PDF(Pubmed)
Abstract：
UNASSIGNED: There is limited evidence regarding the feasibility of living-donor liver transplantation (LDLT) for patients aged over 70. The aims of this study were to assess postoperative outcomes in elderly recipients and to ascertain the potential feasibility and acceptability of LDLT.
UNASSIGNED: Data were collected from 762 recipients, including 26 in the elderly group (aged ≥70) and 736 in the younger group (aged <70), and reviewed even by propensity score matching (PSM).
UNASSIGNED: No significant differences were observed in the frequency of postoperative complications between the two groups. Additionally, both groups exhibited a comparable 30-day mortality rate after LDLT (3.9% in both) and similar hospital stays (36 days vs. 40 days). The 1-, 3-, and 5-year graft survival rates in the elderly group were 92.0%, which was comparable to those in the younger group (p = 0.517), as confirmed by PSM. Notably, all donors for elderly patients were the children of the recipients, with an average age of 41.6 years, and grafts from donors aged ≥50 years were not utilized, signifying the use of high-quality grafts. Our inclusion criterion for elderly recipients was strictly defined as an ECOG-PS score of 0-2, which played a pivotal role in achieving favorable postoperative outcomes.
UNASSIGNED: LDLT can be performed safely for elderly patients aged 70 years or older, provided they have a preserved PS and receive high-quality grafts from younger donors, inevitably all children of elderly recipients. This approach yields acceptable long-term outcomes. Consequently, age alone should not serve as an absolute contraindication for LDLT.
UNASSIGNED: Data were collected from 762 recipients, including 26 in the elderly group (aged ≥70) and 736 in the younger group (aged <70), and reviewed even by propensity score matching (PSM).
UNASSIGNED: No significant differences were observed in the frequency of postoperative complications between the two groups. Additionally, both groups exhibited a comparable 30-day mortality rate after LDLT (3.9% in both) and similar hospital stays (36 days vs. 40 days). The 1-, 3-, and 5-year graft survival rates in the elderly group were 92.0%, which was comparable to those in the younger group (p = 0.517), as confirmed by PSM. Notably, all donors for elderly patients were the children of the recipients, with an average age of 41.6 years, and grafts from donors aged ≥50 years were not utilized, signifying the use of high-quality grafts. Our inclusion criterion for elderly recipients was strictly defined as an ECOG-PS score of 0-2, which played a pivotal role in achieving favorable postoperative outcomes.
UNASSIGNED: LDLT can be performed safely for elderly patients aged 70 years or older, provided they have a preserved PS and receive high-quality grafts from younger donors, inevitably all children of elderly recipients. This approach yields acceptable long-term outcomes. Consequently, age alone should not serve as an absolute contraindication for LDLT.
摘要：
■关于70岁以上患者活体肝移植（LDLT）的可行性的证据有限。这项研究的目的是评估老年受者的术后结局，并确定LDLT的潜在可行性和可接受性。
■数据来自762个收件人，其中老年组（≥70岁）26人，年轻组（<70岁）736人，甚至通过倾向得分匹配(PSM)进行审查。
■两组术后并发症的发生频率没有显着差异。此外,两组在LDLT后的30天死亡率相当（两者均为3.9%）和相似的住院时间（36天vs.40天）。1-,3-,老年组的5年移植物存活率为92.0%，这与年轻群体相当(p=0.517)，由PSM确认。值得注意的是,所有老年患者的捐赠者都是接受者的孩子，平均年龄为41.6岁，未使用年龄≥50岁的供体移植物，表示使用高质量的移植物。我们对老年受者的纳入标准严格定义为ECOG-PS评分为0-2，这在实现良好的术后结局中起着关键作用。
■LDLT可以安全地用于70岁或以上的老年患者，只要他们有保存好的PS，并从年轻的捐赠者那里获得高质量的移植物，不可避免地所有老年接受者的孩子。这种方法产生可接受的长期结果。因此,仅年龄不应作为LDLT的绝对禁忌症。
■数据来自762个收件人，其中老年组（≥70岁）26人，年轻组（<70岁）736人，甚至通过倾向得分匹配(PSM)进行审查。
■两组术后并发症的发生频率没有显着差异。此外,两组在LDLT后的30天死亡率相当（两者均为3.9%）和相似的住院时间（36天vs.40天）。1-,3-,老年组的5年移植物存活率为92.0%，这与年轻群体相当(p=0.517)，由PSM确认。值得注意的是,所有老年患者的捐赠者都是接受者的孩子，平均年龄为41.6岁，未使用年龄≥50岁的供体移植物，表示使用高质量的移植物。我们对老年受者的纳入标准严格定义为ECOG-PS评分为0-2，这在实现良好的术后结局中起着关键作用。
■LDLT可以安全地用于70岁或以上的老年患者，只要他们有保存好的PS，并从年轻的捐赠者那里获得高质量的移植物，不可避免地所有老年接受者的孩子。这种方法产生可接受的长期结果。因此,仅年龄不应作为LDLT的绝对禁忌症。
