Since 1998, our institution has routinely accepted livers from deceased donors older than 70 years for transplantation. The aim of this study was to determine whether these older donor livers should be used in a routine manner. Twenty-five patients received livers from older donors between 1998 and 2002. Older donor liver recipients' actuarial survival was 95.4% at 1 year and 89.8% at 3 years. Graft survivals were 82.7% at 1 year and 71.7% at 3 years. Five older donor liver recipients with hepatitis C had worse patient survival (80% at 1 year and 40% at 3 years) and graft survival (80% at 1 year and 20% at 3 years). In conclusion, use of livers from deceased older donors affords excellent patient and graft survival, comparable with results achieved with younger donor organs. However, use of older donor livers for patient with hepatitis C may result in worse outcome.