Objective To summarize items of donation evaluation of donor liver from an elderly donor with hypernatremia, and to analyze recipient's prognosis, so as to provide reference for pre-acquisition maintenance of elderly donor with hypernatremia and post-transplantation recovery of recipient. Methods The clinical data of liver transplantation from one elderly donor with hypernatremia , whose brain death was resulted by brain stem hemorrhage, were retrospectively analyzed. Combined with literature reviews, summary on donor liver donation evaluation of this category of donors and on recipients' postoperative management items was performed. Results The donor was an elderly male (74 years old) and concomitant hypernatremia, had history of cardiopulmonary resuscitation, and belonged to brain dead organ donation. The recipient was a 41-year-old male who underwent liver transplantation due to decompensation of liver cirrhosis after hepatitis B. After anti-rejection and anti-infection treatment of operation, liver function of the recipient gradually returned to normal, and the recipient was discharged 24 days after operation; in addition, follow-up so far the prognosis is favorable. Conclusion After a thorough preoperative evaluation of the donor and recipient, hypernatremia elderly donor liver can be safely used in liver transplantation, and has no significant effect on early liver function recovery and prognosis of liver transplant recipient.

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