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


METHODS
Review of a prospectively maintained database.


METHODS
University transplant center.


METHODS
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.


METHODS
Liver transplantation.


METHODS
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.
Lipshutz
Gerald S
GS
Center for Surgical Outcomes and Quality, Department of Surgery, David Geffen School of Medicine at UCLA, Room 77-120 CHS, Los Angeles, CA 90095, USA.
Hiatt
Jonathan
J
Ghobrial
R Mark
RM
Farmer
Douglas G
DG
Martinez
Monica M
MM
Yersiz
Hasan
H
Gornbein
Jeffrey
J
Busuttil
Ronald W
RW
D000367:Age Factors; D000368:Aged; D002140:California / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008107:Liver Diseases / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome