*Purpose: The impact of advanced age on liver transplantation (LT) for hepatocellular carcinoma (HCC) has not been well studied. We sought to compare post-OLT survival and tumor recurrence outcomes of patients older than 70 to younger patients.

*Methods: This is a single-center retrospective cohort study of all consecutive patients with HCC treated with LT between 1998 and 2018. Patient and tumor characteristics as well as post-LT survival and oncologic outcomes were compared among patients older and younger than 70 years.

*Results: A total of 45 patients >70 years were identified and their outcomes compared to 588 patients <70 years. The median follow-up duration for the cohort was 54 months (IQR 23-103). Baseline, preoperative and tumor characteristics were comparable among the two age groups with the only exception of liver disease etiology. While Hepatitis C was the most common etiology for liver disease in both groups, HCV was more common among younger patients (61 vs 44%) while NASH was more prevalent among septuagenarians (20 vs 7%, p=0.034) . Post-LT outcomes were not significantly different between age groups . Patients >70 and <70 had comparable 5-year survival rates of 67 and 71% (p=0.349) respectively and 5-year recurrence-free survival rates of 78 and 86% (p=0.581). Finally, the time to recurrence was not significantly different in the two groups with a median of 13 (IQR 7 - 31) for patients < 70 and 25 months (IQR 16 - 42) for those >70 (p=0.151).

*Conclusions: Advanced age is not associated with worse survival or tumor recurrence outcomes. Selected patients older than 70 should have a fair evaluation for LT for HCC without age being a deciding exclusion factor.

« Back to 2019 American Transplant Congress