Living donor liver transplantation in patients older than 60 years

Transplantation. 2010 Aug 27;90(4):433-7. doi: 10.1097/TP.0b013e3181e81b2d.

Abstract

Background: Living donor liver transplantation (LDLT) has been performed in adult patients. However, there are a few reports on how recipient age affects the outcome of LDLT. This study assessed LDLT outcome in patients aged 60 years or older.

Methods: A total of 267 patients were enrolled and classified into two groups: those younger than 60 years (younger group, n=210) and those aged 60 years or older (older group, n=57). The 6-month and 1-, 3-, and 5-year patient survivals and the incidence of complications were compared. Multivariate analysis was performed to identify the risk factors.

Results: Fifty-five of 57 (96.5%) donors in the older group were younger than 50 years (range 25-47 years), whereas only 177 of 210 (84.3%) donors in the younger group were younger than 50 years (P<0.0001). The 6-month and 1-, 3-, and 5-year patient survival rates of the older group were 92.9%, 85.3%, 72.7%, and 70.3%, respectively, whereas those of the younger group were 87.4%, 85.8%, 80.2%, and 78.2%, respectively. Neither difference was significant. A multivariate analysis revealed that the presence of diabetes, lack of hepatocellular carcinoma, and Model for End-Stage Liver Disease (MELD) Score more than or equal to 20 were independent risk factors for survival less than 1 year after LDLT (P=0.0003, P=0.014, and P=0.041, respectively). Another multivariate analysis revealed that the lack of consanguinity, MELD Score more than or equal to 20, and male recipient were independent risk factors for death 1 year or more after LDLT (P=0.004, P=0.005, and P=0.015, respectively).

Conclusion: Recipient age did not affect LDLT outcome when patients with MELD Score less than 20 received grafts from consanguineous donors.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bilirubin / blood
  • Cause of Death
  • Female
  • Follow-Up Studies
  • Graft Survival / physiology
  • Humans
  • Kaplan-Meier Estimate
  • Liver Transplantation / mortality
  • Liver Transplantation / physiology*
  • Living Donors*
  • Male
  • Middle Aged
  • Survival Rate
  • Time Factors
  • Treatment Outcome

Substances

  • Bilirubin