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01 December 2009

Aging of the liver graft and functional quality in the absence of recurrent disease: A 10 year histological follow-up

Maximilian Schmeding, Igor Sauer, Kerstin Hartwig, Tom Theruvath, Johann Pratschke, Ruth Neuhaus, Peter Neuhaus, Ulf P. Neumann

DOI: 10.12659/AOT.880562

Ann Transplant 2010; 15(1): 5-13

Abstract

Background: Although considerable information has been acquired concerning the function of older donor liver grafts it remains unclear how long these organs may fare well in their "cumulative life span". As graft challenge due to recurrent underlying disease can best be eliminated and controlled in patients transplanted for alcoholic liver disease (ALD) we analysed liver biopsies of ALD patients during a 10-year follow-up with special emphasis on donor age and parenchymal quality.
Material/Methods: Biopsies were taken from 271 patients 1, 3, 5, 10 years after LT. Specimen were analysed and staged concerning inflammation, rejection, fatty involution, and fibrosis/cirrhosis. Donor characteristics were recorded along with clinical and serological parameters, immunosuppressive protocols, rejection episodes, and patient and graft survival.
Results:1, 3, 5 years after LT >80% of patients displayed only minimal fibrosis. In the further course fibrosis rates increased among all patients, with slightly more fibrosis for recurrent drinkers. Donor age did not influence fibrosis progression, long-term patient or graft survival. Regardless of alcohol abuse survival was excellent 5 years after LT, after 10 years abstinent patients did significantly better (82%;68%; p=0.017).
Conclusions: LT for ALD offers excellent long-term survival with minimal histological alteration, especially in abstinent patients. Aged organs generate adequate function in ALD recipients.

Keywords: Liver Transplantation, Fibrosis, Alcoholic liver disease, Liver biopsy

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358