Mohamed R Abdelfattah1, Hussien Elsiesy. 1. aLiver Transplant and Hepatobiliary Surgery bLiver Transplant Hepatology, Organ Transplant Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia cDepartment of Surgery, University Of Alexandria, Faculty of Medicine, Alexandria, Egypt.
Abstract
BACKGROUND: Increasingly more elderly recipients are being evaluated for liver transplant nowadays. Reported outcomes of deceased donor liver transplant in elderly recipients have varied in different eras. Little was reported on the outcome of living donor liver transplant (LDLT) in elderly patients, and the upper age limit for consideration for LDLT is variable from center to center. PATIENTS AND METHODS: We retrospectively reviewed our database for LDLT procedures performed for recipients 60 years of age or older. Procedures performed for retransplantation or left lobe liver transplants were excluded. Patients were divided into two groups: group A included recipients at least 60 and younger than 65 years old and group B included recipients at least 65 years old. RESULTS: A total of 55 liver transplants were included in our study. Group A included 30 patients, whereas group B included 25 patients. There was a trend toward more vascular complications, more frequent rejections, and hepatitis B virus recurrence in younger patients. This was only significant for hepatitis B virus recurrence. However, there was a trend toward more biliary complications, incisional hernias, and longer ICU/hospital stay in older patients. None of the latter variables reached statistical significance. Older recipients had better patient survival, which was more evident at 3 and 5 years of follow-up. However, graft and disease-free survivals did not differ significantly between both groups. CONCLUSION: LDLT using right lobe grafts for recipients aged 65 years or older is safe and feasible.
BACKGROUND: Increasingly more elderly recipients are being evaluated for liver transplant nowadays. Reported outcomes of deceased donor liver transplant in elderly recipients have varied in different eras. Little was reported on the outcome of living donor liver transplant (LDLT) in elderly patients, and the upper age limit for consideration for LDLT is variable from center to center. PATIENTS AND METHODS: We retrospectively reviewed our database for LDLT procedures performed for recipients 60 years of age or older. Procedures performed for retransplantation or left lobe liver transplants were excluded. Patients were divided into two groups: group A included recipients at least 60 and younger than 65 years old and group B included recipients at least 65 years old. RESULTS: A total of 55 liver transplants were included in our study. Group A included 30 patients, whereas group B included 25 patients. There was a trend toward more vascular complications, more frequent rejections, and hepatitis B virus recurrence in younger patients. This was only significant for hepatitis B virus recurrence. However, there was a trend toward more biliary complications, incisional hernias, and longer ICU/hospital stay in older patients. None of the latter variables reached statistical significance. Older recipients had better patient survival, which was more evident at 3 and 5 years of follow-up. However, graft and disease-free survivals did not differ significantly between both groups. CONCLUSION: LDLT using right lobe grafts for recipients aged 65 years or older is safe and feasible.