LAUSR

To the Editor: We read with great interest the results of the study of Gao et al about an US cohort of Liver Transplant from 1990 to 2014 and outcomes about older donors. We want to congratulate the authors for the extensive cohort and important results. We found that data unexpectedly show a leveled-off in older donors use over the last period potentially driven by discouraging initial results observed in over-70-years-old donors. This study shows a positive trend in graft loss and mortality ratios for all groups along the period coincident with a significant reduction in median cold ischemia time. These improvements could be surely due to increasing experience in the surgical technique. However, we think these results could be also derived from the improvement in recipient selection and postoperative care. We consider that it is crucial to make an age range bandwidth differentiation when taking into account older donors. In the Gao et al study, we miss a subgroup stratification by age ranges. This study shows a reduction in the difference in both graft and patient survival between groups; however, there is a simultaneous decrease in the age gap between group as time passes (median age 51–64 years in the young vs old group in the