Recipient age influences survival after liver transplant: Results of the French national cohort 2007–2017

Description

Background In recent years, age at liver transplantation (LT) has markedly increased. In the context of organ shortage, we investigated the impact of recipient age on post‐transplantation mortality. Methods All adult patients who received a first LT between 2007 and 2017 were included in this cross‐sectional study. Recipients' characteristics at the time of listing, donor and surgery data, post‐operative complications and follow‐up of vital status were retrieved from the national transplantation database. The impact of age on 5‐year overall mortality post‐LT was estimated using a flexible multivariable parametric model which was also used to estimate the association between age and 10‐year net survival, accounting for expected age‐ and sex‐related mortality. Results Among the 7610 patients, 21.4% were aged 60–65 years, and 15.7% over 65. With increasing age, comorbidities increased but severity of liver disease decreased. Older recipient age was associated with decreased observed survival at 5 years after LT ( p < .001), with a significant effect particularly during the first 2 years. The linear increase in the risk of death associated with age does not allow any definition of an age's threshold for LT ( p = .832). Other covariates associated with an increased risk of 5‐year death were dialysis and mechanical ventilation at transplant, transfusion during LT, hepatocellular carcinoma and donor age. Ten‐year flexible net survival analysis confirmed these results. Conclusion Although there was a selection process for older recipients, increasing age at LT was associated with an increased risk of death, particularly in the first years after LT.

Abstract

Corresponding author: marianne.latournerie@chu-dijon.fr

Abstract

International audience

Additional details