Analysis of liver transplant outcomes for united network for organ sharing recipients 60 years old or older identifies multiple model for end-stage liver disease-independent prognostic factors

Thomas A. Aloia, Richard J. Knight, A. Osama Gaber, R. Mark Ghobrial, John A. Goss

Research output: Contribution to journalArticle

58 Scopus citations

Abstract

Older recipient age is associated with worse posttransplant survival. Although the median age of liver disease patients undergoing orthotopic liver transplantation (OLT) continues to rise, prognostic factors for posttransplant survival specific to older patients have not been defined. To address this issue, the United Network for Organ Sharing/Organ Procurement and Transplantation Network outcome database was searched to identify prognostic factors for the 8070 liver recipients 60 years old or older who underwent transplantation from 1994 to 2005. Prognostic factors were assessed with univariate analysis and multivariate modeling. The 5 strongest prognostic variables (ventilator status, diabetes mellitus, hepatitis C virus, creatinine levels ≥1.6 mg/dL, and recipient and donor age ≥120 years) were aggregated to define a novel older recipient prognostic score (ORPS). The overall 1- and 5-year posttransplant survival rates were 83% and 67%, respectively. The risk model, created by the assignment of 1 point to each ORPS factor, stratified patient outcomes into distinct prognostic groups at the 1-, 3-, and 5-year posttransplant time points (P < 0.001). The 5-year survival rates for patients with ORPS values of 0, 1, and 2 points were 75%, 69%, and 58%, respectively. Patients who underwent transplantation with an ORPS > 2 points consistently experienced 5-year survival rates of less than 50%. In conclusion, in liver transplant recipients 60 years old or older, the ORPS was able to predict significant and clinically relevant differences in posttransplant survival. By optimization of donor selection for recipients over the age of 60 years, clinical utilization of the ORPS model may enhance organ utilization for all patients awaiting OLT.

Original languageEnglish (US)
Pages (from-to)950-959
Number of pages10
JournalLiver Transplantation
Volume16
Issue number8
DOIs
StatePublished - Aug 2010

ASJC Scopus subject areas

  • Surgery
  • Hepatology
  • Transplantation

Fingerprint Dive into the research topics of 'Analysis of liver transplant outcomes for united network for organ sharing recipients 60 years old or older identifies multiple model for end-stage liver disease-independent prognostic factors'. Together they form a unique fingerprint.

Cite this