One-year survival after liver transplantation in a group of geriatric patients

Tinitana-Jumbo, Carlos S.; Hernández-Bautista, Karen A.; Higuera-de la Tijera, María F.; Paéz-Zayas, Víctor M.; Santana-Vargas, Daniel; Montes-Castellanos, Camila; Pérez-Hernández, José L.

doi:10.1016/j.aohep.2024.101419

ISSN: 1665-2681

Annals of Hepatology (AoH) is an international, open access journal published bi-monthly with funds from the Fundación Clínica Médica Sur. It is the official journal of the Mexican Association of Hepatology (AMH), the Latin American Association for the Study of the Liver (ALEH), the Canadian Association for the Study of the Liver (CASL) and the Czech Society of Hepatology (CSH). AoH publishes editorials, opinions, concise reviews, original articles, brief reports, letters to the editor, news from affiliated associations, clinical practice guidelines and summaries of congresses in the field of Hepatology.

Topics covered by AoH include alcoholic liver disease, autoimmune hepatitis, biliary diseases, drug-induced liver injury, genetic liver diseases, NAFLD/NASH and viral hepatitis (HAV, HBV, HCV, HDV, HEV). Our journal seeks to publish articles on basic clinical care and translational research focused on preventing rather than treating the complications of end-stage liver disease.

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Prevalence of patients with decompensated cirrhosis with requirement of liver transplantation (LT) has increased in our country. A significant percentage of patients with this condition belongs to a geriatric population, which could contraindicate LT, although trends in other countries indicate that the results of LT in geriatric patients are excellent.

To assess one-year survival of LT patients over 60 years

Materials and Patients

Retrospective, observational, and analytical study of patients over 60 years who underwent LT, evaluating survival, cold ischemia time (CIT), hot ischemia time (HIT), and donor age (DA), compared with a group of patients under 60 years who underwent LT.

We evaluated survival over time in months with a follow-up at one year of recipients under 60 years and older than 60 using the Kaplan-Meier curve and the log-rank test, with a significant alpha level <0.05.

Results

A total of 81 patients were included: 51 under (44.33 ±10.59) and 30 over 60 years (64.13 ±3.30), 31 females (38.27%) 50 males (61.72%). Etiologies of cirrhosis: alcohol intake 30.86%, autoimmune diseases 24.69%, MALFD 11%, hepatocellular carcinoma 9.88%. CIT and HIT in under and over 60 years were 313.64 ±97.69min and 29.91 ±6.14min, and 307.39 ±101.85min and 30.36 ±7.57min, respectively. DA was 35.55 ±14.33 years. Mortality rates were 11.76% (6/51) and 13.3% (4/30) in patients under and over 60 years, respectively, with a cumulative rate of 12.34% (10/81). The average survival in months was 12.27 (11.45-13.1, 95%CI) and 10.83 (9.6-12.0, 95%CI) in under and over 60 years, respectively. Comparison based on age was not statistically significant (log-rank test, Chi-square 1=0.742, p=0.389).

Conclusions

One year survival in geriatric patients after LT is equal to that of younger patients, indicating that age should not be a contraindication for LT.

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Ethical statement

The protocol was registered and approved by the Ethics Committee. The identity of the patients is protected. Consentment was obtained.

Declaration of interests

None

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.