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Advanced Age No Bar to Liver Transplant

Patients over 70 did as well as those in their 50s, study found

THURSDAY, Aug. 23 (HealthDay News) -- Age alone doesn't increase the risk of death among liver transplant patients age 70 or older and shouldn't restrict liver transplantation in the elderly, a new study finds.

A team at the University of California, Los Angeles, David Geffen School of Medicine reviewed the records of 62 patients age 70 and older (average age 71.9 years) and 864 patients ages 50 to 59 (average age 54.3).

All of the patients received their first liver transplant between 1988 and 2005. The patients' survival time was measured until death, the last known follow-up date, or retransplantation.

Overall, 31 of the 62 patients age 70 and older and 345 of the 864 younger patients died during the study period. After one year, 73.3 percent of older patients and 79.4 percent of younger patients were alive. After 10 years, 39.7 percent of older patients and 45.2 percent of younger patients were alive.

According to the researchers, that means they found "no statistically significant difference in survival in the first 10 years after transplantation" between the two groups of patients.

"The longest-surviving patient was 88 years old at 15 years after transplantation. One-year adjusted survival of septuagenarians in the most recent surgical period, 2001 to 2005, was 94.4 percent," the team noted.

The researchers also analyzed 26 variables to determine which ones might predict patient death. They identified four: preoperative hospitalization; prolonged period of cold storage between liver removal and transplantation; cirrhosis caused by hepatitis C and alcohol; and an increasing model for end-stage liver disease (MELD) score, a measure of disease severity.

Being 70 or older was not an independent predictor of death, the authors said.

"In conclusion, biological and physiological variables may play a more important role than advanced age in predicting poor survival after liver transplantation," the UCLA team wrote. "Measures of physiological age and risk of complications should be used in the evaluation process of elderly transplant candidates. Age by itself should not be used to limit liver transplantation."

The study is published in the August issue of the journal Archives of Surgery.

More information

The American Liver Foundation has more about liver transplantation.

-- Robert Preidt

SOURCE: JAMA/Archives journals, news release, Aug. 20, 2007

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