Survival Outcomes After Liver Transplantation in Elderly Patients: A Single-Center Retrospective Analysis

Egeli, Tufan; Ünek, Tarkan; Ağalar, Cihan; Özbilgin, Mücahit; Derici, Serhan; Cevlik, A.D.; Akarsu, Mesut; Ellıdokuz, Hülya; Astarcıoğlu, İbrahim

doi:10.1016/j.transproceed.2019.01.090

Cited by 5 publications

(2 citation statements)

References 38 publications

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“…Few deceased donor liver transplant (DDLT) centres from the USA and Europe have analysed the outcomes of elderly recipients and have shown conflicting results. [2][3][4][5][6] The literature on outcomes after LDLT in the elderly patients is even more limited. 7 This study will be the first from a resource-constrained country without a robust national health service.…”

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confidence: 99%

Living Donor Liver Transplant in Patients Aged 60 Years or Older: Experience from a Large Volume Centre in India

Nidoni

Kandagaddala

Agarwal

et al. 2021

Journal of Clinical and Experimental Hepatology

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Background: With ageing population and higher prevalence of nonalcoholic steatohepatitis (NASH) and hepatocellular carcinoma (HCC) in older patients, more and more living donor liver transplants (LDLTs) are being considered in this group of patients as eligibility for deceased donor liver transplant is restricted to those aged 65 years and younger. However, the short-and long-term outcomes of this group have not been reported from India, which does not have a robust national health scheme. The aim of this study was to provide guidelines for transplant in this group. Methods: All patients aged 60 years and older (group 1) who underwent LDLT in our centre between January 2006 and December 2017 were studied. A propensity score-matched group in 1:2 ratio was created with comparable sex and Model for End-Stage Liver Disease score (group 2). The 2 groups were compared for duration of hospital stay, surgical complications, hospital mortality and 1-, 3-and 5-year survival. Results: Group 1 consisted of 207 patients, and group 2 had 414 patients. The number of patients in group 1 gradually increased with time from 4 in 2006 to 33 in 2017 accounting for 15% of total cases. Group 1 had more patients with viral hepatitis, NASH and HCC, and they had a higher 30-day mortality due to cardiorespiratory complications. Although 1-and 3-year survival was similar, the 5-year survival was significantly lower in group 1. Conclusion: Five-year survival was lower in the elderly group due to cardiorespiratory complications and recurrence of HCC. Outcomes in the elderly group can be improved with better patient selection and preventing HCC recurrence.

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confidence: 99%

Living Donor Liver Transplant in Patients Aged 60 Years or Older: Experience from a Large Volume Centre in India

Nidoni

Kandagaddala

Agarwal

et al. 2021

Journal of Clinical and Experimental Hepatology

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“…Some studies suggest that outcome of elderly patients receiving LT are comparable to younger patients, whereas other suggest that that median survival in elderly patients is lower than younger age group (18-59 years) [13][14][15]. Several scoring systems have been proposed for predicting longterm outcomes after LT.…”

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confidence: 99%

Preoperative evaluation of geriatric patients undergoing liver transplantation

Akhtar

2021

Current Opinion in Anaesthesiology

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Purpose of reviewAs the population of the world is aging the number of geriatric patients undergoing liver transplantation (LT) is also increasing. They pose a unique challenge for the caregivers, as they have age-related physiological changes, multiple comorbidities and cirrhosis-related pathologies. Recent findingsTwenty-two percent of patients who undergo LT are older than 65 years. Many patients suffer from nonalcoholic steatohepatitis (NASH), hepatocellular carcinoma and hepatitis-C virus. Incidence of NASH tends to increase with age, obesity, diabetes and metabolic syndrome. Elderly patients require comprehensive cognitive, cardiac and pulmonary evaluation prior to LT. Cirrhotic cardiomyopathy, hepatopulmonary syndrome, portopulmonary hypertension and frailty are of specific concern.

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Hepatocellular Carcinoma in Turkey: A Review of Disease Epidemiology and Treatment Outcomes

Andaçoğlu

Donmez

Tokat

2021

Liver Cancer in the Middle East

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Survival Outcomes After Liver Transplantation in Elderly Patients: A Single-Center Retrospective Analysis

Cited by 5 publications

References 38 publications

Living Donor Liver Transplant in Patients Aged 60 Years or Older: Experience from a Large Volume Centre in India

Living Donor Liver Transplant in Patients Aged 60 Years or Older: Experience from a Large Volume Centre in India

Preoperative evaluation of geriatric patients undergoing liver transplantation

Hepatocellular Carcinoma in Turkey: A Review of Disease Epidemiology and Treatment Outcomes

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