title: Long-term results of liver transplantation for over 60 years old patients with hepatitis B virus-related end-stage liver disease.
abstract: BACKGROUND
  Hepatitis B virus (HBV)-related end-stage liver disease is the leading indication for liver transplantation in China, but long-term results of liver transplantation in patients aged over 60 years are not clear. The present study was to reveal the natural history of liver recipients with hepatitis B older than 60 years.
  
  
  METHODS
  The recipients who had received liver transplantation between December 2003 and December 2005 were divided into two groups: those equal or older than 60 years (older group, n=60) and those younger than 60 years (younger group, n=305). Risk factors for poor long-term outcome in patients aged over 60 years were also analyzed.
  
  
  RESULTS
  Except for age and preexisting chronic disease (P<0.05), no significant differences were observed in perioperative characteristics between the two groups. There was also no significant difference in HBV and hepatocellular carcinoma recurrence (P>0.05). The actuarial 1-, 3-, 5- and 8-year survival rates were 81.6%, 71.6%, 66.7% and 63.3% respectively for the older group vs 84.9%, 77.7%, 70.8% and 65.6% for the younger group (P>0.05). Multivariate analyses showed that pre-liver transplant renal insufficiency was a risk factor for poor outcome in the older group (odds ratio=3.615, P=0.014).
  
  
  CONCLUSIONS
  Liver transplantation is safe and feasible for patients with HBV-related end-stage liver disease aged over 60 years. Older patients with renal insufficiency should undergo transplantation earlier than younger patients.
authors.affiliation: Liver Transplant Center, Third Affiliated Hospital, and Transplantation Research Institute, Sun Yat-Sen University, Guangzhou 510630, China. chgh1955@263.net.
authors.forename: Shu-Hong
authors.initials: SH
authors.lastname: Yi
authors.forename: Hui-Min
authors.initials: HM
authors.lastname: Yi
authors.forename: Bin-Sheng
authors.initials: BS
authors.lastname: Fu
authors.forename: Chi
authors.initials: C
authors.lastname: Xu
authors.forename: Min-Ru
authors.initials: MR
authors.lastname: Li
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhang
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.forename: Gui-Hua
authors.initials: GH
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery* / Q000821:virology; D002681:China; D058625:End Stage Liver Disease / Q000150:complications / Q000601:surgery* / Q000821:virology; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery* / Q000821:virology; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D012008:Recurrence; D051437:Renal Insufficiency / Q000150:complications; D012720:Severity of Illness Index; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult