Does matching donor-recipient age affect long-term survival in liver transplantation?

Background: The characteristics of liver donors have changed over the last decade owing to the shortage of organs and high mortality on the waiting list,leading to wider use of extended-criteria donors,including older donors. The aim of this study was to evaluate the effect of matching donor-recipient age on morbidity at 1 year post-transplant and on long-term patient and graft survival. Material/Methods: Retrospective study from a prospectively-obtained database including adult patients who had received a primary liver transplant (LT) from whole graft of brain-dead donors. Recipients were divided into 2 age groups: <60 years and ≥60 years. Both groups were sub-divided according to donor age (younger than 60 years and 60 years or older). A propensity score analysis was performed to further adjust for baseline differences between recipients and donors. Results: We analyzed 642 patients who had LT performed between January 2000 and December 2013. No differences were observed in 1-year morbidity (hospital stay,rejection,surgical complications,and retransplant) between groups. Although patient and graft survival was significantly impaired in the older donor/older recipient group on Kaplan-Meier analysis (p=0.004),the propensity score analysis showed that donor age ≥60 years did not increase the risk of death for recipients aged ≥60 (HR1.40,p 0.074) and <60 years (HR 1.47,p 0.070). Conclusions: Older donor age did not negatively affect survival regardless of recipient age,and comparable outcomes were achieved without an increased rate of complications.