Elderly Living Donor Liver Transplant Recipients Over 60 Years Old at a Japanese Single Center.
BACKGROUND
Among living donor liver transplant (LDLT) recipients, the number of elderly individuals has been increasing because of longer survival due to the improvement of treatment for hepatic diseases such as hepatitis C (HCV). Here we report the outcomes of living donor recipients over the age of 60 years.


METHODS
In 76 adult LDLT patients at our institution before September 2015, there were 21 recipients over 60 years old. We divided all of the recipients into 2 groups ("elderly" recipient group >60 years of age [n = 21], and a "nonelderly" recipient group <60 years [n = 55]), and we investigated outcomes in each group.


RESULTS
The graft survival rates in the elderly group were 89.9% at 1 year, 89.9% at 3 years, 83.0% at 5 years, and 83.0% at 10 years. The graft survival rates in the nonelderly group was 91.1% at 1 year, 85.2% at 3 years, 82.8% at 5 years, and 82.9% at 10 year. There was no significant difference between the 2 age groups. In the elderly group, 3 patients died (2 patients had HCV recurrence and 1 patient had fungal infection in the brain, leading to a fatal subarachnoid hemorrhage). In the nonelderly group, 4 of 10 patients died of graft failure due to the graft size being too small.


CONCLUSIONS
Elderly patients, at the end stage of liver failure, are likely very frail and may have latent infections. Careful examination for latent infections before LDLT should be carefully performed in regard to indications for LDLT, which might reach satisfactory outcomes as in nonelderly LDLT recipients. Even if elderly patients are approved for transplantation, very careful management is needed.
Department of Transplantation and Regenerative Surgery, Kyoto Prefectural University of Medicine, Kyoto City, Japan. Electronic address: ushi@koto.kpu-m.ac.jp.
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Ushigome
Department of Transplantation and Regenerative Surgery, Kyoto Prefectural University of Medicine, Kyoto City, Japan.
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Nakao
Department of Transplantation and Regenerative Surgery, Kyoto Prefectural University of Medicine, Kyoto City, Japan.
S
S
Harada
Department of Transplantation and Regenerative Surgery, Kyoto Prefectural University of Medicine, Kyoto City, Japan.
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Nakamura
Department of Transplantation and Regenerative Surgery, Kyoto Prefectural University of Medicine, Kyoto City, Japan.
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K
Koshino
Department of Transplantation and Regenerative Surgery, Kyoto Prefectural University of Medicine, Kyoto City, Japan.
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Suzuki
Department of Transplantation and Regenerative Surgery, Kyoto Prefectural University of Medicine, Kyoto City, Japan.
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T
Ito
Department of Transplantation and Regenerative Surgery, Kyoto Prefectural University of Medicine, Kyoto City, Japan.
S
S
Nobori
Department of Transplantation and Regenerative Surgery, Kyoto Prefectural University of Medicine, Kyoto City, Japan.
N
N
Yoshimura
D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D058625:End Stage Liver Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D006085:Graft Survival; D006801:Humans; D007564:Japan; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012008:Recurrence; D015996:Survival Rate; D016896:Treatment Outcome