Endoscopy 2005; 37 - A10
DOI: 10.1055/s-2005-922872

Orthotopic liver transplantation in the elderly

G Cullen 1, F Donnellan 1, M Fahy 1, A Coffey 1, PA McCormick 1, JE Hegarty 1
  • 1National Liver Transplant Unit, St Vincent's University Hospital, Dublin, Ireland

Background: There is no consensus as to when age becomes a contraindication to orthotopic liver transplantation (OLT).

Aims: To assess outcome in older OLT patients.

Methods: We collected data for all OLTs performed in the Republic of Ireland between 1993 and 2004 and divided them into three groups according to age.

Results: 277 patients (142 male) underwent OLT between 1993 and 2004: 222 were under the age of 60, 42 over 60 and 13 over 65. The 5-year survival for all 3 groups was similar at 77%, 78% and 68% (p=0.78). Survival was significantly worse for patients over 60 transplanted for primary sclerosing cholangitis (PSC) (p=0.0065). In the over 65 group, 5 year survival was better for female patients (p=0.05). 2 of 13 over 65s (15%) and 4 of 42 over 60s (9.5%) required repeat OLT compared to 26 of 222 (11.7%) in the younger group.

Conclusions: These data support the current practice of performing OLT in patients over 65 years of age, but perhaps older males and older PSC patients should warrant special consideration.