Short and Long-Term Outcomes After Primary Liver Transplantation in Elderly Patients

• Authors: Michał Grąt , Oskar Kornasiewicz , Karolina Grąt , Arkadiusz Antczak , Joanna Ligocka , Wacław Hołówko , Karolina Maria Wronka , Konrad Kobryń , Michał Skalski , Leszek Pączek , Marek Krawczyk
• Languages of publication: EN

Abstracts

EN

The number of elderly patients undergoing liver transplantation (LT) is increasing worldwide. The aim of the study was to evaluate the impact of recipient age exceeding 60 years on early and long-term outcomes after LT. Material and methods. This study comprised data of 786 patients after primary LT performed at a single center between January 2005 and October 2012. Patients over and under 60 years of age were compared with respect to baseline characteristics and outcomes: postoperative mortality (90-day) and 5-year patient (PS) and graft (GS) survival. Associations between recipient age exceeding 60 years and LT results were assessed in multiple Cox regression models. Results. Recipients older than 60 years (n=107; 13.6%) were characterized by more frequent hepatitis C virus infections (p<0.001), malignancies (p<0.001), and cardiovascular comorbidities (p<0.001); less frequent primary sclerosing cholangitis (p=0.002) and Roux-en-Y hepaticojejunostomy (p<0.001); lower Model for End-stage Liver Disease (MELD; p=0.043); and increased donor age (p=0.012). Fiveyear PS of older and younger recipients was 72.7% and 80.6% (p=0.538), while the corresponding rates of GS were 70.3% and 77.5% (p=0.548), respectively. Recipient age exceeding 60 years was not significantly associated with postoperative mortality (p=0.215), PS (p=0.525) and GS (p=0.572) in multivariate analyses. The list of independent predictors comprised MELD (p<0.001) for postoperative mortality; malignancies (p=0.003) and MELD (p<0.001) for PS; and malignancies (p=0.003), MELD (p<0.001) and donor age (p=0.017) for GS. Conclusions. Despite major differences between elderly and young patients, chronological age exceeding 60 years alone should not be considered as a contraindication for LT.

Keywords

EN

liver transplantation; outcomes; elderly patients; recipient age; malignancies; donor age

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2013
• Volume: 85
• Issue: 10
• Pages: 581-588

Dates

published

1 - 10 - 2013

online

01 - 12 - 2013

Contributors

author

Michał Grąt

• Department of General, Transplant and Liver Surgery, Medical University in Warsaw

author

Oskar Kornasiewicz

• Department of General, Transplant and Liver Surgery, Medical University in Warsaw

author

Karolina Grąt

• Department of General, Transplant and Liver Surgery, Medical University in Warsaw

author

Arkadiusz Antczak

• Department of General, Transplant and Liver Surgery, Medical University in Warsaw

author

Joanna Ligocka

• Department of General, Transplant and Liver Surgery, Medical University in Warsaw

author

Wacław Hołówko

• Department of General, Transplant and Liver Surgery, Medical University in Warsaw

author

Karolina Maria Wronka

• Department of General, Transplant and Liver Surgery, Medical University in Warsaw

author

Konrad Kobryń

• Department of General, Transplant and Liver Surgery, Medical University in Warsaw

author

Michał Skalski

• Department of General, Transplant and Liver Surgery, Medical University in Warsaw

author

Leszek Pączek

• Department of Immunology, Transplant Medicine and Internal Diseases, Transplantation Institute, Medical University in Warsaw

author

Marek Krawczyk

• Department of General, Transplant and Liver Surgery, Medical University in Warsaw

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Identifiers

DOI

10.2478/pjs-2013-0087