Donor age has a major impact on graft outcome following transplantation for HCV
http://www.gastrohep.com/news/news.asp?id=1444
Donor age has a major impact on graft outcome following transplantation for
HCV
Donor age has a major influence on fibrosis progression in grafts following
transplantation for HCV, claims a team from Birmingham, England.
The researchers investigated fibrosis progression following liver
transplantation for hepatitis C, and the impact that donor age has on this.
The results of the study were published in the August issue of Gut.
A total of 101 post-transplant specimens from 56 HCV-infected liver
transplant patients were examined.
The biopsies were looked at to assess histological activity, including
fibrosis stage (scored 0-6 units, 6 representing established cirrhosis), and
to calculate fibrosis progression rates.
Univariate and multivariate analyses were used to examine the impact of
parameters, including recipient and donor age and sex, on fibrosis
progression rate and on predicted time to cirrhosis.
The median fibrosis progression rate was found to be 0.78 units/year, and
median interval from transplantation to development of cirrhosis was 7.7
years.
In multivariate analysis, donor age (not recipient age) was a powerful
determinant of fibrosis progression rate.
Interval to cirrhosis:
Donors < 40: 10 years
Donors
When the liver donor was younger than 40 years, median progression rate was
0.6 units/year and interval to cirrhosis was 10 years.
However, when the donor was aged 50 years or more, median progression rate
was 2.7 units/year and interval to cirrhosis only 2.2 years.
The investigators found that, during the observation period, there was a
significant increase in donor age. However, date of transplantation per se
was not a determinant of progression rate when included in multivariate
analyses.
Author M. Wali, of the Queen Elizabeth Hospital, Birmingham, said on behalf
of the group, "Donor age has a major influence on graft outcome following
transplantation for HCV.
"The changing organ donor profile will affect the long-term results of liver
transplantation for HCV."
"These observations have important implications for donor liver allocation,"
it was concluded.
Gut 2002; 51: 248-52
22 July 2002