Living Donor Liver Transplantation for Patients Older Than Age 70 Years: A Single-Center Experience

被引:25
作者
Kwon, J. H. [1 ]
Yoon, Y. I. [2 ]
Song, G. W. [1 ]
Kim, K. H. [1 ]
Moon, D. B. [1 ]
Jung, D. H. [1 ]
Park, G. C. [1 ]
Tak, E. Y. [3 ,4 ]
Kirchner, V. A. [5 ,6 ]
Lee, S. G. [1 ]
机构
[1] Univ Ulsan, Coll Med, Div Hepatobiliary Surg & Liver Transplantat, Dept Surg,Asan Med Ctr, Seoul, South Korea
[2] Korea Univ, Med Ctr, Div Hepatobiliary Surg & Liver Transplantat, Dept Surg,Univ Korea,Coll Med, Seoul, South Korea
[3] Univ Ulsan, Coll Med, Asan Med Ctr, Asan Inst Life Sci, Seoul, South Korea
[4] Univ Ulsan, Coll Med, Asan Med Ctr, Asan Minnesota Inst Innovating Transplantat, Seoul, South Korea
[5] Univ Minnesota, Dept Surg, Div Transplantat, Box 242 UMHC, Minneapolis, MN 55455 USA
[6] Univ Minnesota, Asan Minnesota Inst Innovating Transplantat, Minneapolis, MN USA
基金
新加坡国家研究基金会;
关键词
UNITED-STATES; HEPATOCELLULAR-CARCINOMA; WAITING-LIST; ACCESS; DISPARITIES; SURVIVAL; WAITLIST; RISK; MORTALITY; CIRRHOSIS;
D O I
10.1111/ajt.14355
中图分类号
R61 [外科手术学];
学科分类号
摘要
Over the past two decades, the age of liver transplantation (LT) recipients has been increasing. We reviewed our experience with LT for patients aged >= 70 years (range: 70-78 years) and investigated the feasibility of performing LT, especially living donor LT (LDLT), for older patients. We retrospectively reviewed the medical records of 25 patients (15 LDLT recipients, 10 deceased donor LT recipients) aged >= 70 years who underwent LT from January 2000 to April 2016. Their perioperative morbidity rate was 28.0%, and the in-hospital mortality rate was 16.0%; these results were comparable to those of matched patients in their 60s (n = 73; morbidity, p = 0.726; mortality, p = 0.816). For patients in their 70s, the 1- and 5-year patient survival rates were 84.0% and 69.8%, and the 1- and 5-year graft survival rates were 83.5% and 75.1%, respectively. Comparisons of patient and graft survival rates between matched patients in their 60s and 70s showed no statistically significant differences (patient survival, p = 0.372; graft survival, p = 0.183). Our experience suggests that patients aged = 70 years should not be excluded from LT, or even LDLT, based solely on age and implies that careful selection of recipients and donors as well as meticulous surgical technique are necessary for successful results.
引用
收藏
页码:2890 / 2900
页数:11
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