Recipient age influences survival after liver transplant: Results of the French national cohort 2007-2017.

Autor: Lerosey L; Service d'Hépato-gastro-entérologie, CHU Dijon-Bourgogne, Dijon, France., Ksiasek E; CHU Dijon Bourgogne, INSERM, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, France., Abrahamowicz M; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada., Antoine C; Agence de Biomédecine, Direction Prélèvement Greffe Organes-Tissus, Saint-Denis, France., Dharancy S; Service des maladies de l'appareil digestif, CHRU de Lille, Lille, France.; Université Lille 2 and Inserm U795, Lille, France., Dumortier J; Service d'Hépa-gastroentérologie, Hôpital Édouard Herriot, Hospices Civils de Lyon, Lyon, France., Doussot A; Service de Chirurgie Hépato-biliaire, Hôpital Jean Minjoz, Besançon, France., Di Martino V; Service d'Hépatologie, Hôpital Jean Minjoz, Besançon, France., Houssel-Debry P; Service des Maladies du Foie, CHU Rennes, Rennes, France., Conti F; Service d'Hépatologie, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, Paris, France., Francoz C; Service d'hépatologie, Hôpital Beaujon, Assistance Publique des Hôpitaux de Paris, Paris, France., Pageaux GP; Service d'Hépatologie, CHU Montpellier, Montpellier, France., Salame E; Service de chirurgie digestive et transplantation hépatique, CHU Tours, Tours, France., Faitot F; Service de chirurgie, CHU Strasbourg, Strasbourg, France., Coilly A; Service d'Hépatologie, Hôpital Paul Brousse, Assistance Publique des Hôpitaux de Paris, Paris, France., Hardwigsen J; Service de chirurgie digestive et transplantation hépatique, CHU Marseille, Marseille, France., Decaens T; Service d'hépato-gastroentérologie, CHU Grenoble, Grenoble, France., Chermak F; Service d'Hépato-gastro-entérologie, CHU Bordeaux, Bordeaux, France., Muscari F; Service Chirurgie Hépato-Bilio-Pancréatique et Transplantation, CHU Toulouse, Toulouse, France., Anty R; Service d'Hépatologie, CHU Nice, Nice, France., Duvoux C; Service d'hépatologie, CHU Henri Mondor, CRETEIL, Creteil, France., Abergel A; Hépatologie, CHU de Clermont Ferrand, Clermont-Ferrand, France., Minello A; Service d'Hépato-gastro-entérologie, CHU Dijon-Bourgogne, Dijon, France., Mouillot T; Service d'Hépato-gastro-entérologie, CHU Dijon-Bourgogne, Dijon, France., Binquet C; CHU Dijon Bourgogne, INSERM, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, France., Latournerie M; Service d'Hépato-gastro-entérologie, CHU Dijon-Bourgogne, Dijon, France.
Jazyk: angličtina
Zdroj: Liver international : official journal of the International Association for the Study of the Liver [Liver Int] 2024 Jun; Vol. 44 (6), pp. 1396-1408. Date of Electronic Publication: 2024 Mar 07.
DOI: 10.1111/liv.15867
Abstrakt: Background: In recent years, age at liver transplantation (LT) has markedly increased. In the context of organ shortage, we investigated the impact of recipient age on post-transplantation mortality.
Methods: All adult patients who received a first LT between 2007 and 2017 were included in this cross-sectional study. Recipients' characteristics at the time of listing, donor and surgery data, post-operative complications and follow-up of vital status were retrieved from the national transplantation database. The impact of age on 5-year overall mortality post-LT was estimated using a flexible multivariable parametric model which was also used to estimate the association between age and 10-year net survival, accounting for expected age- and sex-related mortality.
Results: Among the 7610 patients, 21.4% were aged 60-65 years, and 15.7% over 65. With increasing age, comorbidities increased but severity of liver disease decreased. Older recipient age was associated with decreased observed survival at 5 years after LT (p < .001), with a significant effect particularly during the first 2 years. The linear increase in the risk of death associated with age does not allow any definition of an age's threshold for LT (p = .832). Other covariates associated with an increased risk of 5-year death were dialysis and mechanical ventilation at transplant, transfusion during LT, hepatocellular carcinoma and donor age. Ten-year flexible net survival analysis confirmed these results.
Conclusion: Although there was a selection process for older recipients, increasing age at LT was associated with an increased risk of death, particularly in the first years after LT.
(© 2024 The Authors. Liver International published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
Externí odkaz: