What the study found
The study found that donor age has a stronger negative association with liver transplant outcomes in younger recipients than in older ones. Older recipients appeared to tolerate older donor livers with less impact on survival.
Why the authors say this matters
The authors conclude that these findings support more age-conscious organ allocation strategies and provide thresholds that may help guide donor-recipient matching in liver transplantation. They present donor-recipient age matching as relevant because donor and recipient populations are aging.
What the researchers tested
The researchers analyzed adult and pediatric liver transplant recipients in the U.S. from 2011 to 2021. They examined donor and recipient characteristics, time trends, and allocation patterns, and used multivariable Cox models to assess donor age across recipient age groups for patient survival, graft survival, and death-censored graft survival.
What worked and what didn't
The cohort included 57,142 liver transplant recipients, with a median age of 57 years, and donors with a mean age of 41.1 years. From 2011 to 2021, mean donor and recipient age increased modestly but significantly, and five-year patient and graft survival declined as donor age increased, especially among younger recipients. Donor age over 45 years was linked to higher mortality and graft failure in recipients 35 years old or younger, while outcomes in recipients 65 years old or older were largely unaffected; death-censored analyses showed similar trends, and the donor-recipient age interaction was statistically significant across all outcomes.
What to keep in mind
The summary does not describe limitations in detail beyond the study being based on U.S. transplant data from 2011 to 2021. The findings are reported as associations from modeled analyses rather than as a direct test of changing allocation policy.
Key points
- The study found a significant donor-recipient age interaction for all measured outcomes.
- Donor age over 45 years was associated with worse survival and graft outcomes in recipients 35 years old or younger.
- Recipients 65 years old or older were largely unaffected by donor age.
- Five-year patient and graft survival declined as donor age increased, especially in younger recipients.
- Mean donor and recipient age both increased modestly but significantly from 2011 to 2021.
Disclosure
- Research title:
- Donor age affects younger liver transplant recipients more
- Authors:
- Charbel Elias, Jason Mial-Anthony, Abiha Abdullah, Vrishketan Sethi, Amaan Rahman, Xingyu Zhang, Sabin Subedi, Godwin Packaraj, Stalin Dharmayan, Christopher Kaltenmeier, Hao Liu, Michele Molinari
- Institutions:
- University of Pittsburgh, University of Pittsburgh Medical Center, University of Pittsburgh Medical Center, University of Pittsburgh Medical Center, University of Pittsburgh Medical Center, University of Pittsburgh Medical Center, University of Pittsburgh Medical Center, University of Pittsburgh Medical Center, University of Pittsburgh Medical Center, University of Pittsburgh Medical Center, University of Pittsburgh Medical Center, University of Pittsburgh Medical Center
- Publication date:
- 2026-03-05
- OpenAlex record:
- View
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