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Comparative Study
. 2009 Nov;84(11):973-8.
doi: 10.1016/S0025-6196(11)60667-8.

Outcomes after liver transplant in patients aged 70 years or older compared with those younger than 60 years

Javier F Aduen  1 , Bangarulingam Sujay, Rolland C Dickson, Michael G Heckman, Winston R Hewitt, Wolf H Stapelfeldt, Jeffrey L Steers, Denise M Harnois, David J Kramer
Affiliations
Comparative Study

Outcomes after liver transplant in patients aged 70 years or older compared with those younger than 60 years

Javier F Aduen et al. Mayo Clin Proc. 2009 Nov.

Abstract

Objective: To compare mortality, graft loss, and postoperative complications after liver transplant in older patients (> or =70 years) with those in younger patients (<60 years).

Patients and methods: Outcomes for 42 patients aged 70 years or older who underwent liver transplant were compared with those of 42 matched controls younger than 60 years. All patients underwent transplants between March 19, 1998, and May 7, 2004. Information was collected on patient characteristics, comorbid conditions, laboratory results, donor and operative variables, medical and surgical complications, and mortality and graft loss.

Results: Preoperative characteristics were similar across age groups, except for creatinine (P=.01) and serum albumin (P=.03) values, which were higher in older patients, and an earlier year of transplant in younger patients (P<.001). Intraoperatively, older patients required more erythrocyte transfusions (P=.04) and more intraoperative fluids (P=.001) than did younger patients. Postoperatively, bilirubin level (P=.007) and international normalized ratios (P=.01) were lower in older patients, whereas albumin level was higher (P<.001). The median follow-up was 5.1 years (range, 0.1-8.5 years). Compared with younger patients, older patients were not at an increased risk of death (relative risk, 1.00; 95% confidence interval, 0.43-2.31; P>.99) or graft loss (relative risk, 1.17; 95% confidence interval, 0.54-2.52; P=.70). The frequency of other complications did not differ significantly between age groups, although older patients had more cardiovascular complications.

Conclusion: Five-year mortality and graft loss in older recipients were comparable with those in younger recipients, suggesting that age alone should not exclude older patients from liver transplant.

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Figures

FIGURE 1.
FIGURE 1.
Estimated cumulative rate of mortality after liver transplant, by patient age at time of transplant.
FIGURE 2.
FIGURE 2.
Estimated cumulative rate of graft loss after liver transplant, by patient age at time of transplant.
See this image and copyright information in PMC

References

    1. United Network for Organ Sharing www.unos.org/ UNOS Web site. Accessed August 27, 2009.
    1. U.S. Census Bureau 2008 national population projections. www.census.gov/population/www/projections/2008projections.html. www.census.gov/population/www/projections/2008projections.html Accessed August 27, 2009.
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