Prolonged allograft survival in liver transplantation
Introduction: Donor age has traditionally been considered a factor associated with allograft failure in liver transplantation. We sought to examine the characteristics and outcomes of all liver allografts with a cumulative age of over 80 years within the US to better understand liver senescence. Met...
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Elsevier
2025-04-01
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| Series: | Surgery Open Science |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589845025000259 |
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| author | Yash Kadakia, MD Andrew D. Shubin, MD, PhD Malcolm MacConmara, MBBCh FACS Madhukar S. Patel, MD, MBA, ScM Jorge A. Sanchez-Vivaldi, MD Lauren E. Matevish, MD Steven I. Hanish, MD, FACS Parsia A. Vagefi, MD, FACS Christine S. Hwang, MD, FACS |
| author_facet | Yash Kadakia, MD Andrew D. Shubin, MD, PhD Malcolm MacConmara, MBBCh FACS Madhukar S. Patel, MD, MBA, ScM Jorge A. Sanchez-Vivaldi, MD Lauren E. Matevish, MD Steven I. Hanish, MD, FACS Parsia A. Vagefi, MD, FACS Christine S. Hwang, MD, FACS |
| author_sort | Yash Kadakia, MD |
| collection | DOAJ |
| description | Introduction: Donor age has traditionally been considered a factor associated with allograft failure in liver transplantation. We sought to examine the characteristics and outcomes of all liver allografts with a cumulative age of over 80 years within the US to better understand liver senescence. Methods: Using the UNOS STARfile, allografts with a cumulative age (sum of age at transplant plus post-transplant survival) of octogenarian, 90–99 nonagenarian, and 100 years or greater (centurion) were identified from all adult transplant recipients between 1990 and 2022. Donor and recipient data as well as outcomes were analyzed. Results: There were 3437 octogenarian, 622 nonagenarian, and 29 centurion allografts. Donors from allografts with prolonged cumulative age had less diabetes, less alcohol use, and fewer infections compared to all other donors. Recipients had significantly lower MELD scores at the time of transplant and dialysis rates. Conclusions: Careful matching of older donors with lower MELD recipients results in excellent outcomes as evidenced by the presence of prolonged cumulative age livers, demonstrating the resilience of the liver to senescent events in appropriately matched recipients. |
| format | Article |
| id | doaj-art-55e3ee18c3ee4569a69686fac56a1ed9 |
| institution | DOAJ |
| issn | 2589-8450 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Surgery Open Science |
| spelling | doaj-art-55e3ee18c3ee4569a69686fac56a1ed92025-08-20T03:14:59ZengElsevierSurgery Open Science2589-84502025-04-012581310.1016/j.sopen.2025.03.006Prolonged allograft survival in liver transplantationYash Kadakia, MD0Andrew D. Shubin, MD, PhD1Malcolm MacConmara, MBBCh FACS2Madhukar S. Patel, MD, MBA, ScM3Jorge A. Sanchez-Vivaldi, MD4Lauren E. Matevish, MD5Steven I. Hanish, MD, FACS6Parsia A. Vagefi, MD, FACS7Christine S. Hwang, MD, FACS8Department of Surgery, University of Pennsylvania, Pennsylvania Hospital, Philadelphia, PA, USADepartment of Surgery, Division of Surgical Transplantation, University of Texas Southwestern Medical Center, Dallas, TX, USA; Division of Pediatric Transplantation, Children's Medical Center, Dallas, TX, USATransMedics Inc, Andover, MA, USADepartment of Surgery, Division of Surgical Transplantation, University of Texas Southwestern Medical Center, Dallas, TX, USA; Division of Pediatric Transplantation, Children's Medical Center, Dallas, TX, USAPrograma Transplante Hígado Adulto Y Pedíatrico, Auxilio Mutuo, San Juan, PR, USADepartment of Surgery, Division of Surgical Transplantation, University of Texas Southwestern Medical Center, Dallas, TX, USADivision of Transplant Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC, USADepartment of Surgery, Division of Surgical Transplantation, University of Texas Southwestern Medical Center, Dallas, TX, USA; Division of Pediatric Transplantation, Children's Medical Center, Dallas, TX, USADepartment of Surgery, Division of Surgical Transplantation, University of Texas Southwestern Medical Center, Dallas, TX, USA; Division of Pediatric Transplantation, Children's Medical Center, Dallas, TX, USA; Corresponding author at: University of Texas Southwestern Medical Center, 5339 Harry Hines Blvd., 4th Floor, Dallas, TX 75390-8567, USA.Introduction: Donor age has traditionally been considered a factor associated with allograft failure in liver transplantation. We sought to examine the characteristics and outcomes of all liver allografts with a cumulative age of over 80 years within the US to better understand liver senescence. Methods: Using the UNOS STARfile, allografts with a cumulative age (sum of age at transplant plus post-transplant survival) of octogenarian, 90–99 nonagenarian, and 100 years or greater (centurion) were identified from all adult transplant recipients between 1990 and 2022. Donor and recipient data as well as outcomes were analyzed. Results: There were 3437 octogenarian, 622 nonagenarian, and 29 centurion allografts. Donors from allografts with prolonged cumulative age had less diabetes, less alcohol use, and fewer infections compared to all other donors. Recipients had significantly lower MELD scores at the time of transplant and dialysis rates. Conclusions: Careful matching of older donors with lower MELD recipients results in excellent outcomes as evidenced by the presence of prolonged cumulative age livers, demonstrating the resilience of the liver to senescent events in appropriately matched recipients.http://www.sciencedirect.com/science/article/pii/S2589845025000259LiverTransplantDonor ageOutcomes |
| spellingShingle | Yash Kadakia, MD Andrew D. Shubin, MD, PhD Malcolm MacConmara, MBBCh FACS Madhukar S. Patel, MD, MBA, ScM Jorge A. Sanchez-Vivaldi, MD Lauren E. Matevish, MD Steven I. Hanish, MD, FACS Parsia A. Vagefi, MD, FACS Christine S. Hwang, MD, FACS Prolonged allograft survival in liver transplantation Surgery Open Science Liver Transplant Donor age Outcomes |
| title | Prolonged allograft survival in liver transplantation |
| title_full | Prolonged allograft survival in liver transplantation |
| title_fullStr | Prolonged allograft survival in liver transplantation |
| title_full_unstemmed | Prolonged allograft survival in liver transplantation |
| title_short | Prolonged allograft survival in liver transplantation |
| title_sort | prolonged allograft survival in liver transplantation |
| topic | Liver Transplant Donor age Outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S2589845025000259 |
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