Liver transplantation in patients aged 65 and over: a case-control study.
BACKGROUND
The average age of patients undergoing liver transplantation (LT) is consistently increasing. The aim of this case-control study is to evaluate survival and outcome of patients ≥65 yr compared to younger patients undergoing LT.


METHODS
From 10/00 to 4/08 we performed 330 primary LT, 31 (9.4%) of these were in patients aged 65-70. Following a case-control approach, we compared these patients with 31 patients aged between 41 and 64 yr and matched according to sex, LT indication, viral status, cadaveric/living donor, LT timing, and Model for End-Stage Liver Disease (MELD) score.


RESULTS
There were no statistically significant differences in demographic and surgical donor characteristics. The mean MELD score was under 18 in both groups. Post-LT complications occurred with a similar incidence in the two groups. one-, three-, and five-yr survival was 83.9%, 80.6%, and 80.6%, respectively, for the elderly group, and 80.6%, 73.8%, and 73.8%, respectively, for the young group (p = 0.61).


CONCLUSIONS
Patients aged between 65 and 70 with low MELD score who undergo LT have the same short- and middle-term survival expectancy, morbidity, and outcome quality as younger patients with the same indication and same pre-LT pathology severity, whatever they might be. Thus, chronological age alone should not deter LT workup in patients >65 and <70.
Liver and Multivisceral Transplant Centre, University of Modena and Reggio Emilia, Modena, Italy. robertomontalti@yahoo.it
R
R
Montalti
G
G
Rompianesi
F
F
Di Benedetto
R
R
Ballarin
R C
RC
Gerring
S
S
Busani
L
L
De Pietri
N
N
De Ruvo
R M
RM
Iemmolo
G P
GP
Guerrini
N
N
Smerieri
G E
GE
Gerunda
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006085:Graft Survival; D006801:Humans; D017093:Liver Failure / Q000601:surgery*; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome