Older donor allografts are associated with poor patient survival after living donor liver transplantation for hepatitis B virus-related liver diseases

Background and Aims: The significance of donor age in living donor liver transplantation (LDLT) for hepatitis B virus (HBV) infection has not been fully evaluated. Methods: We analyzed the data of 136 patients who underwent LDLT for HBV-related liver diseases from January 1999 to April 2004. The recipients were divided into an older donor group (donor age ≥40) and a younger donor group (donor age <40). Posttransplant clinical outcomes and survival were compared between two groups, and predictors of survival after LDLT were evaluated. Results: Baseline characteristics were not different between the two groups, except for more number of female donors and higher positive donor anti-HBc rate in the older group. The frequencies of acute rejection and early mortality after transplantation were similar in the two groups. The long-term survival rates for the older donor group were significantly lower than those of the younger donor group (1-, 3-, 5-year survival rate = 84%, 75%, 46% vs. 92%, 86%, and 83%, P = 0.03). Multivariate analysis showed that older donor age was the only independent risk factor associated with survival after LDLT (HR = 2.3; 95% CI = 1.1-5.6, P = 0.04). Conclusions: Our study suggests that older donor allografts would be associated with poor patient survival after LDLT for HBV-related liver diseases.