The effect of donor age on the outcome of Liver Transplant in patients with Hepatitis B Virus Infection

Abstract

BACKGROUND: Liver regeneration power has been showed to decrease with advanced age. Large scale analysis for hepatitis B virus infection in this aspect is lacking. Objectives: Since liver donation rate is still very low in many parts of the world, we aim to study whether the use of advanced donor age liver graft has an adverse effect on survival in patients with hepatitis B virus infection. METHODS: 918 patients received liver transplantation in Queen Mary Hospital between January 1996 to December 2011. Patients with hepatitis B virus related pathology who had undergone deceased donor liver transplantation were included and the outcome of liver transplantation were studied. RESULTS: Amongst the 214 patients included, 135 patients were transplanted for cirrhosis, 48 patients for acute on chronic live failure, and 30 patients for acute fl are of hepatitis B virus infection. 57 patients had concomitant hepatocellular carcinoma. The median age of the donor was 54 year (range 2-76). Liver donors were divided in to two groups by the donor age. Group 1 consisted of donor less than or equals to 60 years (n=184). Group 2 consisted of donor age more than 60 years (n=30). The median recipient age for group 1 was 48.5 years. The median recipient age for group 2 was 49 years . (p=0.297) The median MELD score for group 1 was 29 (range 13-56). The median recipient age for group 2 was 24 years. (p=0.436). The median graft weigh was 1032.5g (range 810-1600g) in group 2 which is lower than the median graft weight in group 1 patients (1210g)( range 365-2180g) (p=0.007). The median estimated standard liver volume (ESLV) was 83.3% (range 61.4- 136.6%) in group 2 which is lower than the median ESLV in group 1 patients (98.3%) (Range 31.9%-177.9%) (p=0.013). The 1 year, 3 year and 5 year graft survival for group 1 patients was 93.4%, 88.7%, 88.7% respectively. The 1 year, 3 year and 5 year graft survival for group 1 patients was 90.5%, 90.5%, 90.5% respectively. (p=0.682). The 1 year, 3 year and 5 year overall survival for group 1 patients was 93.4%, 90.2%, 90.2% respectively. The 1 year, 3 year and 5 year graft survival for group 1 patients was 90.5%, 90.5%, 90.5% respectively. (p=0.809). CONCLUSION: Advanced donor age does not seem to have adverse effect on graft and patients survival for transplant patients with hepatitis B virus infection.