Session Name: Liver: Recipient Selection
Session Date & Time: None. Available on demand.
*Purpose: The average age of liver transplant (LT) recipients has continued to increase. In spite of this, with the ongoing organ shortage, liver transplantation in the elderly remains controversial. Our goal was to assess the outcomes of LT recipients who were 70 years or older.
*Methods: We assessed LT recipients 70 years of age or older who received a LT at our center between January 2015 and June 2020.
*Results: During this period, 144 patient >70 years were evaluated for LT at our center; 54.2% were denied candidacy, 35.4% were approved and transplanted, 5.6% were approved but then delisted, and 4.9% remain active awaiting LT. Of the 697 LT performed at our center during this time, 45 (6.5%) were in recipients who were 70 years or older. Of these 45 recipients studied, 7 underwent a simultaneous liver-kidney transplant. Four recipients (8.9%) were re-transplants. The most common indications for LT were nonalcoholic steatohepatitis (NASH) (28.9%) and alcohol-related liver disease (20.0%); 26.7% had hepatocellular carcinoma (HCC). The average Model for End Stage Liver Disease (MELD) score was 21.2±8.0. Comorbidities studied included diabetes (28.9%), hypertension (26.7%), and coronary artery disease (11.1%). Assessments of functional ability prior to LT included 6-minute walk test (341.6±96.3 meters) and Karnofsky score (median 80.0). Donation after cardiac death (DCD) donors were utilized in 33.3% of transplants. Median intensive care unit (ICU) length of stay (LOS) was 1 day; hospital LOS was 6 days. The majority of LT recipients were discharged home (n=37, 82.2%) with 13.3% requiring acute rehabilitation and 2.2% requiring a skilled nursing facility. One-year patient survival was 97.8% and one-year graft survival was 93.3%.
*Conclusions: There has been an increase in the number of patients >70 years referred for LT. With appropriate pre-transplant assessment, septuagenarians undergoing LT can have favorable outcomes. Age itself should not be an absolute contraindication for pursuing liver transplantation.
|Septuagenarian LT Recipients (n=45)|
|Age (median)||71.3±1.4 (71.0)|
|MELD (median)||21.2±8.0 (22.0)|
|SLK recipients||7 (15.6%)|
|Re-LT recipients||4 (8.9%)|
|6 minute walk (meters)||341.6±96.3|
|Karnofsky score (median)||80.0|
To cite this abstract in AMA style:Egbert L, Das D, Ohara S, Wagler J, Mahdi G, Aqel B, Moss A, Reddy KS, Jadlowiec C. Liver Transplantation in Septuagenarians [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/liver-transplantation-in-septuagenarians/. Accessed September 21, 2021.
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