Living Donor Liver Transplantation: A Better Option for Patients 70 Years or Older
University of Pittsburgh Medical Center, Pittsburgh, PA
Meeting: 2022 American Transplant Congress
Abstract number: 1775
Keywords: Elderly patients, Liver transplantation, Living donor, Living-related liver donors
Topic: Clinical Science » Liver » 58 - Liver: Living Donor Liver Transplant and Partial Grafts
Session Information
Session Name: Liver: Living Donor Liver Transplant and Partial Grafts
Session Type: Poster Abstract
Date: Tuesday, June 7, 2022
Session Time: 7:00pm-8:00pm
Presentation Time: 7:00pm-8:00pm
Location: Hynes Halls C & D
*Purpose: The burden of liver diseases in patients of advanced age has risen. Irrespective of its possible causes, older recipients have a higher waitlist mortality and a decreased likelihood of transplantation. Living donor liver transplantation (LDLT) reduces the waitlist time with excellent outcomes. The aim of this study was to compare transplant outcomes between LDLT and deceased donor liver transplant (DDLT) recipients aged 70 years or older. We hypothesize that elderly LT recipients should preferentially receive LDLT.
*Methods: We retrospectively reviewed institutional adult liver transplant database at the University of Pittsburgh Medical Center. Liver transplants performed between January 2009 and June 2021 in recipients 70 years or older were identified. The following transplant outcomes were recorded for LDLT and DDLT: waitlist removal, time spent in the waitlist, and overall posttransplant survival. Apart from non-parametric statistics, Kaplan-Meir curves were constructed and compared with log rank test.
*Results: A total of 1239 liver transplant were performed between 2009 and 2021. From this, 446 were LDLT and 793 were DDLT. 38 LDLT and 61 DDLT were performed in patients aged 70 years or older. The mean age at the time of transplant for both LDLT and DDLT was 72. 29.4% elderly patients 68 years or older were removed from the waitlist due to either death or for being too sick for transplant. The mean time on the waitlist for LDLT and DDLT recipients was 116 + 94 days vs 220 +254 days (p=0.0038). The mean MELD score for LDLT vs DDLT at the time of transplant was 15 + 6 vs 27 + 7 (p<0.001). The 6-months and 12-months patient survival was 92% and 87% for LDLT vs 79% and 75% for DDLT (p<0.001).
*Conclusions: LDLT can safely be performed in elderly patients 70 years or older with improved survival rates. Given the high waitlist time-associated mortality in older patients and MELD-associated high post-transplant mortality, patients 70 years and older would experience better survival rates if a living donor is available.
To cite this abstract in AMA style:
Ganoza A, Duarte-Rojo A, Gunabushanam V, Molinari M, Ganesh S, Reddy D, Thompson AM, Tevar A, Hughes C, Humar A. Living Donor Liver Transplantation: A Better Option for Patients 70 Years or Older [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/living-donor-liver-transplantation-a-better-option-for-patients-70-years-or-older/. Accessed November 21, 2024.« Back to 2022 American Transplant Congress