Published March 2024
| Version v1
Journal article
Recipient age influences survival after liver transplant: Results of the French national cohort 2007–2017
Creators
- Lerosey, Lea
- Ksiasek, Elea
- Abrahamowicz, Michal
- Antoine, Corinne
- Dharancy, Sébastien
- Dumortier, Jérôme
- Doussot, Alexandre
- Di Martino, Vincent
- Houssel-Debry, Pauline
- Conti, Filomena
- Francoz, Claire
- Pageaux, Georges‐philippe
- Salame, Ephrem
- Faitot, François
- Coilly, Audrey
- Hardwigsen, Jean
- Decaens, Thomas
- Chermak, Faiza
- Muscari, Fabrice
- Anty, Rodolphe
- Duvoux, Christophe
- Abergel, Armand
- Minello, Anne
- Mouillot, Thomas
- Binquet, Christine
- Latournerie, Marianne
Contributors
Others:
- Service d'Hépato-Gastro-Entérologie (CHU de Dijon) ; Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)
- McGill University = Université McGill [Montréal, Canada]
- Agence de la biomédecine [Saint-Denis la Plaine]
- Centre Hospitalier Régional Universitaire [CHU Lille] (CHRU Lille)
- Hôpital Edouard Herriot [CHU - HCL] ; Hospices Civils de Lyon (HCL)
- Service de chirurgie viscérale et digestive - Unité de transplantation hépatique ; Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)
- Service d'Hépatologie [CHRU Besançon] ; Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)
- Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
- CHU Pitié-Salpêtrière [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
- Hôpital Beaujon [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
- Hôpital Saint Eloi (CHRU Montpellier) ; Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
- CHU Trousseau [Tours] ; Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)
- Hôpital de Hautepierre [Strasbourg]
- Hôpital Paul Brousse
- Service chirurgie générale et transplantation hépatique, APHM, Hôpital La Timone, Marseille, France
- Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB) ; Centre Hospitalier Universitaire [CHU Grenoble] (CHUGA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)
- Hôpital Haut-Lévêque [CHU Bordeaux] ; CHU Bordeaux
- Chirurgie Générale et Digestive [Rangueil] ; Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
- Centre méditerranéen de médecine moléculaire (C3M) ; Université Nice Sophia Antipolis (1965 - 2019) (UNS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UniCA)
- Hôpital Archet 2 [Nice] (CHU)
- CHU Henri Mondor [Créteil]
- CHU Clermont-Ferrand
- Centre des Sciences du Goût et de l'Alimentation [Dijon] (CSGA) ; Université de Bourgogne (UB)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE)-Institut Agro Dijon ; Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)
- Société Nationale Française de Gastro-entérologie.
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.frAbstract
International audienceAdditional details
Identifiers
- URL
- https://hal.inrae.fr/hal-04667801
- URN
- urn:oai:HAL:hal-04667801v1
Origin repository
- Origin repository
- UNICA