Living donor liver transplantation in patients older than 60 years.
BACKGROUND
Living donor liver transplantation (LDLT) has been performed in adult patients. However, there are a few reports on how recipient age affects the outcome of LDLT. This study assessed LDLT outcome in patients aged 60 years or older.


METHODS
A total of 267 patients were enrolled and classified into two groups: those younger than 60 years (younger group, n=210) and those aged 60 years or older (older group, n=57). The 6-month and 1-, 3-, and 5-year patient survivals and the incidence of complications were compared. Multivariate analysis was performed to identify the risk factors.


RESULTS
Fifty-five of 57 (96.5%) donors in the older group were younger than 50 years (range 25-47 years), whereas only 177 of 210 (84.3%) donors in the younger group were younger than 50 years (P<0.0001). The 6-month and 1-, 3-, and 5-year patient survival rates of the older group were 92.9%, 85.3%, 72.7%, and 70.3%, respectively, whereas those of the younger group were 87.4%, 85.8%, 80.2%, and 78.2%, respectively. Neither difference was significant. A multivariate analysis revealed that the presence of diabetes, lack of hepatocellular carcinoma, and Model for End-Stage Liver Disease (MELD) Score more than or equal to 20 were independent risk factors for survival less than 1 year after LDLT (P=0.0003, P=0.014, and P=0.041, respectively). Another multivariate analysis revealed that the lack of consanguinity, MELD Score more than or equal to 20, and male recipient were independent risk factors for death 1 year or more after LDLT (P=0.004, P=0.005, and P=0.015, respectively).


CONCLUSIONS
Recipient age did not affect LDLT outcome when patients with MELD Score less than 20 received grafts from consanguineous donors.
Yoshizumi
Tomoharu
T
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. yosizumi@surg2.med.kyushu-u.ac.jp
Shirabe
Ken
K
Soejima
Yuji
Y
Taketomi
Akinobu
A
Yamashita
Natsumi
N
Ikegami
Toru
T
Uchiyama
Hideaki
H
Kayashima
Hiroto
H
Ninomiya
Mizuki
M
Maehara
Yoshihiko
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D001663:Bilirubin / Q000097:blood; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation / Q000401:mortality / Q000502:physiology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
D001663:Bilirubin