Living Donor Liver Transplant in Patients Aged 60 Years or Older: Experience from a Large Volume Centre in India.
J Clin Exp Hepatol
; 11(1): 3-8, 2021.
Article
en En
| MEDLINE
| ID: mdl-33679042
BACKGROUND: With ageing population and higher prevalence of nonalcoholic steatohepatitis (NASH) and hepatocellular carcinoma (HCC) in older patients, more and more living donor liver transplants (LDLTs) are being considered in this group of patients as eligibility for deceased donor liver transplant is restricted to those aged 65 years and younger. However, the short- and long-term outcomes of this group have not been reported from India, which does not have a robust national health scheme. The aim of this study was to provide guidelines for transplant in this group. METHODS: All patients aged 60 years and older (group 1) who underwent LDLT in our centre between January 2006 and December 2017 were studied. A propensity score-matched group in 1:2 ratio was created with comparable sex and Model for End-Stage Liver Disease score (group 2). The 2 groups were compared for duration of hospital stay, surgical complications, hospital mortality and 1-, 3- and 5-year survival. RESULTS: Group 1 consisted of 207 patients, and group 2 had 414 patients. The number of patients in group 1 gradually increased with time from 4 in 2006 to 33 in 2017 accounting for 15% of total cases. Group 1 had more patients with viral hepatitis, NASH and HCC, and they had a higher 30-day mortality due to cardiorespiratory complications. Although 1- and 3-year survival was similar, the 5-year survival was significantly lower in group 1. CONCLUSION: Five-year survival was lower in the elderly group due to cardiorespiratory complications and recurrence of HCC. Outcomes in the elderly group can be improved with better patient selection and preventing HCC recurrence.
BMI, Body Mass Index; CIT, Cold Ischaemia Time; CLD, Chronic Liver Disease; GRWR, Graft Recipient Weight Ratio; HAT, Hepatic Artery Thrombosis; HCC, Hepatocellular Carcinoma; LDLT, Living Donor Liver Transplant; MELD, Model of End-Stage Liver Disease; NASH, Nonalcoholic Steatohepatitis; PVT, Portal Vein Thrombosis; WIT, Warm Ischaemia Time; elderly liver recipients; liver transplant in India; liver transplant in old patients; liver transplant outcomes; living donor liver transplantation
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1
Colección:
01-internacional
Base de datos:
MEDLINE
Tipo de estudio:
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Revista:
J Clin Exp Hepatol
Año:
2021
Tipo del documento:
Article
País de afiliación:
India
Pais de publicación:
India