Use of liver grafts from older donors decreased despite better outcomes in recipients

More than 10 percent of patients waiting for a liver transplant die each year. This observational study looked at trends in the transplantation of livers from older donors (70 and older) and outcomes in recipients of these older livers from 2003 to 2016. There was a decrease in the use of liver grafts from older donors despite improvements in liver graft loss and death among recipients of these older liver grafts.

The study included 4,127 liver grafts from older donors and 3,350 liver-only recipients of these older liver grafts, and 78,990 liver grafts from younger donors (18 to 69) and 64,907 liver-only recipients of these younger liver grafts. A limitation of the study was the inability to determine whether the improvement in outcomes was associated with improved post-transplant care or improved older donor candidate selection. The findings suggest it may be reasonable to expand the donor pool with broader use of liver grafts from older donors.