The prognostic relationship between donor age and infectious risk in liver transplant patients with nonalcoholic steatohepatitis: Analysis of UNOS database

We investigate the effects of advancing donor age on the prognostic outcomes of patients with NASH who undergo liver transplant (LT), with a specialized attention toward infectious outcomes post-LT. The UNOS-STAR registry was used to select 2005 to 2019 LT recipients with NASH, who were stratified b...

Full description

Saved in:
Bibliographic Details
Published in:Digestive and liver disease 2023-06, Vol.55 (6), p.751-762
Main Authors: Lee, David Uihwan, Ponder, Reid, Lee, Ki Jung, Chou, Harrison, Lee, Keeseok, Jung, Daniel, Fan, Gregory Hongyuan, Urrunaga, Nathalie Helen
Format: Article
Language:English
Subjects:
Advancing donor age
Age Factors
Aged
Aged, 80 and over
Aging and frailty
Graft Survival
Humans
Liver Transplantation - adverse effects
Liver-transplants
Middle Aged
NASH
Non-alcoholic Fatty Liver Disease - etiology
Post-transplant prognosis
Prognosis
Tissue Donors
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:We investigate the effects of advancing donor age on the prognostic outcomes of patients with NASH who undergo liver transplant (LT), with a specialized attention toward infectious outcomes post-LT. The UNOS-STAR registry was used to select 2005 to 2019 LT recipients with NASH, who were stratified by donor age into the following categories: recipients with younger donors (less than 50 years of age–reference), quinquagenarian donors, sexagenarian donors, septuagenarian donors, and octogenarian donors. Cox regression analyses were conducted for all-cause mortality, graft failure, infectious causes of death. From a total of 8888 recipients, the quinquagenarian, septuagenarian, and octogenarian donor cohorts showed greater risk of all-cause mortality (quinquagenarian: aHR 1.16 95%CI 1.03–1.30; septuagenarian: aHR 1.20 95%CI 1.00–1.44; octogenarian: aHR 2.01 95%CI 1.40–2.88). With advancing donor age, there was an increased risk of death from sepsis (quinquagenarian: aHR 1.71 95% CI 1.24–2.36; sexagenarian: aHR 1.73 95% CI 1.21–2.48; septuagenarian: aHR 1.76 95% CI 1.07–2.90; octogenarian: aHR 3.58 95% CI 1.42–9.06) and infectious causes (quinquagenarian: aHR 1.46 95% CI 1.12–1.90; sexagenarian: aHR 1.58 95% CI 1.18–2.11; septuagenarian: aHR 1.73 95% CI 1.15–2.61; octogenarian: aHR 3.70 95% CI 1.78–7.69). NASH patients who receive grafts from elderly donors exhibit higher risk of post-LT mortality, especially due to infection.
ISSN:1590-8658
1878-3562
DOI:10.1016/j.dld.2023.01.160