Liver transplantation in recipients over 65 yr old: a single center experience
| Autor: | M. Audet, D. Jaeck, Philippe Wolf, Fabrizio Panaro, T. Piardi, E. Ghislotti, H. Habibeh, M. Cag, Stefano Maria Giulini |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Health Status medicine.medical_treatment Liver transplantation Single Center Gastroenterology Cohort Studies Coronary artery disease Young Adult Liver disease Risk Factors Diabetes mellitus Internal medicine medicine Humans Contraindication Kidney transplantation Aged Retrospective Studies Transplantation business.industry Liver Diseases Patient Selection Mortality rate Graft Survival Age Factors Middle Aged medicine.disease Survival Analysis Liver Transplantation Surgery Treatment Outcome business |
| Zdroj: | Clinical Transplantation. 24:84-90 |
| ISSN: | 1399-0012 0902-0063 |
| DOI: | 10.1111/j.1399-0012.2009.00972.x |
| Popis: | Audet M, Piardi T, Panaro F, Cag M, Ghislotti E, Habibeh H, Giulini SM, Jaeck D, Wolf Ph. Liver transplantation in recipients over 65 yr old: a single center experience. Clin Transplant 2010: 24: 84–90. © 2009 John Wiley & Sons A/S. Abstract: Introduction: The advanced age of the recipient is considered a “relative contraindication” to liver transplantation (LT). However, recently some studies reported a morbidity rate and an overall survival comparable with those of younger patients. Here, we reported the outcome after LT in recipients aged >65 yr. Methods: Between January 2000 and December 2006, 565 LT was performed in 502 recipients in our institution. Of these, 34 were recipients of >65 yr old (aged group). We focused our study comparing: donor age, co-morbidities, model for end-stage liver disease (MELD) and American Society of Anesthesiologists (ASA) score, duration of operation, transfusions and outcome between the two groups (young/aged). Results: For the group aged >65: the mean donor age was 52.5 (range 16–75) yr and the graft weight 1339 g (890–1880 g). Co-morbidity was recorded in 25 (73.5%), coronary artery disease (CAD) in 17 (50%), diabetes mellitus (DM) and chronic renal insufficiency in four (11.7%) and chronic obstructive pulmonary disease (COPD) in three patients (8.8%). Mean MELD score was 14.9 (range 12–29) and ASA score was two in 15 (44.1%); and three in 19 (55.8%) recipients. Mean operation time was four h 45 min, three patients also received combined kidney transplantation. Twenty-five (73.5%) recipients received blood transfusions (mean 3.2). Morbidity was observed in 20 patients (58.8%); of these two had hepatic artery thrombosis requiring re-LT. Overall survival was 80% (40 months of follow-up), in particularly, at 30-d, one yr, three yr was 91%, 84%, 80%, respectively. The only two statistical differences reported (p = 0.02) are: the lower rate of CAD in the younger group of recipients (12%), compared with the aged group (50%) and the subsequently lower mortality rate secondary to cardiac causes in the younger group (1.4%) compared with aged group (8.8%). Conclusion: Our results suggest that the recipient age should not be considered an absolute contraindication for LT when the graft/recipient matching is optimal and when an adequate cardiac assessment is performed. |
| Databáze: | OpenAIRE |
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