TY - JOUR
T1 - Grafts from selected deceased donors over 80 years old can safely expand the number of liver transplants
T2 - A systematic review and meta-analysis
AU - Domagala, Piotr
AU - Takagi, Kosei
AU - Ijzermans, Jan N.
AU - Polak, Wojciech G.
N1 - Funding Information:
The authors thank Wichor M. Bramer (Biomedical Information Specialist) from the Medical Library in Erasmus MC, Erasmus University Medical Centre Rotterdam (Rotterdam, the Netherlands) for help in constructing research queries in databases. Piotr Domagala and Kosei Takagi contributed equally to this manuscript as co-first authors.
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/10
Y1 - 2019/10
N2 - Aim: The aim of this systematic review and meta-analysis was to present the outcome of deceased adult liver transplantation from octogenarian (≥80 years old) donors compared to younger grafts. Methods: A systematic search was performed on six databases to identify all available original papers that report the outcome of adult recipients who underwent liver transplantation from a deceased octogenarian donor. Results: Overall, 39,034 liver transplantations from 12 studies were reported with 789 (2.02%) cases receiving grafts from octogenarian donors. Eight studies were included in the meta-analysis. There was no difference regarding the one, three, and five-year graft and patient survival between the recipients of livers <80 years old and octogenarian grafts. There were significantly more episodes of biliary complications in the recipients of octogenarian grafts (34/459; 7.4%) in comparison to the recipients of livers <80 years old (372/37074; 1.0%) (OR 0.53; 95% CI = 0.35–0.81; P 0.004; I2 = 0%). The incidence of primary non-function, vascular complications and re-transplantation did not differ between groups. Conclusions: The short- and medium-term graft and patient survival of octogenarian liver transplantation is not inferior compared to the liver transplantation with younger grafts, however with a higher rate of biliary complications.
AB - Aim: The aim of this systematic review and meta-analysis was to present the outcome of deceased adult liver transplantation from octogenarian (≥80 years old) donors compared to younger grafts. Methods: A systematic search was performed on six databases to identify all available original papers that report the outcome of adult recipients who underwent liver transplantation from a deceased octogenarian donor. Results: Overall, 39,034 liver transplantations from 12 studies were reported with 789 (2.02%) cases receiving grafts from octogenarian donors. Eight studies were included in the meta-analysis. There was no difference regarding the one, three, and five-year graft and patient survival between the recipients of livers <80 years old and octogenarian grafts. There were significantly more episodes of biliary complications in the recipients of octogenarian grafts (34/459; 7.4%) in comparison to the recipients of livers <80 years old (372/37074; 1.0%) (OR 0.53; 95% CI = 0.35–0.81; P 0.004; I2 = 0%). The incidence of primary non-function, vascular complications and re-transplantation did not differ between groups. Conclusions: The short- and medium-term graft and patient survival of octogenarian liver transplantation is not inferior compared to the liver transplantation with younger grafts, however with a higher rate of biliary complications.
KW - Biliary complications
KW - Graft survival
KW - Liver transplantation
KW - Octogenarian donors
KW - Systematic review
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U2 - 10.1016/j.trre.2019.06.004
DO - 10.1016/j.trre.2019.06.004
M3 - Review article
C2 - 31303351
AN - SCOPUS:85068585327
VL - 33
SP - 209
EP - 218
JO - Transplantation Reviews
JF - Transplantation Reviews
SN - 0955-470X
IS - 4
ER -