Older Donors Lead to Late Hepatic Artery Thrombosis in Liver Recipients: Presented at ACS
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Older Donors Lead to Late Hepatic Artery Thrombosis in Liver Recipients: Presented at ACS

By Roberta Friedman, PhD

SAN FRANCISCO -- October 15, 2008 -- Use of livers from older donors appears to be associated with an increase in the risk of delayed hepatic artery thrombosis (HAT) in the organs' recipients, according to research presented here at the American College of Surgeons (ACS) 94th Annual Clinical Congress.

"Given organ shortages, there has been a distinct trend in using older donors," said Zoe Stewart, MD, PhD, Johns Hopkins Comprehensive Transplant Center, Baltimore, Maryland.

However, Dr. Stewart said, factors in the donated organ are likely to be the cause of delayed HAT, as opposed to technical factors that produce HAT soon after the surgery. She said her investigation supports this idea.

The study reported here on October 14 involved data from a cohort of 1,246 patients who underwent liver transplantation from 1987 to 2006 and had graft loss due to HAT.

Results show that the risk of HAT increased with each increasing decade of life of the donor. There was no significant risk if the donor was less than 50 years old, while the relative risk was 1.35 for donors in their 50s and 1.52 for donors in their 60s. Donors older than 70 years produced a relative risk of HAT of 1.61 for the recipients (all risk values were significant, P < .001).

More than 7,400 donors were older than age 70, which lent power to the study, Dr. Stewart said.

Donor factors that may play into the increased risk for HAT included cerebral hypoxia, female gender, and hypertension. Those factors identified in recipients that might increase the risk of HAT included female gender, prior transplant, or split graft.

Recipients' age also produced risk, with increases for each decade of life for those aged 50 years and older, similar to that for the donors.

"Since we are not going to stop using these allografts" from older donors, Dr. Stewart said, doctors should focus on postoperative care to avoid HAT.

[Presentation title: Hepatic Artery Thrombosis After Liver Transplantation Is Increasing and Is Associated With Older Donors. Session GS46]

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