Outcome of liver transplantation using donors 60 to 79 years of age.

Abstract

As of March 31, 1994, there were 34,493 patients on the United Network for Organ Sharing (UNOS) waiting list,1 up from 13,115 in December 31, 1987, an increase of 263%. Of these, 3264 awaited liver transplantation (OLT), up from 449 in 1987 (727% increase). The supply of organ donors, on the other hand, underwent a marginal increase between 1988 and 1990 (from 4085 to 4514), and has remained relatively stable since (4531 in 1991, 4521 in 1992, and 4849 in 1993). Consequently, although the need has increased dramatically, we observe with mounting concern the persistent wastage of available organs and the death of potential recipients. Many routes have been explored in an attempt to remedy this situation, including the development of artificial organs,2 utilization of living donors, even for extrarenal organs,3 xenotransplantation,4,5 and non-heartbeating donors.6,7 However, a more immediate impact on organ shortage could be effected by changing the current donor selection criteria to include the so-called marginal donors (ie, obese or older living donors).