The Tuscany Region has a quite high annual number of donors per million population (100 donors/pmp (annually)). Considering the increasing donor age and organ shortage, the donation and transplantation community needs to expand procurement and transplants from elderly donors. We assessed the utilization rate in donors aged ≥80 years during the study period (2018–2024) in Tuscany.
Our retrospective observational study comprised 809 donors aged ≥80 years. We compared Period 1 (from 2018 to 2020, before the COVID pandemic) to Period 2 (from 2021 to 2024, after the COVID pandemic).
cDCD donors significantly increased in Period 2 (0.0001). The utilization rate increased from Period 1 to Period 2 (81.5% vs. 91.7%). In the study period (2018–2024), 377 liver transplants were performed. Overall graft and patient survival at 1, 3, and 5 years when an octogenarian graft was used was 89.4%, 85.0%, 81.8% and 92.5%, 88.7%, 85.5%, respectively. EAD (early allograft dysfunction) was observed in 2.9% of the cases, and IC (ischemic cholangiopathy) developed in 6.3% of the cases. Forty kidneys were transplanted into 22 patients, including 18 dual kidney transplants.
During the 7-year study period, donors aged ≥80 years represented a consistent subgroup, since they accounted for one-third of the overall donor population. The increase in utilization rate observed during the study period may be related to several factors, both in the procurement and the transplant phase.
Trial Registration: Clinicaltrial.gov: #NCT04744389