Hepatitis C Viral infection is the most common cause of LTx in the USA. The demand for liver allografts has exceeded the supply, thus older deceased donor grafts are more frequently being utilized for life saving procedures. The outcome of LTx using older donor grafts (age > 60 years) is poor in comparison to the younger donor grafts (age < 60 years). The survival of LTx recipients with HCV infection is inferior to that of HCV negative recipients. The aim of this study is to evaluate the effect of donor age on patient and graft survival outcomes in hepatitis C positive LTx recipients. Between February 1993 to November 2003, 152 deceased donor LTx recipients (males: 115, females: 37; mean Age 49.7+7.6), were examined retrospectively after obtaining an approval from the Institutional Review Board. All patients were followed until January 2004. Out of 152 patients, 108(71.1%) patients received allografts from donors <60 (group A) and 44(28.9%) from donors >60 (group B). The mean follow up time was 41+30.2 months. Patient Survival: During the follow up period 34 (22.4 %) patients died. The death rate in group A was 21.3% and in group B 25%. Actuarial 1, 3, 5-year survival in group A and B was 91.4%, 76.7%, 72.3% and 77.3%, 66.1%, 66.1% respectively (p=0.30). Graft Survival: 16(10.3%) patients required a second transplant for HAT (n=6), PNF (n=5), HCV recurrence (N=2), and other causes (n=2). Two patients required a third transplant. Overall graft survival at 1, 3 and 5 years in-group A and B was 85.9%, 73.5%, 66.3% and 68.1%, 57.2%, 57.2% respectively (p=0.12). Patient and graft survival were inferior when older donor grafts were used in HCV LTx recipients. However, it did not reach statistical significance. The use of older donor grafts should still be considered a viable option as a life saving procedure with a 5-year patient and graft survival rate of 66.1% and 57.2% respectively.