au><au>LEWIS, W. D</au><au>JENKINS, R. L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Graft function and outcome of older (≥60 years) donor livers</atitle><jtitle>Transplantation</jtitle><addtitle>Transplantation</addtitle><date>1996-04-15</date><risdate>1996</risdate><volume>61</volume><issue>7</issue><spage>1062</spage><epage>1066</epage><pages>1062-1066</pages><issn>0041-1337</issn><eissn>1534-6080</eissn><coden>TRPLAU</coden><abstract>Livers from donors > or = 60 years of age are often considered inadequate for transplantation by many centers. With waiting times exceeding 1 year in our region, we have aggressively used livers from this donor age group. Between 1990 and 1994, 209 patients received 223 liver grafts at our institution. Of these, 29 (13%) were from donors > or = 60 years of age (group A) and 194 (87%) were from donors < 60 years of age (group B). The two groups were matched for recipient diagnosis and severity of disease. Group A and B donors had similar liver, renal, and hematologic studies prior to donation. Weight, sex, race and vasopressor requirement were also similar. Postoperative alanine aminotransferase, aspartate aminotransferase,and prothrombin time were not significantly different over the first 10 postoperative days. Group A grafts were significantly more cholestatic than group B grafts on postoperative days 6-10. The retransplantation rate for primary graft nonfunction was not significantly different from group A (6.7%) and group B (3.4%; P=0.04). Patient and graft survival rates at 1 year were 58.6 % and 44.8% for group A and 79.2% and 74.5% for group B (P<0.001 for both). Four of 12 deaths in the first year in group A were completely unrelated to graft function. If these are excluded, patient and graft survival rates were 68% and 52%, which are better but still significantly less than in group B. Initial graft function of older donor livers are similar to that of the matched younger group. However, patient and graft survival rates were significantly worse for the older donors, even when corrected for unrelated deaths. Livers should not be discarded based on age alone without inspection and/or biopsy to rule out significant steatosis. Prompt retransplantation for primary graft nonfunction of older donors are generally more cholestatic than those from the younger donor age group; however, many of them function quite well. At the present time, given the inability to identify donor variables associated with decreased recipient survival, we recommend cautious use of older liver grafts in healthier recipients.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>8623186</pmid><doi>10.1097/00007890-199604150-00013</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0041-1337 |
| ispartof | Transplantation, 1996-04, Vol.61 (7), p.1062-1066 |
| issn | 0041-1337 1534-6080 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_78006701 |
| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adult Age Factors Aged Biological and medical sciences Female Graft Survival Humans Liver Transplantation Liver, biliary tract, pancreas, portal circulation, spleen Male Medical sciences Middle Aged Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Tissue Donors Treatment Outcome |
| title | Graft function and outcome of older (≥60 years) donor livers |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-27T23%3A45%3A51IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Graft%20function%20and%20outcome%20of%20older%20(%E2%89%A560%20years)%20donor%20livers&rft.jtitle=Transplantation&rft.au=WASHBURN,%20W.%20K&rft.date=1996-04-15&rft.volume=61&rft.issue=7&rft.spage=1062&rft.epage=1066&rft.pages=1062-1066&rft.issn=0041-1337&rft.eissn=1534-6080&rft.coden=TRPLAU&rft_id=info:doi/10.1097/00007890-199604150-00013&rft_dat=%3Cproquest_cross%3E15675144%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=15675144&rft_id=info:pmid/8623186&rfr_iscdi=true |