Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Dec 24, 2017; 7(6): 324-328
Published online Dec 24, 2017. doi: 10.5500/wjt.v7.i6.324
Elderly donor graft for liver transplantation: Never too late
Harleen Chela, Mohamad H Yousef, Abdelmajeed A Albarrak, Bhupinder S Romana, Dania N Hudhud, Veysel Tahan
Harleen Chela, Dania N Hudhud, Department of Internal Medicine, University of Missouri, Columbia, MO 65212, United States
Mohamad H Yousef, Abdelmajeed A Albarrak, Bhupinder S Romana, Veysel Tahan, Division of Gastroenterology and Hepatology, Missouri University, Columbia, MO 65212, United States
Author contributions: All authors contributed to the acquisition of data, writing and revision of this manuscript.
Conflict-of-interest statement: All the authors have no conflicts of interests to declare. All authors of this article declare that was no conflicting interests (including but not limited to commercial, personal, political, intellectual or religious interests) that are related to the work submitted for consideration of publication.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Veysel Tahan, MD, FACP, FACG, FESBGH, Division of Gastroenterology and Hepatology, University of Missouri, 1 Hospital Dr., Columbia, MO 65212, United States.
Telephone: +1-573-8846044 Fax: +1-573-8844595
Received: November 4, 2017
Peer-review started: November 5, 2017
First decision: November 20, 2017
Revised: November 27, 2017
Accepted: December 5, 2017
Article in press: December 6, 2017
Published online: December 24, 2017

The definitive treatment for end stage liver disease remains a liver transplant and hence livers are needed for these patients along with cases of acute fulminant liver failure. Hence livers are a scarce and highly valuable commodity in the current time. By extending the pool of donors to include the elderly livers, it allows for increased availability of donors and reduces the mortality that is associated with the waiting list itself. There is an increasing prevalence of end stage liver disease due to conditions like chronic hepatitis B and C, non-alcoholic steatohepatitis, alcoholic liver disease. Many studies show non-inferior outcomes when elderly livers are used as a vigorous selection process is implemented. The process takes into account the characteristics of the donor, graft and recipient allowing for appropriate donor-recipient coupling. To meet the increasing demands of livers, elderly donors should be utilized for liver transplantation. The aim of this review article is to describe the aging process of the liver and the outcomes associated with use of elderly livers for transplantation.

Keywords: Liver transplantation, Donor age, Elderly, Age, Outcome, Success

Core tip: There is an increasing demand of livers for transplantation. Several studies showed successful results with elderly donors. We reviewed the aging process of the liver and the transplant outcomes of elderly donors. We highlight that elderly donors can be utilized given the extensive screening process allowing for risk factor analysis and appropriate allocation. Hence they should be used to allow for treatment of liver disease globally and help mitigate the shortage of hepatic grafts.