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Arch Surg. 2007 Aug;142(8):775-81; discussion 781-4.

Outcome of liver transplantation in septuagenarians: a single-center experience.

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  • 1Center for Surgical Outcomes and Quality, Department of Surgery, David Geffen School of Medicine at UCLA, Room 77-120 CHS, Los Angeles, CA 90095, USA.

Abstract

HYPOTHESIS:

We hypothesized that selected septuagenarians may do as well after transplantation as those of a younger group of older recipients. This work compares post-liver transplant survival in septuagenarians with that of patients aged 50 to 59 years.

DESIGN:

Review of a prospectively maintained database.

SETTING:

University transplant center.

PATIENTS:

First-time liver transplant recipients treated from January 1, 1988, to December 31, 2005. Group 1 consisted of liver transplant recipients aged 70 years or older at the time of transplant. Group 2 was a younger cohort of patients aged 50 to 59 years.

INTERVENTIONS:

Liver transplantation.

MAIN OUTCOME MEASURES:

Patient survival. Survival data were stratified, Kaplan-Meier survival was calculated, and a multivariate analysis was performed.

RESULTS:

Group 1 included 62 patients aged 70 years or older (average, 71.9 +/- 2.1 years). Group 2 included 864 patients aged 50 to 59 years (average, 54.3 +/- 2.9 years). Unadjusted patient survival of group 1 at 1, 3, 5, and 10 years was 73.3%, 65.8%, 47.1%, and 39.7%, respectively. Unadjusted patient survival of group 2 at 1, 3, 5, and 10 years was 79.4%, 71.5%, 65.3%, and 45.2%, respectively. The difference was not statistically significant (P = .14). Multivariate analysis for factors affecting survival demonstrated preoperative hospitalization, cold ischemia time, and hepatitis C/ethanol as risk factors for death. Age 70 years or more was not a strong risk factor (mortality ratio, 1.28; P = .27).

CONCLUSIONS:

When other risk factors for mortality are controlled in older recipients, risk of death due to age is reduced in well-selected recipients. Age by itself should not be used to limit liver transplantation.

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PMID:
17709732
[PubMed - indexed for MEDLINE]
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