ACS: accepting liver from older donor better than waiting

(HealthDay)—Accepting a liver from an older liver donor (OLD) is associated with long-term survival benefit, according to a study presented at the annual meeting of the American College of Surgeons, held from Oct. 21 to 25 in Boston.

Christine E. Haugen, M.D., from the Johns Hopkins University in Baltimore, and colleagues identified 42,533 adult liver transplantation candidates offered OLDs that were eventually transplanted in another recipient. Patients were followed from date of offer until death or the end of the study.

The researchers found that 48.8 percent of candidates who declined an OLD had died or were removed from the waitlist after five years. Compared with candidates who declined OLDs, the risk for mortality was lower for candidates who accepted OLDs within 90 days post-decision (adjusted hazard ratio, 0.61) and beyond 90 days post-decision (adjusted hazard ratio, 0.39). OLD acceptance correlated with a decreased risk for mortality beyond 90 days for candidates with a Model for End-Stage Liver Disease (MELD) score of 10 to 24 or 25 to 34 (adjusted hazard ratios, 0.44 and 0.46, respectively). OLD acceptance also correlated with a reduced risk for mortality within the first 90 days for candidates with a MELD score of 35 to 40 (adjusted hazard ratio, 0.22).

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