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Differential Effects of Donor Age in Liver Transplant Recipients Infected With Hepatitis B, Hepatitis C and Without Viral Hepatitis

  1. John R. Lake1,*,
  2. Jolene S. Shorr2,
  3. Bettina J. Steffen2,
  4. Alice H. Chu2,
  5. Robert D. Gordon3,
  6. Russell H. Wiesner4

Article first published online: 11 FEB 2005

DOI: 10.1111/j.1600-6143.2005.00741.x

Issue

American Journal of Transplantation

American Journal of Transplantation

Volume 5, Issue 3, pages 549–557, March 2005

Additional Information

How to Cite

Lake, J. R., Shorr, J. S., Steffen, B. J., Chu, A. H., Gordon, R. D. and Wiesner, R. H. (2005), Differential Effects of Donor Age in Liver Transplant Recipients Infected With Hepatitis B, Hepatitis C and Without Viral Hepatitis. American Journal of Transplantation, 5: 549–557. doi: 10.1111/j.1600-6143.2005.00741.x

Author Information

  1. 1

    Gastroenterology Division, University of Minnesota, Minneapolis, Minnesota, USA

  2. 2

    ProSanos Corporation, La Jolla, California, USA

  3. 3

    Medical Affairs, Roche Laboratories, Inc., Nutley, New Jersey, USA

  4. 4

    Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA

* *Corresponding author: John R. Lake, lakex009@tc.umn.edu.

Publication History

  1. Issue published online: 11 FEB 2005
  2. Article first published online: 11 FEB 2005
  3. Received 30 July 2004, revised 11 October, 2004 and accepted for publication 18 October 2004

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Keywords:

  • Donor age;
  • graft survival;
  • hepatitis C;
  • mycophenolate mofetil;
  • patient survival;
  • tacrolimus

The variable impact of specific risk factors on survival outcomes based on pre-transplantation diagnosis was analyzed in adult liver transplant recipients reported to the Scientific Registry of Transplant Recipients: 778 with hepatitis B (HBV), 3463 with hepatitis C (HCV) and 7429 without viral hepatitis. Graft and patient survival for the HBV and no viral hepatitis groups did not differ significantly. The HCV group had significantly lower graft (p = 0.0019) and patient survival (p < 0.0001) than the no viral hepatitis group. Patient survival was significantly lower (p = 0.0011) for HCV compared to HBV patients; differences in graft survival approached significance (p = 0.0561). Donor age, which was not a risk factor in patients with HBV, was the strongest predictor of graft loss and death in patients with HCV, starting with donors >40 years. Donor age >60 years was the strongest predictor of graft loss and death in patients without viral hepatitis. The risks of graft loss and death were reduced for patients on tacrolimus-based immunosuppression with mycophenolate mofetil, regardless of disease etiology. There are clear differences in risk factors for poor outcomes based on underlying liver disease, particularly with regard to the impact of donor age.

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