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Donor age affects fibrosis progression and graft survival after liver transplantation for hepatitis C.
Transplantation 2004; 77(1):84-92T

Abstract

BACKGROUND

The use of liver allografts from an older donor (OD) (age>50 years) is a widespread strategy to manage the disparity between supply and demand of organs for liver transplantation. This study determines the effect of OD allografts on fibrosis progression and graft survival after liver transplantation in patients with and without infection caused by hepatitis C virus (HCV).

METHODS

All patients undergoing liver transplantation at our center from March 1998 to December 2001 were analyzed. Protocol liver biopsies were performed at 1, 16, and 52 weeks after transplantation and yearly thereafter. One liver pathologist scored all biopsy specimens for modified hepatic activity index (0-18) and fibrosis (0-6).

RESULTS

A total of 402 patients (167 with HCV and 235 without HCV) underwent liver transplantation during the study period. Among patients with HCV, baseline characteristics of OD recipients were similar to younger donor (YD) (age<50 years) recipients. In patients with HCV, graft survival was shorter in OD graft recipients than in YD recipients (P<0.001). In patients without HCV, graft survival was independent of donor age. In patients with HCV, a fibrosis score of 3 or greater was present in 17% of OD recipients at 4 months and in 26% at 12 months after transplantation, compared with 8% of YD recipients at 4 months and 13% at 12 months (P<0.001).

CONCLUSIONS

Liver transplantation with OD grafts is associated with rapid progression of fibrosis and decreased graft survival in patients with HCV, but not in patients without HCV. OD grafts should be considered preferentially for patients without HCV.

Authors+Show Affiliations

Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida 32216, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

14724440

Citation

Machicao, Victor I., et al. "Donor Age Affects Fibrosis Progression and Graft Survival After Liver Transplantation for Hepatitis C." Transplantation, vol. 77, no. 1, 2004, pp. 84-92.
Machicao VI, Bonatti H, Krishna M, et al. Donor age affects fibrosis progression and graft survival after liver transplantation for hepatitis C. Transplantation. 2004;77(1):84-92.
Machicao, V. I., Bonatti, H., Krishna, M., Aqel, B. A., Lukens, F. J., Nguyen, J. H., ... Dickson, R. C. (2004). Donor age affects fibrosis progression and graft survival after liver transplantation for hepatitis C. Transplantation, 77(1), pp. 84-92.
Machicao VI, et al. Donor Age Affects Fibrosis Progression and Graft Survival After Liver Transplantation for Hepatitis C. Transplantation. 2004 Jan 15;77(1):84-92. PubMed PMID: 14724440.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Donor age affects fibrosis progression and graft survival after liver transplantation for hepatitis C. AU - Machicao,Victor I, AU - Bonatti,Hugo, AU - Krishna,Murli, AU - Aqel,Bashar A, AU - Lukens,Frank J, AU - Nguyen,Justin H, AU - Rosser,Barry G, AU - Satyanarayana,Raj, AU - Grewal,Hani P, AU - Hewitt,Winston R, AU - Harnois,Denise M, AU - Crook,Julia E, AU - Steers,Jeffery L, AU - Dickson,Rolland C, PY - 2004/1/16/pubmed PY - 2004/2/20/medline PY - 2004/1/16/entrez SP - 84 EP - 92 JF - Transplantation JO - Transplantation VL - 77 IS - 1 N2 - BACKGROUND: The use of liver allografts from an older donor (OD) (age>50 years) is a widespread strategy to manage the disparity between supply and demand of organs for liver transplantation. This study determines the effect of OD allografts on fibrosis progression and graft survival after liver transplantation in patients with and without infection caused by hepatitis C virus (HCV). METHODS: All patients undergoing liver transplantation at our center from March 1998 to December 2001 were analyzed. Protocol liver biopsies were performed at 1, 16, and 52 weeks after transplantation and yearly thereafter. One liver pathologist scored all biopsy specimens for modified hepatic activity index (0-18) and fibrosis (0-6). RESULTS: A total of 402 patients (167 with HCV and 235 without HCV) underwent liver transplantation during the study period. Among patients with HCV, baseline characteristics of OD recipients were similar to younger donor (YD) (age<50 years) recipients. In patients with HCV, graft survival was shorter in OD graft recipients than in YD recipients (P<0.001). In patients without HCV, graft survival was independent of donor age. In patients with HCV, a fibrosis score of 3 or greater was present in 17% of OD recipients at 4 months and in 26% at 12 months after transplantation, compared with 8% of YD recipients at 4 months and 13% at 12 months (P<0.001). CONCLUSIONS: Liver transplantation with OD grafts is associated with rapid progression of fibrosis and decreased graft survival in patients with HCV, but not in patients without HCV. OD grafts should be considered preferentially for patients without HCV. SN - 0041-1337 UR - https://www.unboundmedicine.com/medline/citation/14724440/Donor_age_affects_fibrosis_progression_and_graft_survival_after_liver_transplantation_for_hepatitis_C_ L2 - http://Insights.ovid.com/pubmed?pmid=14724440 DB - PRIME DP - Unbound Medicine ER -