Increasing Age and Survival after Orthotopic Liver Transplantation for Patients with Hepatocellular Cancer

Hepatocellular carcinoma in elderly patients: challenges and solutions

“…However, long-term survival results of elderly seem to be worse than younger due to higher rate of postoperative complications, such as malignancy and heart disease. More recently, these results were supported by Kim et al,42 which studied outcome in a large cohort of 10,238 patients who underwent OLT for HCC. Although OS was prolonged in younger patients, there was no difference in term of specific disease survival between the two groups, with a cutoff at 65 years old.…”

Liver transplantation in elderly patients: a systematic review and first meta-analysis

“…The selected studies were performed in ten countries. Eight studies used data from registries, 7,22,24,26,27,29,32,37 two were comparative series, 30,41 and the remaining 12 were all singlecenter retrospective reviews of a cohort of adult deceased-…”

“…A meta-analysis is not currently available. According to the GRADE system, 17 (77.3%) studies 7,[21][22][23][24][25][26][27][28][29][31][32][33][37][38][39][40] were considered low quality, and the remaining 5 studies 30,[34][35][36]41 had a very low quality of evidence.…”

“…Elderly was defined as a recipient age >63 years in one study, 35 >65 years in thirteen studies, 7,21,22,24,25,27,28,31,33,34,37,38,40 >70 years in seven studies, 23,26,29,32,36,39,41 and >75 years in one study 30 ( Table 1). The oldest reported recipient was 80 years old.…”

Liver transplantation in elderly patients: what do we know at the beginning of 2020?

“…As early as 2001, Levy et al reported poor survival after LT in older patients at high risk, namely those hospitalized in an intensive care unit at the time of transplant or with high serum bilirubin levels [51]. Since 2002, the MELD score has become a worldwide predictor of mortality for patients waiting for a LT. Interestingly, the lower MELD scores of older recipients in most of the studies published during the MELD era [6,8,11,52,53] suggest that LT was reserved for older candidates with less severe disease and that a form of unconscious or conscious selection was applied. Despite this selection, some studies have reported poor results after transplanting elderly patients with high MELD scores [20,48].…”