Long-Term Results Using Old Liver Grafts for Transplantation: Sexagenerian Versus Liver Donors Older than 70 Years



The most practical measure to augment the available number of liver grafts and thus reduce waiting list mortality is to increase the donor age limit. We hypothesized that with careful selection of old liver donors without age limit it should be possible to obtain good patient and graft survival.


The present study comprises 351 adults who underwent liver transplantation. They were divided into three groups according to the age of the liver donors: group 1: 226 recipients of donors <60 years; group 2: 75 recipients of donors between 60 and 70 years; and group 3: 50 recipients of donors >70 years. A comparative study among the groups was performed.


Patient survival rates at 1, 3, and 5 years were, respectively, 81.0, 76.1, and 71.1 % in group 1; 83.8, 74, and 72.2 % in group 2; and 76, 70.0, and 62.9 % in group 3 (P = NS). Graft survival at 1, 3, and 5 years was, respectively, 74.8, 69.0, and 64.1 % in group 1; 82.7, 71.4, and 69.6 % in group 2; and 71.4, 64.8, and 58.3 % in group 3 (P = NS). We analyzed the use of older grafts in recipients with HCV cirrhosis and did not find significant differences in patient and graft survival at 1, 3, and 5 years. In multivariate analysis increased donor body mass index and decreased recipient albumin were associated with lower patient and graft survival.


Because patient and graft survival rates are not affected by donor age, well-selected older donor livers can be safely used if they show good function and preharvesting conditions.

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Body mass index


Confidence interval


Cold ischemia time


Fresh frozen plasma


Gamma-glutamyl transpeptidase


Glutamic oxaloacetic transaminase


Glutamic pyruvic transaminase


Hepatitis B virus




Hepatitis C virus


Hazard ratio


Intensive care unit


Initial poor function


Ortothopic liver transplantation


Primary nonfunction


packed red blood cells


Warm ischemia time


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The authors thank Javier de la Cruz and David Lora for contributions to the statistical analysis. We also thank Dr. M. Abradelo, Dr. F. Cambra, and Dr. F. Colina for collaboration in this article.

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Correspondence to Carlos Jiménez-Romero.

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Jiménez-Romero, C., Clemares-Lama, M., Manrique-Municio, A. et al. Long-Term Results Using Old Liver Grafts for Transplantation: Sexagenerian Versus Liver Donors Older than 70 Years. World J Surg 37, 2211–2221 (2013). https://doi.org/10.1007/s00268-013-2085-7

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  • Graft Survival
  • Intensive Care Unit Stay
  • Orthotopic Liver Transplantation
  • Chronic Rejection
  • Liver Graft