Background: Past studies on donor age in liver transplantation have largely relied on binary groups (i.e., young vs. old) with arbitrarily defined cut-offs. The aim of this study is to describe the impact of 10-year increments of donor age on liver transplant outcomes.

Methods: The United Network for Organ Sharing liver transplant database was reviewed for all first adult liver transplants between March 2002 and September 2016. 70,492 recipients were categorized by 10-year increments in donor age. Multivariate time-to-event Cox regression was performed for graft survival and multivariate logistic regression was performed for prolonged length of stay (PLOS), defined as > 30 days post-transplant. Recipients that died or had graft failure prior to discharge were censored from the PLOS analysis. Confounding variables found to be significant upon univariate regression were entered into the multivariate model. All donor age groups were forced into the multivariate regression, with the group encompassing the mean donor age set as the reference.

Results: Mean donor age in this cohort was 41.8 years. As demonstrated in Figure 1, nearly each 10-year increment in donor age incurred additional risk for graft loss, even after adjustment for multiple other risk factors. Donor age was inconsistently associated with PLOS (Figure 2).

Conclusion: Donor age is an important risk factor for graft loss, but not necessarily for other complications that might prolong the hospital course without causing graft failure. Rather than a threshold effect, risk for graft failure incrementally increases with donor age. Therefore, donor age should not be regarded as a binary variable.

CITATION INFORMATION: Yoeli D., Pan E., Kueht M., Galvan N., Cotton R., O'Mahony C., Goss J., Rana A. When Does Donor Age Matter? A Review of over 70,000 Liver Transplants Am J Transplant. 2017;17 (suppl 3).

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