Korean J Transplant.  2022 Nov;36(Supple 1):S343. 10.4285/ATW2022.F-4882.

Group analysis of outcomes after liver transplant in patients aged 70 years or older

• Kim J
• Choi Y
• Suh KS
• Lee KW
• Yi NJ
• Hong SK
• Lee JM
• Hong Sy
• Lee S

• KMID: 2535570
• DOI: http://doi.org/10.4285/ATW2022.F-4882

Abstract

Background
Liver transplantation (LT) in the elderly requires caution because of its low survival and high morbidity. Since the definition of the elderly beneficiary was unclear, the base age was sequentially changed to 65 years and, more recently, to 70 years. In this study, postoperative outcomes of Orthotopic LT (OLT) in patients aged 70 and older are compared to younger pa-tients to assess its safety and efficacy.
Methods
Data on 1,457 OLT recipients were abstracted from Seoul National University Hospital over a 10 year period (2010– 2020). The median age was 55 years, and three age-based subgroups were created: elderly (70 years and older), middle-aged (55–69 years old), and young adults (18–54 years old). Pediatric recipients (age <18 years) were excluded. Standard statistical analyzes were performed using donor and recipient data to compare indications, mortality, and graft survival.
Results
There were 93 elderly OLT patients (6.4%), compared to 674 (46.3%) middle-aged patients and 690 (47.4%) young patients. There were 368 (25.3%) transplanted with liver from deceased donors and 1,089 (74.7%) from living donors. In elderly OLT patients were significantly more transplanted from deceased donors than others (37.6 % vs. 23.1% and 25.7%) (P=0.0101). The survival rate after transplantation in the elderly patient group was statistically significantly lower than in other groups (65.6 % vs. 80.3% and 85.6%) (P<0.0001). When survival was divided by life expectancy, the younger patient group was significantly lower than the other groups (0.13±0.09 vs. 0.21±0.19 and 0.19±0.14) (P<0.01).
Conclusions
Survival rates were significantly lower in the elderly group, but patients who had expired compared to life expec-tancy did not reach full life expectancy. It is important to determine whether there is sufficient benefit when comparing the life expectancy and postoperative survival rate in surgery for elderly patients, and it is necessary to consider the patient's underlying disease, especially the history of cerebrovascular accident and infection status.