OBJECTIVE: To determine whether liver transplantation is judicious in recipients older than 60 years of age. SUMMARY BACKGROUND DATA: The prevailing opinion among the transplant community remains that elderly recipients of liver allografts fare as well as their younger counterparts, but our results have in some cases been disappointing. This study was undertaken to review the results of liver transplants in the elderly in a large single-center setting. A secondary goal was to define, if possible, factors that could help the clinician in the prudent allocation of the donor liver. METHODS: A retrospective review of a prospectively maintained single-institution database of 1,446 consecutive liver transplant recipients was conducted. The 241 elderly patients (older than 60 years) were compared with their younger counterparts by preoperative laboratory values, illness severity, nutritional status, and donor age. Survival data were stratified and logistic regression analyses were conducted. RESULTS: Elderly patients with better-preserved hepatic synthetic function or with lower pretransplant serum bilirubin levels fared as well as younger patients. Elderly patients who had poor hepatic synthetic function or high bilirubin levels or who were admitted to the hospital had much lower survival rates than the sicker younger patients or the less-ill older patients. Recipient age 60 years or older, pretransplant hospital admission, and high bilirubin level were independent risk factors for poorer outcome. CONCLUSIONS: Low-risk elderly patients fare as well as younger patients after liver transplantation. However, unless results can be improved, high-risk patients older than 60 years should probably not undergo liver transplantation.
OBJECTIVE: To determine whether liver transplantation is judicious in recipients older than 60 years of age. SUMMARY BACKGROUND DATA: The prevailing opinion among the transplant community remains that elderly recipients of liver allografts fare as well as their younger counterparts, but our results have in some cases been disappointing. This study was undertaken to review the results of liver transplants in the elderly in a large single-center setting. A secondary goal was to define, if possible, factors that could help the clinician in the prudent allocation of the donor liver. METHODS: A retrospective review of a prospectively maintained single-institution database of 1,446 consecutive liver transplant recipients was conducted. The 241 elderly patients (older than 60 years) were compared with their younger counterparts by preoperative laboratory values, illness severity, nutritional status, and donor age. Survival data were stratified and logistic regression analyses were conducted. RESULTS: Elderly patients with better-preserved hepatic synthetic function or with lower pretransplant serum bilirubin levels fared as well as younger patients. Elderly patients who had poor hepatic synthetic function or high bilirubin levels or who were admitted to the hospital had much lower survival rates than the sicker younger patients or the less-ill older patients. Recipient age 60 years or older, pretransplant hospital admission, and high bilirubin level were independent risk factors for poorer outcome. CONCLUSIONS: Low-risk elderly patients fare as well as younger patients after liver transplantation. However, unless results can be improved, high-risk patients older than 60 years should probably not undergo liver transplantation.
Authors: L Bäckman; J Gibbs; M Levy; R McMillan; M Holman; B Husberg; R Goldstein; T A Gonwa; G Klintmalm Journal: Transplant Proc Date: 1993-02 Impact factor: 1.066
Authors: I Bilbao; J Balsells; J L Lazaro; R Charco; E Murio; E Gifre; C Ruiz; A Edo; C Margarit Journal: Transplant Proc Date: 1995-08 Impact factor: 1.066
Authors: B K Brooks; M F Levy; L W Jennings; O Abbasoglu; M Vodapally; R M Goldstein; B S Husberg; T A Gonwa; G B Klintmalm Journal: Transplantation Date: 1996-12-27 Impact factor: 4.939
Authors: J I Roodnat; R Zietse; P G Mulder; J Rischen-Vos; T van Gelder; J N IJzermans; W Weimar Journal: Transplantation Date: 1999-02-27 Impact factor: 4.939
Authors: O Abbasoglu; M F Levy; B B Brkic; G Testa; D R Jeyarajah; R M Goldstein; B S Husberg; T A Gonwa; G B Klintmalm Journal: Transplantation Date: 1997-12-27 Impact factor: 4.939
Authors: P Baliga; R M Merion; J G Turcotte; J M Ham; K S Henley; M R Lucey; A Schork; Y Shyr; D A Campbell Journal: Surgery Date: 1992-10 Impact factor: 3.982
Authors: Frank V Schiødt; Raymond T Chung; Michael L Schilsky; J Eileen Hay; Erik Christensen; William M Lee Journal: Liver Transpl Date: 2009-11 Impact factor: 5.799
Authors: Sukeshi Patel Arora; Gabor Liposits; Susan Caird; Richard F Dunne; Gordon Taylor Moffat; David Okonji; Maria Grazia Rodriquenz; Divyanshu Dua; Efrat Dotan Journal: J Geriatr Oncol Date: 2019-11-06 Impact factor: 3.599
Authors: G Werkgartner; D Wagner; S Manhal; A Fahrleitner-Pammer; H J Mischinger; M Wagner; R Grgic; R E Roller; D Kniepeiss Journal: Age (Dordr) Date: 2013-03-26
Authors: Gregory C Wilson; R Cutler Quillin; Koffi Wima; Jeffrey M Sutton; Richard S Hoehn; Dennis J Hanseman; Ian M Paquette; Flavio Paterno; E Steve Woodle; Daniel E Abbott; Shimul A Shah Journal: HPB (Oxford) Date: 2014-08-06 Impact factor: 3.647
Authors: Javier F Aduen; Bangarulingam Sujay; Rolland C Dickson; Michael G Heckman; Winston R Hewitt; Wolf H Stapelfeldt; Jeffrey L Steers; Denise M Harnois; David J Kramer Journal: Mayo Clin Proc Date: 2009-11 Impact factor: 7.616