title: Is an elderly recipient a risk for living donor adult liver transplantation?
abstract: OBJECTIVE
  In cadaveric liver transplantation, it has been reported that elderly recipients over 60 years are at risk because of high incidence of complication and malignancy. However, in living-donor adult liver transplantation (LDALT), it is unclear whether the elderly recipient is risky or not risky. In this study, the outcome after LDALT of elderly patients has been evaluated.
  
  
  METHODS
  One hundred twenty two consecutive LDALT recipients were studied. The recipients were divided into an elderly group (older than 60 yrs, n = 21), and a control group (younger than 60 yrs, n = 101). Comparative examination of background factors, postoperative complications and de novo malignancy was carried out.
  
  
  RESULTS
  Elderly patients more frequently received transplantation for hepatocellular carcinoma. Pretransplant liver damage such as Child-Pugh, MELD or bilirubin level was same among the groups. There was no significant difference in posttransplant complications except renal failure. Postoperative renal failure (postoperative creatinine level over 2mg/dL) occurred in 29% (n = 5) of the elderly group vs. 8% (n = 6) of the control group. De novo malignancy occurred in 1 case (lung) in the elderly group and 1 case (Vater) in the control group. In the control group, the 1, 3 and 5 year patient survival rates were 78.5%, 73.1% and 71.4%, respectively. And in the elderly group, the 1, 3 and 5 year patient survival rates were 85.7%, 81.0% and 70.8%, respectively.
  
  
  CONCLUSIONS
  It may be, we concluded that living donor adult liver transplantation is good treatment for end stage liver diseases in elderly recipients over 60 years. However caution should be taken in the administration of medicine, including immunosuppressants or antibiotics, do to a propensity for postoperative renal failure in elderly recipients.
authors.affiliation: Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi 371-8511, Japan. tsuehiro@med.gunma-u.ac.jp
authors.forename: Taketoshi
authors.initials: T
authors.lastname: Suehiro
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Shimada
authors.forename: Keiji
authors.initials: K
authors.lastname: Kishikawa
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Shimura
authors.forename: Yuji
authors.initials: Y
authors.lastname: Soejima
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Yoshizumi
authors.forename: Kohji
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Mochida
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012307:Risk Factors; D015996:Survival Rate