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Liver Transplant Recipients Older Than 60 Years Have Lower Survival and Higher Incidence of Malignancy
Author(s) -
Herrero J. Ignacio,
Lucena Juan Felipe,
Quiroga Jorge,
Sangro Bruno,
Pardo Fernando,
Rotellar Fernando,
AlvárezCienfuegos Javier,
Prieto Jesús
Publication year - 2003
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1046/j.1600-6143.2003.00227.x
Subject(s) - medicine , hazard ratio , hepatocellular carcinoma , contraindication , liver transplantation , incidence (geometry) , gastroenterology , malignancy , transplantation , confidence interval , liver disease , surgery , pathology , alternative medicine , physics , optics
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 .