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Long-term results of liver transplantation for over 60 years old patients with hepatitis B virus-related end-stage liver disease |
Shu-Hong Yi, Hui-Min Yi, Bin-Sheng Fu, Chi Xu, Min-Ru Li, Qi Zhang, Yang Yang and Gui-Hua Chen |
Guangzhou, China
Author Affiliations: Liver Transplant Center, Third Affiliated Hospital, and Transplantation Research Institute, Sun Yat-Sen University, Guangzhou 510630, China (Yi SH, Yi HM, Fu BS, Xu C, Li MR, Zhang Q, Yang Y and Chen GH)
Corresponding Author: Gui-Hua Chen, MD, PhD, Liver Transplant Center, Third Affiliated Hospital, and Transplantation Research Institute of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou 510630, China (Tel/Fax: +86-20-85252276; Email: chgh1955@263.net) |
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Abstract BACKGROUND: Hepatitis B virus (HBV)-related end-stage liver disease is the leading indication for liver transplantation in China, but long-term results of liver transplantation in patients aged over 60 years are not clear. The present study was to reveal the natural history of liver recipients with hepatitis B older than 60 years.
METHODS: The recipients who had received liver transplantation between December 2003 and December 2005 were divided into two groups: those equal or older than 60 years (older group, n=60) and those younger than 60 years (younger group, n=305). Risk factors for poor long-term outcome in patients aged over 60 years were also analyzed.
RESULTS: Except for age and preexisting chronic disease (P<0.05), no significant differences were observed in perioperative characteristics between the two groups. There was also no significant difference in HBV and hepatocellular carcinoma recurrence (P>0.05). The actuarial 1-, 3-, 5- and 8-year survival rates were 81.6%, 71.6%, 66.7% and 63.3% respectively for the older group vs 84.9%, 77.7%, 70.8% and 65.6% for the younger group (P>0.05). Multivariate analyses showed that pre-liver transplant renal insufficiency was a risk factor for poor outcome in the older group (odds ratio=3.615, P=0.014).
CONCLUSIONS: Liver transplantation is safe and feasible for patients with HBV-related end-stage liver disease aged over 60 years. Older patients with renal insufficiency should undergo transplantation earlier than younger patients.
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