Outcome of liver transplantation in septuagenarians: A single-center experience

Hypothesis: We hypothesized that selected septuagenarians may do as well after transplantation as those of a younger group of older recipients. This work compares post-liver transplant survival in septuagenarians with that of patients aged 50 to 59 years. Design: Review of a prospectively maintained database. Setting: University transplant center. Patients: First-time liver transplant recipients treated from January 1, 1988, to December 31, 2005. Group 1 consisted of liver transplant recipients aged 70 years or older at the time of transplant. Group 2 was a younger cohort of patients aged 50 to 59 years. Interventions: Liver transplantation. Main Outcome Measures: Patient survival. Survival data were stratified, Kaplan-Meier survival was calculated, and a multivariate analysis was performed. Results: Group 1 included 62 patients aged 70 years or older (average, 71.9 ± 2.1 years). Group 2 included 864 patients aged 50 to 59 years (average, 54.3 ± 2.9 years). Unadjusted patient survival of group 1 at 1, 3, 5, and 10 years was 73.3%, 65.8%, 47.1%, and 39.7%, respectively. Unadjusted patient survival of group 2 at 1, 3, 5, and 10 years was 79.4%, 71.5%, 65.3%, and 45.2%, respectively. The difference was not statistically significant (P = .14). Multivariate analysis for factors affecting survival demonstrated preoperative hospitalization, cold ischemia time, and hepatitis C/ethanol as risk factors for death. Age 70 years or more was not a strong risk factor (mortality ratio, 1.28; P = .27). Conclusions: When other risk factors for mortality are controlled in older recipients, risk of death due to age is reduced in well-selected recipients. Age by itself should not be used to limit liver transplantation.