The findings from a study of septuagenarians suggest that age per se should not prevent a patient from having a liver transplant. According to a report in the Archives of Surgery, older patients often do well, provided that any accompanying risk factors are appropriately addressed.
"Biological and physiological variables may play a more important role than advanced age in predicting poor survival after liver transplantation," senior author Dr Ronald W. Busuttil, from the University of California at Los Angeles, and colleagues state.
The team compared the outcome of 62 transplant recipients age 70 years or older with those of 864 recipients in their 50s. All of the patients were first-time recipients and underwent transplantation between 1988 and 2005.
No significant differences in survival were noted between the two age groups. For the older group, the 1-, 5-, and 10-year survival rates were 73 percent, 47 percent, and 40 percent, respectively. The corresponding survival rates for the younger group were 79 percent, 65 percent, and 45 percent.
After more extensive analysis, the researchers identified some patient factors that significantly predicted death. These included the need for hospitalisation before the surgery, hepatitis C infection, and alcoholic cirrhosis.
Conversely, being 70 years of age or older not a significant predictor of death.
Measures that assess a patient's age based on his physical condition, rather than his chronological age, as well as estimates of the risk of complications "should be used in the evaluation process of elderly transplant candidates." "Chronologic age by itself is not a sole predictor of outcome," the authors conclude.
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