Effect of donor age and sex on the outcome of liver transplantation

Ignazio Roberto Marino, Howard Doyle, Luca Aldrighetti, Cataldo Doria, John McMichael, Timothy Gayowski, John J. Fung, Andreas G. Tzakis, Thomas E. Starzl

Research output: Contribution to journalArticle

168 Citations (Scopus)

Abstract

We correlated donor and recipient factors with graft outcome in 436 adult patients who underwent 462 liver transplants. Donor variables analyzed were age, gender, ABO blood group, cause of death, length of stay in the intensive care unit, use of pressors or pitressin, need for cardiopulmonary resuscitation, terminal serum transaminases, and ischemia time. Recipient variables analyzed were age, gender, primary diagnosis, history of previous liver transplant, ABO blood group, cytotoxic antibody crossmatch, United Network for Organ Sharing (UNOS) status, and waiting time (except for the cross-match results, they were all known at the time of the operation). The endpoint of the analysis was graft failure, defined as patient death or retransplantation. Using multivariate analysis, graft failure was significantly associated with donor age, donor gender, previous liver transplantation, and UNOS 4 status of the recipient. The effect of donor age became evident only when they were older than 45 years. Livers from female donors yielded significantly poorer results, with 2-year graft survival of female to male 55% (95% CI, 45% to 67%); female to female, 64% (95% CI, 54% to 77%); male to male, 72% (95% CI, 66% to 78%); and male to female, 78% (95% CI, 70% to 88%). The only donors identified as questionable for liver procurement were old (-60 years) women in whom the adverse age and gender factors were at least additive. However, rather than discard even these livers, in the face of an organ shortage crisis, their individualized use is suggested with case reporting in a special category.

Original languageEnglish (US)
Pages (from-to)1754-1762
Number of pages9
JournalHepatology
Volume22
Issue number6
DOIs
StatePublished - 1995
Externally publishedYes

Fingerprint

Liver Transplantation
Tissue Donors
Transplants
Liver
Blood Group Antigens
Age Factors
Cardiopulmonary Resuscitation
Graft Survival
Transaminases
Vasopressins
Intensive Care Units
Cause of Death
Length of Stay
Multivariate Analysis
Ischemia
Antibodies
Serum

ASJC Scopus subject areas

  • Hepatology

Cite this

Marino, I. R., Doyle, H., Aldrighetti, L., Doria, C., McMichael, J., Gayowski, T., ... Starzl, T. E. (1995). Effect of donor age and sex on the outcome of liver transplantation. Hepatology, 22(6), 1754-1762. https://doi.org/10.1016/0270-9139(95)90202-3

Effect of donor age and sex on the outcome of liver transplantation. / Marino, Ignazio Roberto; Doyle, Howard; Aldrighetti, Luca; Doria, Cataldo; McMichael, John; Gayowski, Timothy; Fung, John J.; Tzakis, Andreas G.; Starzl, Thomas E.

In: Hepatology, Vol. 22, No. 6, 1995, p. 1754-1762.

Research output: Contribution to journalArticle

Marino, IR, Doyle, H, Aldrighetti, L, Doria, C, McMichael, J, Gayowski, T, Fung, JJ, Tzakis, AG & Starzl, TE 1995, 'Effect of donor age and sex on the outcome of liver transplantation', Hepatology, vol. 22, no. 6, pp. 1754-1762. https://doi.org/10.1016/0270-9139(95)90202-3
Marino IR, Doyle H, Aldrighetti L, Doria C, McMichael J, Gayowski T et al. Effect of donor age and sex on the outcome of liver transplantation. Hepatology. 1995;22(6):1754-1762. https://doi.org/10.1016/0270-9139(95)90202-3
Marino, Ignazio Roberto ; Doyle, Howard ; Aldrighetti, Luca ; Doria, Cataldo ; McMichael, John ; Gayowski, Timothy ; Fung, John J. ; Tzakis, Andreas G. ; Starzl, Thomas E. / Effect of donor age and sex on the outcome of liver transplantation. In: Hepatology. 1995 ; Vol. 22, No. 6. pp. 1754-1762.
@article{809b9065b51a4b7e89afa150229a5452,
title = "Effect of donor age and sex on the outcome of liver transplantation",
abstract = "We correlated donor and recipient factors with graft outcome in 436 adult patients who underwent 462 liver transplants. Donor variables analyzed were age, gender, ABO blood group, cause of death, length of stay in the intensive care unit, use of pressors or pitressin, need for cardiopulmonary resuscitation, terminal serum transaminases, and ischemia time. Recipient variables analyzed were age, gender, primary diagnosis, history of previous liver transplant, ABO blood group, cytotoxic antibody crossmatch, United Network for Organ Sharing (UNOS) status, and waiting time (except for the cross-match results, they were all known at the time of the operation). The endpoint of the analysis was graft failure, defined as patient death or retransplantation. Using multivariate analysis, graft failure was significantly associated with donor age, donor gender, previous liver transplantation, and UNOS 4 status of the recipient. The effect of donor age became evident only when they were older than 45 years. Livers from female donors yielded significantly poorer results, with 2-year graft survival of female to male 55{\%} (95{\%} CI, 45{\%} to 67{\%}); female to female, 64{\%} (95{\%} CI, 54{\%} to 77{\%}); male to male, 72{\%} (95{\%} CI, 66{\%} to 78{\%}); and male to female, 78{\%} (95{\%} CI, 70{\%} to 88{\%}). The only donors identified as questionable for liver procurement were old (-60 years) women in whom the adverse age and gender factors were at least additive. However, rather than discard even these livers, in the face of an organ shortage crisis, their individualized use is suggested with case reporting in a special category.",
author = "Marino, {Ignazio Roberto} and Howard Doyle and Luca Aldrighetti and Cataldo Doria and John McMichael and Timothy Gayowski and Fung, {John J.} and Tzakis, {Andreas G.} and Starzl, {Thomas E.}",
year = "1995",
doi = "10.1016/0270-9139(95)90202-3",
language = "English (US)",
volume = "22",
pages = "1754--1762",
journal = "Hepatology",
issn = "0270-9139",
publisher = "John Wiley and Sons Ltd",
number = "6",

