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Liver transplant recipients older than 60 years have lower survival and higher incidence of malignancy.

Abstract

Older age is not considered a contraindication for liver transplantation, but age-related morbidity may be a cause of mortality. Survival and the incidence of the main post-transplant complications were assessed in 111 adult liver transplant recipients. They were divided in two groups according to their age (patients younger than 60 years, n=54; patients older than 60 years, n=57) and both groups were compared. Older patients were more frequently transplanted for hepatitis C (p= 0.03) and hepatocellular carcinoma (p= 0.05) and their liver disease was less advanced (Child-Pugh and MELD scores were significantly lower; p=0.004 and p=0.05, respectively). After transplantation, older patients had a significantly lower survival (p=0.02). Higher age was independently associated with mortality (hazard ratio for each 10-year increase: 2.1; 95% confidence interval: 1.1- 4.0; p=0.02). The incidence of de novo neoplasia and nonskin neoplasia were higher in older patients (p=0.02 and p =0.007, respectively). Malignancy was the cause of death in one patient younger than 60 years and in 12 patients older than 60 years (p =0.002). In multivariate analysis, a higher age and smoking were independently associated with a higher risk of dying of de novo neoplasia. In conclusion, older liver transplant recipients have a significantly lower survival than younger patients. Malignancy is responsible for this decreased survival.

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  • Authors+Show Affiliations

    ,

    Department of Surgery, Clínica Universitaria, Pamplona, Spain. iherrero@unav.es

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    Source

    MeSH

    Age Factors
    Aged
    Carcinoma, Hepatocellular
    Cardiovascular Diseases
    Cause of Death
    Female
    Graft Rejection
    Graft Survival
    Hepatitis C
    Humans
    Immunosuppressive Agents
    Liver Neoplasms
    Liver Transplantation
    Male
    Middle Aged
    Multivariate Analysis
    Postoperative Complications
    Retrospective Studies
    Risk
    Risk Factors
    Time Factors

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    14525602

    Citation

    Herrero, J Ignacio, et al. "Liver Transplant Recipients Older Than 60 Years Have Lower Survival and Higher Incidence of Malignancy." American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons, vol. 3, no. 11, 2003, pp. 1407-12.
    Herrero JI, Lucena JF, Quiroga J, et al. Liver transplant recipients older than 60 years have lower survival and higher incidence of malignancy. Am J Transplant. 2003;3(11):1407-12.
    Herrero, J. I., Lucena, J. F., Quiroga, J., Sangro, B., Pardo, F., Rotellar, F., ... Prieto, J. (2003). Liver transplant recipients older than 60 years have lower survival and higher incidence of malignancy. American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 3(11), pp. 1407-12.
    Herrero JI, et al. Liver Transplant Recipients Older Than 60 Years Have Lower Survival and Higher Incidence of Malignancy. Am J Transplant. 2003;3(11):1407-12. PubMed PMID: 14525602.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Liver transplant recipients older than 60 years have lower survival and higher incidence of malignancy. AU - Herrero,J Ignacio, AU - Lucena,Juan Felipe, AU - Quiroga,Jorge, AU - Sangro,Bruno, AU - Pardo,Fernando, AU - Rotellar,Fernando, AU - Alvárez-Cienfuegos,Javier, AU - Prieto,Jesús, PY - 2003/10/4/pubmed PY - 2003/12/25/medline PY - 2003/10/4/entrez SP - 1407 EP - 12 JF - American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons JO - Am. J. Transplant. VL - 3 IS - 11 N2 - Older age is not considered a contraindication for liver transplantation, but age-related morbidity may be a cause of mortality. Survival and the incidence of the main post-transplant complications were assessed in 111 adult liver transplant recipients. They were divided in two groups according to their age (patients younger than 60 years, n=54; patients older than 60 years, n=57) and both groups were compared. Older patients were more frequently transplanted for hepatitis C (p= 0.03) and hepatocellular carcinoma (p= 0.05) and their liver disease was less advanced (Child-Pugh and MELD scores were significantly lower; p=0.004 and p=0.05, respectively). After transplantation, older patients had a significantly lower survival (p=0.02). Higher age was independently associated with mortality (hazard ratio for each 10-year increase: 2.1; 95% confidence interval: 1.1- 4.0; p=0.02). The incidence of de novo neoplasia and nonskin neoplasia were higher in older patients (p=0.02 and p =0.007, respectively). Malignancy was the cause of death in one patient younger than 60 years and in 12 patients older than 60 years (p =0.002). In multivariate analysis, a higher age and smoking were independently associated with a higher risk of dying of de novo neoplasia. In conclusion, older liver transplant recipients have a significantly lower survival than younger patients. Malignancy is responsible for this decreased survival. SN - 1600-6135 UR - https://www.unboundmedicine.com/medline/citation/14525602/Liver_transplant_recipients_older_than_60_years_have_lower_survival_and_higher_incidence_of_malignancy_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1600-6135&date=2003&volume=3&issue=11&spage=1407 DB - PRIME DP - Unbound Medicine ER -