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Recipient age influences survival after liver transplant: Results of the French national cohort 2007-2017.
- Source :
-
Liver international : official journal of the International Association for the Study of the Liver [Liver Int] 2024 Jun; Vol. 44 (6), pp. 1396-1408. Date of Electronic Publication: 2024 Mar 07. - Publication Year :
- 2024
-
Abstract
- Background: In recent years, age at liver transplantation (LT) has markedly increased. In the context of organ shortage, we investigated the impact of recipient age on post-transplantation mortality.<br />Methods: All adult patients who received a first LT between 2007 and 2017 were included in this cross-sectional study. Recipients' characteristics at the time of listing, donor and surgery data, post-operative complications and follow-up of vital status were retrieved from the national transplantation database. The impact of age on 5-year overall mortality post-LT was estimated using a flexible multivariable parametric model which was also used to estimate the association between age and 10-year net survival, accounting for expected age- and sex-related mortality.<br />Results: Among the 7610 patients, 21.4% were aged 60-65 years, and 15.7% over 65. With increasing age, comorbidities increased but severity of liver disease decreased. Older recipient age was associated with decreased observed survival at 5 years after LT (p < .001), with a significant effect particularly during the first 2 years. The linear increase in the risk of death associated with age does not allow any definition of an age's threshold for LT (p = .832). Other covariates associated with an increased risk of 5-year death were dialysis and mechanical ventilation at transplant, transfusion during LT, hepatocellular carcinoma and donor age. Ten-year flexible net survival analysis confirmed these results.<br />Conclusion: Although there was a selection process for older recipients, increasing age at LT was associated with an increased risk of death, particularly in the first years after LT.<br /> (© 2024 The Authors. Liver International published by John Wiley & Sons Ltd.)
- Subjects :
- Humans
Middle Aged
Male
Female
France epidemiology
Aged
Age Factors
Cross-Sectional Studies
Adult
Risk Factors
Postoperative Complications mortality
Survival Analysis
End Stage Liver Disease surgery
End Stage Liver Disease mortality
Transplant Recipients statistics & numerical data
Liver Transplantation mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1478-3231
- Volume :
- 44
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Liver international : official journal of the International Association for the Study of the Liver
- Publication Type :
- Academic Journal
- Accession number :
- 38451069
- Full Text :
- https://doi.org/10.1111/liv.15867