}

TY - JOUR

T1 - Effect of donor age and sex on the outcome of liver transplantation

AU - Marino, Ignazio Roberto

AU - Doyle, Howard

AU - Aldrighetti, Luca

AU - Doria, Cataldo

AU - McMichael, John

AU - Gayowski, Timothy

AU - Fung, John J.

AU - Tzakis, Andreas G.

AU - Starzl, Thomas E.

PY - 1995

Y1 - 1995

N2 - We correlated donor and recipient factors with graft outcome in 436 adult patients who underwent 462 liver transplants. Donor variables analyzed were age, gender, ABO blood group, cause of death, length of stay in the intensive care unit, use of pressors or pitressin, need for cardiopulmonary resuscitation, terminal serum transaminases, and ischemia time. Recipient variables analyzed were age, gender, primary diagnosis, history of previous liver transplant, ABO blood group, cytotoxic antibody crossmatch, United Network for Organ Sharing (UNOS) status, and waiting time (except for the cross-match results, they were all known at the time of the operation). The endpoint of the analysis was graft failure, defined as patient death or retransplantation. Using multivariate analysis, graft failure was significantly associated with donor age, donor gender, previous liver transplantation, and UNOS 4 status of the recipient. The effect of donor age became evident only when they were older than 45 years. Livers from female donors yielded significantly poorer results, with 2-year graft survival of female to male 55% (95% CI, 45% to 67%); female to female, 64% (95% CI, 54% to 77%); male to male, 72% (95% CI, 66% to 78%); and male to female, 78% (95% CI, 70% to 88%). The only donors identified as questionable for liver procurement were old (-60 years) women in whom the adverse age and gender factors were at least additive. However, rather than discard even these livers, in the face of an organ shortage crisis, their individualized use is suggested with case reporting in a special category.

AB - We correlated donor and recipient factors with graft outcome in 436 adult patients who underwent 462 liver transplants. Donor variables analyzed were age, gender, ABO blood group, cause of death, length of stay in the intensive care unit, use of pressors or pitressin, need for cardiopulmonary resuscitation, terminal serum transaminases, and ischemia time. Recipient variables analyzed were age, gender, primary diagnosis, history of previous liver transplant, ABO blood group, cytotoxic antibody crossmatch, United Network for Organ Sharing (UNOS) status, and waiting time (except for the cross-match results, they were all known at the time of the operation). The endpoint of the analysis was graft failure, defined as patient death or retransplantation. Using multivariate analysis, graft failure was significantly associated with donor age, donor gender, previous liver transplantation, and UNOS 4 status of the recipient. The effect of donor age became evident only when they were older than 45 years. Livers from female donors yielded significantly poorer results, with 2-year graft survival of female to male 55% (95% CI, 45% to 67%); female to female, 64% (95% CI, 54% to 77%); male to male, 72% (95% CI, 66% to 78%); and male to female, 78% (95% CI, 70% to 88%). The only donors identified as questionable for liver procurement were old (-60 years) women in whom the adverse age and gender factors were at least additive. However, rather than discard even these livers, in the face of an organ shortage crisis, their individualized use is suggested with case reporting in a special category.

UR - http://www.scopus.com/inward/record.url?scp=0028884552&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028884552&partnerID=8YFLogxK

U2 - 10.1016/0270-9139(95)90202-3

DO - 10.1016/0270-9139(95)90202-3

M3 - Article

C2 - 7489985

AN - SCOPUS:0028884552

VL - 22

SP - 1754

EP - 1762

JO - Hepatology

JF - Hepatology

SN - 0270-9139

IS - 6

ER -