Clinical

Age in itself not a barrier to liver transplantation

Last Updated: 2007-08-20 16:00:10 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Findings from a study of septuagenarians suggest that age per se should not be a contraindication to liver transplantation.

According to the report in the Archives of Surgery for August, older patients often do well, provided that accompanying risk factors are appropriately addressed.

"Biological and physiological variables may play a more important role than advanced age in predicting poor survival after liver transplantation," senior author Dr. Ronald W. Busuttil, from the University of California at Los Angeles, and colleagues state.

The team compared outcomes for 62 transplant recipients aged 70 years and older with those among 864 recipients in their 50s. All of the subjects were first-time recipients and underwent transplantation between 1988 and 2005.

No significant differences in survival were noted between the groups. For the older group, the 1-, 3-, 5-, and 10-year survival rates were 73.3%, 65.8%, 47.1%, and 39.7%, respectively. The corresponding rates in the younger group were 79.4%, 71.5%, 65.3%, and 45.2%.

On multivariate analysis, preoperative hospitalization, cold ischemia time, hepatitis C and alcoholic cirrhosis were all significant correlates of mortality. Age 70 years or older, by contrast, was not a significant predictor of death.

"Measures of physiological age and risk of complications should be used in the evaluation process of elderly transplant candidates. Chronologic age by itself is not a sole predictor of outcome," the authors conclude.

Arch Surg 2007;142:775-784.