Long-term results of liver transplantation for over 60 years old patients with hepatitis B virus-related end-stage liver disease

• Published in: Hepatobiliary & pancreatic diseases international Vol. 13; no. 5; pp. 501 - 507
• Main Authors: Yi, Shu-Hong, Yi, Hui-Min, Fu, Bin-Sheng, Xu, Chi, Li, Min-Ru, Zhang, Qi, Yang, Yang, Chen, Gui-Hua
• Format: Journal Article
• Language: English
• Published: Singapore Elsevier B.V 01.10.2014
• Subjects: Adolescent; Adult; age; Age Factors; Aged; Carcinoma, Hepatocellular - surgery; Carcinoma, Hepatocellular - virology; China; End Stage Liver Disease - complications; End Stage Liver Disease - surgery; End Stage Liver Disease - virology; Endocrinology & Metabolism; Female; Gastroenterology and Hepatology; hepatitis B virus; Hepatitis B, Chronic - complications; Humans; Liver Neoplasms - surgery; Liver Neoplasms - virology; liver transplantation; Liver Transplantation - adverse effects; long-term; Male; Middle Aged; Neoplasm Recurrence, Local - diagnosis; Recurrence; renal insufficiency; Renal Insufficiency - complications; Severity of Illness Index; Survival Rate; Time Factors; Treatment Outcome; Young Adult; 临床; 医学; 治疗; 肝胆疾病; 诊断; China; hepatitis B virus; renal insufficiency; age; liver transplantation; long-term
• ISSN: 1499-3872
• DOI: 10.1016/S1499-3872(14)60316-7

BACKGROUND： Hepatitis B virus（HBV）-related end-stage liver disease is the leading indication for liver transplantation in China, but long-term results of liver transplantation in patients aged over 60 years are not clear. The present study was to reveal the natural history of liver recipients with hepatitis B older than60 years.METHODS： The recipients who had received liver transplantation between December 2003 and December 2005 were divided into two groups： those equal or older than 60 years（older group,n60） and those younger than 60 years（younger group, n305）.Risk factors for poor long-term outcome in patients aged over 60 years were also analyzed.RESULTS： Except for age and preexisting chronic disease（P0.05）,no significant differences were observed in perioperative characteristics between the two groups. There was also no significant difference in HBV and hepatocellular carcinoma recurrence（P0.05）. The actuarial 1-, 3-, 5- and 8-year survival rates were 81.6%, 71.6%, 66.7% and 63.3% respectively for the older group vs 84.9%, 77.7%, 70.8% and 65.6% for the younger group（P0.05）. Multivariate analyses showed that pre-liver transplant renal insufficiency was a risk factor for poor outcome in the older group（odds ratio=3.615, P0.014）.CONCLUSIONS： Liver transplantation is safe and feasible for patients with HBV-related end-stage liver disease aged over 60years. Older patients with renal insufficiency should undergo transplantation earlier than younger patients.