Backing Into Benefit: What Fringe Donors Can Teach the Mainstream.

In the current issue, de Boer et al. report the Eurotransplant experience with older liver donors.1 The authors note comparable early outcomes among suitable recipients, with an as-expected decrement in longer-term survival. The data suggest that center volume or experience is not critical for success, provided that older organs are used in "preferred" candidates. This group is defined by the exclusion of those aged 45 years or less, those with BMI 35 or above, patients with HCV as the etiology of ESLD, and long cold ischemic times. Over the 2000-2015 study period, the total numbers of age 70+ donors evaluated increased by a factor of 3.5, but the number of age 70+ livers transplanted rose by a factor of 6.3, suggesting greater confidence and familiarity with this donor subset. This article is protected by copyright. All rights reserved.