1. Impact of Donor Age on Recipient Survival in Adult-to-Adult Living-donor Liver Transplantation
- Author
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Noriyo Yamashiki, Toshimi Kaido, Hideaki Okajima, Shinji Uemoto, Hirokazu Tanaka, Toyonari Kubota, Shintaro Yagi, Ichiro Tamaki, Jiro Kusakabe, Takayuki Anazawa, Yusuke Okamura, Hirofumi Hirao, Koichiro Hata, Takashi Sozu, Shoichi Kageyama, Yoshihide Ueda, Junichi Yoshikawa, and Atsushi Yoshizawa
- Subjects
Adult ,medicine.medical_specialty ,Multivariate analysis ,medicine.medical_treatment ,030230 surgery ,Liver transplantation ,Gastroenterology ,Donor age ,Nuclear Family ,End Stage Liver Disease ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Living Donors ,medicine ,Humans ,Young adult ,Retrospective Studies ,business.industry ,Graft Survival ,Age Factors ,Retrospective cohort study ,Hepatitis C ,Middle Aged ,medicine.disease ,Liver regeneration ,Liver Transplantation ,030211 gastroenterology & hepatology ,Surgery ,Living donor liver transplantation ,business - Abstract
OBJECTIVE To investigate the influence of donor age on recipient outcome after living-donor partial liver transplantation (LDLT). BACKGROUND Donor age is a well-known prognostic factor in deceased donor liver transplantation; however, its role in LDLT remains unclear. METHODS We retrospectively analyzed 315 consecutive cases of primary adult-to-adult LDLT in our center between April 2006 and March 2014. Recipients were divided into 5 groups according to the donor age: D-20s (n = 60); D-30s (n = 72); D-40s (n = 57); D-50s (n = 94); and D-60s (n = 32). The recipient survival and the association with various clinical factors were investigated. RESULTS Recipient survival proportions were significantly higher in D-20s compared with all the other groups (P = 0.008, < 0.001, < 0.001, and = 0.006, vs D-30s, -40s, -50s, and -60s, respectively), whereas there was no association between recipient survival and their own age. There are 3 typical relationships between donors and recipients in adult-to-adult LDLT: from child-to-parent, between spouses/siblings, and from parent-to-child. The overall survival in child-to-parent was significantly higher than in spouses/siblings (P = 0.002) and in parent-to-child (P = 0.005), despite significantly higher recipient age in child-to-parent [59 (42-69) years, P < 0.001]. Contrastingly, parent-to-child exhibited the lowest survival, despite the youngest recipient age [26 (20-43) years, P < 0.001]. In addition, younger donor age exhibited significantly better recipient survival both in hepatitis C virus-related and in non-hepatitis C virus diseases. Univariate and multivariate analyses both demonstrated that donor age and graft-type (right-sided livers) are independent prognostic factors for recipient survival. CONCLUSIONS Donor age is an independent, strong prognostic factor in adult-to-adult LDLT.
- Published
- 2018