Simply Age Not Linked To Risk Of Death From Liver Transplant

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Main Category: Transplants / Organ Donations
Also Included In: Liver Disease / Hepatitis;  Seniors / Aging
Article Date: 20 Aug 2007 - 15:00 PDT

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The age alone of a liver transplant recipient seems not to be linked to the risk of death following liver transplant, says a report in Archives of Surgery (JAMA/Archives), August issue.

The authors of the article explain that the over 70s are becoming a larger and larger proportion of the general population each year. A healthy seventy-year-old who lives in a developed country, receives high-quality medical care and follows a healthy diet will live till he/she is 80 or 90.

"As longevity has increased, the burden of liver disease in patients of advancing age has also increased and is associated with a higher mortality than in younger adults. In the 1980s, the death rate from chronic liver disease was highest in patients 65 to 74 years of age. This has led to more older patients undergoing liver transplantation," the authors wrote.

Gerald S. Lipshutz, M.D., M.S., David Geffen School of Medicine at UCLA, and team examined the records of patients who had received their first liver transplant between the years 1988-2005. 62 patients over 70 were compared to 864 aged 50-59. Survival time was measured until death, the last known follow-up or retransplantation.

During the study period, exactly half (31) of the 62 patients over 70 died, compared to 345 of the 864 patients aged 50-59. A year later 73.3% of the older patients and 79.4% of the younger ones survived. Ten years later 39.7% of the over 70s and 45.2% of the younger ones were still living.

"We found no statistically significant difference in survival in the first 10 years after transplantation for a group of 62 patients 70 years or older when compared with a younger cohort of 864 recipients aged 50 to 59 years with similar characteristics. The longest-surviving patient was 88 years old at 15 years after transplantation. One-year unadjusted survival of septuagenarians in the most recent surgical period, 2001 to 2005, was 94.4 percent," the researchers said.

26 variables, related to the recipients, donors and transplant operations were analyzed. The aim was to see which variable(s) predicted patient deaths.

Four variables were linked to death rates:

-- Preoperative hospitalization
-- The liver being kept in cold storage for a long time between its removal and transplantation
-- Cirrhosis caused by hepatitis C and alcohol
-- An increasing model for end-stage liver disease (MELD) score
Being 70 years old or older did not predict death in transplant patients on its own.

The researchers conclude "In conclusion, biological and physiological variables may play a more important role than advanced age in predicting poor survival after liver transplantation. Measures of physiological age and risk of complications should be used in the evaluation process of elderly transplant candidates. Age by itself should not be used to limit liver transplantation."

Archives of Surgery (JAMA/Archives)

Written by: Christian Nordqvist
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