Impact of donor age on right lobe living donor liver transplantation in a single centre

Abstract

Background: With limited availability of deceased donor, living donor from a family member accounted for the majority of liver transplantation as a definitive or even life-saving treatment for end-stage liver disease in Hong Kong. The impact of donor age on the outcomes of both donor hepatectomy and living donor liver transplantation had not been clarified. Methods: We performed retrospective analysis of recipients of right lobe living donor liver transplantation (RL LDLT) between May 1996 and December 2007 in our centre by same team of surgeons. Patients were divided into 2 groups, donor age ≤45 years (group A) and >45 years (group B). Blood loss, operation time, and post-operative complications of donor right hepatectomy were compared. Graft survival, acute cellular rejection, and post-operative complications of recipients were also compared. Results: There were 287 RL LDLT performed in this period, 230(80%) patients in group A and 57(20%) in group B. There was signifi cantly more female donors in group B (60% vs. 80%, p=0.004). Operation time in both groups were comparable (454 minutes vs. 458minutes, p=0.448). Donor right hepatectomy in group B had more blood loss (312ml vs. 389ml, p=0.035), and longer hospital stay (7 days vs. 9 days, p=0.003). The complication rates between two groups of donors were comparable (17% vs. 15.8%, p=0.833). There was no significant difference in liver function between two groups within first week after operation. There was no hospital mortality of donors in both groups.For recipients, both groups had comparable demographic characteristics, MELD scores and percentage of graft weight to estimated standard liver volume (ESLV). Post-operative complication rate were 55.2% vs. 57.9% (p=0.716). Incidence of acute cellular rejection were 16.5% vs. 19.3% (p=0.618). 1-, 3- and 5-year graft survivals among two groups were comparable (93%, 86%, 82% vs. 93%, 84%, 79%, p=0.47). Conclusion: Provided stringent selection protocol and standardized surgical technique, right hepatectomy was safe for older donor. Impact of donor age was not significant on outcomes of living donor liver transplantation.