title: Recipient Age and Mortality Risk after Liver Transplantation: A Population-Based Cohort Study.
abstract: The aim of the present large population-based cohort study is to explore the risk factors of age-related mortality in liver transplant recipients in Taiwan. Basic information and data on medical comorbidities for 2938 patients who received liver transplants between July 1, 1998, and December 31, 2012, were extracted from the National Health Insurance Research Database on the basis of ICD-9-codes. Mortality risks were analyzed after adjusting for preoperative comorbidities and compared among age cohorts. All patients were followed up until the study endpoint or death. This study finally included 2588 adults and 350 children [2068 (70.4%) male and 870 (29.6%) female patients]. The median age at transplantation was 52 (interquartile range, 43-58) years. Recipients were categorized into the following age cohorts: <20 (n = 350, 11.9%), 20-39 (n = 254, 8.6%), 40-59 (n = 1860, 63.3%), and ≥60 (n = 474, 16.1%) years. In the total population, 428 deaths occurred after liver transplantation, and the median follow-up period was 2.85 years (interquartile range, 1.2-5.5 years). Dialysis patients showed the highest risk of mortality irrespective of age. Further, the risk of death increased with an increase in the age at transplantation. Older liver transplant recipients (≥60 years), especially dialysis patients, have a higher mortality rate, possibly because they have more medical comorbidities. Our findings should make clinicians aware of the need for better risk stratification among elderly liver transplantation candidates.
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan.|College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
authors.forename: Hsiu-Pin
authors.initials: HP
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan.|College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
authors.forename: Yung-Fong
authors.initials: YF
authors.lastname: Tsai
authors.affiliation: Clinical Informatics and Medical Statistics Research Center and Graduate Institute of Clinical Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
authors.forename: Jr-Rung
authors.initials: JR
authors.lastname: Lin
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan.|College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
authors.forename: Fu-Chao
authors.initials: FC
authors.lastname: Liu
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan.|College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
authors.forename: Huang-Ping
authors.initials: HP
authors.lastname: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D016208:Databases, Factual; D003710:Demography; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D012189:Retrospective Studies; D012306:Risk; D013624:Taiwan; D055815:Young Adult