ORGANS from old and diseased donors are increasingly being transplanted into gravely ill Australians.
The oldest donor last year was 84, and record numbers of organs are being transplanted from donors with cancer, diabetes and hepatitis, the Australian and New Zealand Organ Donation Registry 2011 Report reveals.
Despite an increase in organ donations, 1600 Australians are awaiting a transplant and many will die before they get one.
Last year, half the nation's 309 donors had been smokers, 14 had cancer, 20 had hepatitis B, two had hepatitis C, 29 had diabetes and 86 had high blood pressure.
In Australia, hepatitis B and C, cancer and the arenavirus have been passed on through infected donor organs and recipients have died.
Nine livers were transplanted from donors with hepatitis B or C.
Austin Hospital liver transplant unit director Professor Bob Jones said while some recipients might not have had hepatitis, others already would have had the disease.
He said there was a risk of hepatitis being passed from donor to recipient through a transplant.
"It's all about balancing the degree of risk - you have to balance these risks versus the risk of dying waiting," he said.
"If a patient is dying in ICU and has 24 hours to live and the only donor has hepatitis B, we will discuss it with the family."
Some elderly donors were suitable - a dying 30-year-old woman received a 78-year-old's liver, and two or three years later, it was still working "beautifully", he said.
Royal Australasian College of Surgeons transplant surgery chair Jonathan Fawcett said each year the average age of donors was rising.
"In the mid-1990s, (surgeons) were reluctant to use organs retrieved from donors over 50, but now it's common to use organs from donors well into their 60s," Mr Fawcett said.
Victorian medical director of organ and tissue donation Dr Helen Opdam said: "Ten years ago, we would not entertain using organs from someone who was a heavy smoker or a heavy drinker.
"Now we will, as long as they are functioning well."