Liver transplantation in patients aged 65 and over: a case–control study

Abstract

Montalti R, Rompianesi G, Di Benedetto F, Ballarin R, Gerring RC, Busani S, De Pietri L, De Ruvo N, Iemmolo RM, Guerrini GP, Smerieri N, Gerunda GE. Liver transplantation in patients aged 65 and over: a case–control study.Clin Transplant 2010 DOI: 10.1111/j.1399‐0012.2010.01230.x.© 2010 John Wiley & Sons A/S. Introduction: The average age of patients undergoing liver transplantation (LT) is consistently increasing. The aim of this case–control study is to evaluate survival and outcome of patients ≥65 yr compared to younger patients undergoing LT. Materials and methods: From 10/00 to 4/08 we performed 330 primary LT, 31 (9.4%) of these were in patients aged 65–70. Following a case–control approach, we compared these patients with 31 patients aged between 41 and 64 yr and matched according to sex, LT indication, viral status, cadaveric/living donor, LT timing, and Model for End‐Stage Liver Disease (MELD) score. Results: There were no statistically significant differences in demographic and surgical donor characteristics. The mean MELD score was under 18 in both groups. Post‐LT complications occurred with a similar incidence in the two groups. one‐, three‐, and five‐yr survival was 83.9%, 80.6%, and 80.6%, respectively, for the elderly group, and 80.6%, 73.8%, and 73.8%, respectively, for the young group (p = 0.61). Discussion: Patients aged between 65 and 70 with low MELD score who undergo LT have the same short‐ and middle‐term survival expectancy, morbidity, and outcome quality as younger patients with the same indication and same pre‐LT pathology severity, whatever they might be. Thus, chronological age alone should not deter LT workup in patients >65 and <70.