Background. The global organ shortage and aging population lead to the use of liver grafts with increasing donor–recipient age discrepancies. This study evaluated the impact of donor–recipient age mismatch on posttransplant outcomes. Methods. Organ Procurement and Transplantation Network/United Network for Organ Sharing data were analyzed, stratifying donor-to-recipient pairs by age difference: young-to-old (≥20 y), old-to-young (≥20 y), and similar-age group (60 or >70 y old showed markedly reduced 1-y survival of 81%–82%. The multivariate analysis confirmed an independent 10% increase in 1-y graft failure in the old-to-young compared with similar-age group ( P = 0.021). Conclusions. A greater donor-to-recipient age difference, particularly with older donors, negatively impacted liver graft survival. However, patient survival was not affected, supporting the use of older grafts to optimize transplant benefits for selected recipient populations.
Shirini et al. (Wed,) studied this question.