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Long-term results of liver transplantation in older patients 60 years of age and older.
Transplantation 2000; 70(5):780-3T

Abstract

BACKGROUND

Advances in perioperative care and immunosuppression have enabled clinicians to broaden the indications for organ transplantation. Advanced age is no longer considered a contraindication to transplantation at most centers. Although short-term studies of elderly liver transplant recipients have demonstrated that the incidence of complications and overall patient survival are similar to those of younger adults, transplant center-specific, long-term data are not available.

METHODS

From August of 1984 to September of 1997, 91 patients 60 years of age or older received primary liver transplants at the University of Wisconsin, Madison. This group of patients was compared with a group of younger adults (n=387) ranging in age from 18 to 59 years who received primary liver transplants during the same period. The most common indications for transplantation in both groups were Laennec's cirrhosis, hepatitis C, primary biliary cirrhosis, primary sclerosing cholangitis, and cryptogenic cirrhosis. There was no difference in the preoperative severity of illness between the groups. Results. The length of hospitalization was the same for both groups, and there were no significant differences in the incidence of rejection, infection (surgical or opportunistic), repeat operation, readmission, or repeat transplantation between the groups. The only significant difference identified between the groups was long-term survival. Five-year patient survival was 52% in the older group and 75% in the younger group (P<0.05). Ten-year patient survival was 35% in the older group and 60% in the younger group (P<0.05). The most common cause of late mortality in elderly liver recipients was malignancy (35.0%), whereas most of the young adult deaths were the result of infectious complications (24.2%).

CONCLUSION

Although older recipients at this center did as well as younger recipients in the early years after liver transplantation, long-term survival results were not as encouraging.

Authors+Show Affiliations

Department of Surgery, University of Wisconsin, Madison 53792, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11003357

Citation

Collins, B H., et al. "Long-term Results of Liver Transplantation in Older Patients 60 Years of Age and Older." Transplantation, vol. 70, no. 5, 2000, pp. 780-3.
Collins BH, Pirsch JD, Becker YT, et al. Long-term results of liver transplantation in older patients 60 years of age and older. Transplantation. 2000;70(5):780-3.
Collins, B. H., Pirsch, J. D., Becker, Y. T., Hanaway, M. J., Van der Werf, W. J., D'Alessandro, A. M., ... Kalayoglu, M. (2000). Long-term results of liver transplantation in older patients 60 years of age and older. Transplantation, 70(5), pp. 780-3.
Collins BH, et al. Long-term Results of Liver Transplantation in Older Patients 60 Years of Age and Older. Transplantation. 2000 Sep 15;70(5):780-3. PubMed PMID: 11003357.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term results of liver transplantation in older patients 60 years of age and older. AU - Collins,B H, AU - Pirsch,J D, AU - Becker,Y T, AU - Hanaway,M J, AU - Van der Werf,W J, AU - D'Alessandro,A M, AU - Knechtle,S J, AU - Odorico,J S, AU - Leverson,G, AU - Musat,A, AU - Armbrust,M, AU - Becker,B N, AU - Sollinger,H W, AU - Kalayoglu,M, PY - 2000/9/26/pubmed PY - 2000/10/21/medline PY - 2000/9/26/entrez SP - 780 EP - 3 JF - Transplantation JO - Transplantation VL - 70 IS - 5 N2 - BACKGROUND: Advances in perioperative care and immunosuppression have enabled clinicians to broaden the indications for organ transplantation. Advanced age is no longer considered a contraindication to transplantation at most centers. Although short-term studies of elderly liver transplant recipients have demonstrated that the incidence of complications and overall patient survival are similar to those of younger adults, transplant center-specific, long-term data are not available. METHODS: From August of 1984 to September of 1997, 91 patients 60 years of age or older received primary liver transplants at the University of Wisconsin, Madison. This group of patients was compared with a group of younger adults (n=387) ranging in age from 18 to 59 years who received primary liver transplants during the same period. The most common indications for transplantation in both groups were Laennec's cirrhosis, hepatitis C, primary biliary cirrhosis, primary sclerosing cholangitis, and cryptogenic cirrhosis. There was no difference in the preoperative severity of illness between the groups. Results. The length of hospitalization was the same for both groups, and there were no significant differences in the incidence of rejection, infection (surgical or opportunistic), repeat operation, readmission, or repeat transplantation between the groups. The only significant difference identified between the groups was long-term survival. Five-year patient survival was 52% in the older group and 75% in the younger group (P<0.05). Ten-year patient survival was 35% in the older group and 60% in the younger group (P<0.05). The most common cause of late mortality in elderly liver recipients was malignancy (35.0%), whereas most of the young adult deaths were the result of infectious complications (24.2%). CONCLUSION: Although older recipients at this center did as well as younger recipients in the early years after liver transplantation, long-term survival results were not as encouraging. SN - 0041-1337 UR - https://www.unboundmedicine.com/medline/citation/11003357/Long_term_results_of_liver_transplantation_in_older_patients_60_years_of_age_and_older_ L2 - http://Insights.ovid.com/pubmed?pmid=11003357 DB - PRIME DP - Unbound Medicine ER -