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Livers From Elderly Donors Safe, Effective for Recipients With Hepatitis C CHICAGO -- July 21, 2008 -- Receiving a liver from a donor aged 60 years and older does not appear to be associated with transplant failure, death, or recurrent disease in the next 5 years among transplant recipients with hepatitis C, according to a study in the July issue of Archives of Surgery. "There are concerning reports in recipients with hepatitis C virus that extended criteria donors, particularly older donors, are associated with poorer outcome, especially with early and severe hepatitis C virus recurrence in the donor graft," the authors wrote. M.B. Majella Doyle, MD, Washington University School of Medicine, St. Louis, Missouri, and colleagues analysed data from 489 adult liver transplants performed at the school between 1997 and 2006. Of these patients, 187 (38.2%) were hepatitis C virus-positive and 302 (61.8%) had other indications for liver transplant. Of patients with the hepatitis C virus, 88.1% were alive after 1 year, 78.3% survived 3 years, and 69.2% survived 5 years. Donor livers were still functioning in 85.6% of recipients with hepatitis C after 1 year, 75.6% after 3 years, and 65.6% after 5 years. There were no differences in rates of survival and graft survival between patients with and without hepatitis C at 1, 3, or 5 years. "However, similar to other long-term transplant centers, we observed a negative effect from recurrent hepatitis C virus with a trend toward worsened long-term survival between years 5 and 10," the authors wrote. A total of 72 patients received organs from donors aged 60 years and older. Of these patients, 24 (12.8%) were hepatitis C virus-positive and 48 (15.9%) were hepatitis C virus-negative. There were no differences in 1-, 3-, or 5-year patient or graft survival rates when these patients, or those who received organs from donors aged 65 years and older, were compared with those who received organs from younger donors. Because the use of older donors has primarily occurred in the past 5 years, long-term comparisons were not possible. However, the early results suggest the practice is safe, said the authors. "Overall patient and graft survival in hepatitis C virus-positive recipients is comparable with that in hepatitis C virus-negative patients, and there seems to be little, if any, adverse effect on short- and medium-term follow-up with the use of carefully selected older donor grafts in recipients with hepatitis C virus," the authors wrote. "Data from this series suggest that the continued use of selected older donors is a safe method of expanding the liver donor pool, even for hepatitis C-positive recipients." SOURCE: Archives of Surgery E-mail this page to a friend or colleague! To print, use this version