ArticleWorld journal of transplantation2025
Donor-recipient age mismatch and outcomes in liver transplantation: A scientific registry of transplant recipients database analysis.
Article in World journal of transplantation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundOld donor allografts in liver transplantation (LT) account for 25% of all allografts, and their utilization is projected to increase with the aging general population. Older allografts are associated with higher rates of all-cause mortality and graft failure; however, there is limited literature exploring the specific phenotypic changes (
aimTo investigate differences in functional impairment and cause-specific mortality between different donor:recipient age pairs.
methodsThis was a retrospective analysis of LT patients from the Scientific Registry of Transplant Recipients from 2002 to 2022. Donors were categorized into younger age donors, ≤ 45-years (YAD), middle-aged donors, 46-69-years (MAD), and older age donors, ≥ 70-years (OAD). Recipients were categorized into younger age recipients, ≤ 55-years (YAR) and older age recipients, > 55-years (OAR) age recipients. Multivariate Fine-Gray competing risk and logistic regression analyses identified independent risk factors for cause-specific mortality and improvements in functional status, respectively.
resultsOverall, 126185 patients were included in the analysis: YAD:YAR (32.7%), YAD:OAR (25.2%), MAD:YAR (17.5%), MAD:OAR (20.7%), OAD:YAR (1.3%), and OAD:OAR (2.7%). Compared to YAD:YAR, OAD pairs had the lowest likelihoods of improved functional status 5 years post-LT (OAD:YAR odds ratio 0.53, 95% confidence interval 0.42-0.67,
conclusionDonor:recipient age mismatch was associated with differences in cause-specific mortality and functional status. These insights could potentially inform age-matched organ allocation strategies, though future work is warranted.
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