Open AccessAdvanced donor age does not increase risk of hepatocellular carcinoma recurrence after liver transplantation: a retrospective two‐centre analysis using competing risk analysis
Author(s) -
Cusumano Caterina,
De Carlis Luciano,
Centonze Leonardo,
Lesourd Romain,
Levi Sandri Giovanni Battista,
Lauterio Andrea,
De Carlis Riccardo,
Ferla Fabio,
Di Sandro Stefano,
Camus Christophe,
Jézéquel Caroline,
BardouJacquet Edouard,
Rayar Michel
Publication year - 2021
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.13950
Subject(s) - medicine , hepatocellular carcinoma , propensity score matching , liver transplantation , transplantation , gastroenterology , milan criteria , retrospective cohort study , risk factor , surgery
Summary The impact of donor age on the recurrence of hepatocellular carcinoma (HCC) after liver transplantation is still debated. Between 2002 and 2014, all patients transplanted for HCC in 2 European liver transplantation tertiary centres were retrospectively reviewed. Risk factors for HCC recurrence were assessed using competing risk analysis, and the impact of donor age < or ≥65 years and < or ≥80 years was specifically evaluated after propensity score matching. 728 patients transplanted with a median follow‐up of 86 months were analysed. The 1‐, 3‐ and 5‐year recurrence rates were 4.9%, 10.7% and 13.9%, respectively. In multivariable analysis, recipient age (sHR: 0.96 [0.93; 0.98], P < 0.01), number of lesions (sHR: 1.05 [1.04; 1.06], P < 0.001), maximum size of the lesions (sHR: 1.37 [1.27; 1.48], P < 0.01), presence of a hepatocholangiocarcinoma (sHR: 6.47 [2.91; 14.38], P < 0.01) and microvascular invasion (sHR: 3.48 [2.42; 5.02], P < 0.01) were significantly associated with HCC recurrence. After propensity score matching, neither donor age ≥65 ( P = 0.29) nor donor age ≥80 ( P = 0.84) years increased the risk of HCC recurrence. In conclusion, donor age was not found to be a risk factor for HCC recurrence. Patients listed for HCC can receive a graft from an elderly donor without compromising the outcome.