Age does not affect long-term survival after living donor liver transplantation

While older recipients of living donor liver transplantation (LDLT) appear to suffer from worse mortality outcomes, such deficiency may be attributable to clinical confounders, a recent study has found. In controlled analysis, older and younger patients show comparable long-term survival following LDLT.

The study included 171 LDLT recipients who were classified into two groups according to age: ≥65 years (n=22) and <65 years (n=149). Propensity score matching (PSM) was performed to eliminate potential effects of confounding variables, such as liver disease severity and comorbidities, leaving 56 participants eligible in the matched cohort.

In the matched analysis, 20 participants were ≥65 years of age and the rest were younger. Over a mean follow-up period of 1,054 days, researchers obtained 1-, 3-, and 5-year survival estimates of 88.3 percent, 82.1 percent, and 76.7 percent, respectively, for the whole cohort before PSM.

Disaggregating by age group showed that older participants had corresponding estimated survival rates of 68.2 percent, 59.1 percent, and 59.1 percent, while younger counterparts saw better survival rates: 91.3 percent, 85.5 percent, and 79.1 percent, respectively. The between-group difference was significant (p=0.004).

However, such effect was attenuated after PSM. The resulting 1-, 3-, and 5-year survival rates in the older group were 65.0 percent, 60.0 percent, and 60.0 percent, respectively, while corresponding estimates in the younger group were 88.9 percent, 84.7 percent, and 71.4 percent.

These findings indicate better 1-year mortality in younger patients but comparable long-term mortality, the researchers said.