Outcomes of liver transplantation in patients 70 years or older: a systematic review and meta-analysis
Introduction and Objectives: The rate of liver transplantation is increasing among the elderly population; however, data is limited on the post-liver transplantation outcomes in patients ≥70 years. Given the scarcity in liver allograft resources, a meta-analysis on the outcomes of liver transplantat...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-11-01
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| Series: | Annals of Hepatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268122000837 |
| _version_ | 1811246985526640640 |
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| author | Babu Pappu Mohan Sentia Iriana Shahab Rasool Khan Pradeep Yarra Suresh Ponnada Juan Fernando Gallegos-Orozco |
| author_facet | Babu Pappu Mohan Sentia Iriana Shahab Rasool Khan Pradeep Yarra Suresh Ponnada Juan Fernando Gallegos-Orozco |
| author_sort | Babu Pappu Mohan |
| collection | DOAJ |
| description | Introduction and Objectives: The rate of liver transplantation is increasing among the elderly population; however, data is limited on the post-liver transplantation outcomes in patients ≥70 years. Given the scarcity in liver allograft resources, a meta-analysis on the outcomes of liver transplantation in patients ≥70 years is warranted. Materials and Methods: Multiple databases were searched through March 2022 for studies that reported on the outcomes of liver-transplantation in patients ≥70 years. Meta-analysis was conducted using the random-effects model and heterogeneity was assessed using the I2 statistics. Results: Ten studies were included that analyzed 162,725 patients. The pooled rate of 1-year, 3-years and 5-years post liver transplant survival for patients ≥70 years was 78.7% (72.6–83.7; I2=74%), 61.2% (52.3–69.5; I2=87%), and 48.9% (39.3–58.6; I2=96%), respectively. The corresponding 1-year, 3-years and 5-years survival for patients <70 years were 86.6% (82.4–89.9; I2=99%), 73.2% (63–81.3; I2=99%), and 70.1% (66.8–73.2; I2=99%); respectively. Descriptive p-values of comparison were statistically significant at 1-year and 5-years (p = 0.02 and <0.001). The pooled rate of perioperative complications in patients ≥70 years was 40.7% (26.2–57; I2=93%). The pooled rate of graft failure in patients ≥70 years was 6.7% (3.3–13.1; I2=93%) and in patients <70 years was 3.7% (1–12.4; I2=99%). The pooled rate of perioperative mortality in patients ≥70 years was 16.6% (7.6–32.5; I2=99%) and in patients <70 years was 0.8% (0–33.1; I2=88%). Conclusion: Patients ≥70 years undergoing liver transplantation seem to demonstrate significantly lower 1-year and 5-year survival rates as compared to patients <70 years, albeit limited by heterogeneity. |
| first_indexed | 2024-04-12T15:01:42Z |
| format | Article |
| id | doaj.art-fa87ed6397df46d2ad46599c3e0e5c08 |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-04-12T15:01:42Z |
| publishDate | 2022-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-fa87ed6397df46d2ad46599c3e0e5c082022-12-22T03:28:04ZengElsevierAnnals of Hepatology1665-26812022-11-01276100741Outcomes of liver transplantation in patients 70 years or older: a systematic review and meta-analysisBabu Pappu Mohan0Sentia Iriana1Shahab Rasool Khan2Pradeep Yarra3Suresh Ponnada4Juan Fernando Gallegos-Orozco5Gastroenterology and Hepatology, University of Utah Health, Salt Lake City, Utah, United StatesTransplant Hepatology, University of Southern California, Keck School of Medicine, Los Angeles, United StatesBrigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United StatesInternal Medicine, University of Kentucky, Lexington, Kentucky, United StatesInternal Medicine, Carilion Roanoke Medical Center, Roanoke, Virginia, United StatesGastroenterology and Hepatology, University of Utah Health, Salt Lake City, Utah, United States; Corresponding author.Introduction and Objectives: The rate of liver transplantation is increasing among the elderly population; however, data is limited on the post-liver transplantation outcomes in patients ≥70 years. Given the scarcity in liver allograft resources, a meta-analysis on the outcomes of liver transplantation in patients ≥70 years is warranted. Materials and Methods: Multiple databases were searched through March 2022 for studies that reported on the outcomes of liver-transplantation in patients ≥70 years. Meta-analysis was conducted using the random-effects model and heterogeneity was assessed using the I2 statistics. Results: Ten studies were included that analyzed 162,725 patients. The pooled rate of 1-year, 3-years and 5-years post liver transplant survival for patients ≥70 years was 78.7% (72.6–83.7; I2=74%), 61.2% (52.3–69.5; I2=87%), and 48.9% (39.3–58.6; I2=96%), respectively. The corresponding 1-year, 3-years and 5-years survival for patients <70 years were 86.6% (82.4–89.9; I2=99%), 73.2% (63–81.3; I2=99%), and 70.1% (66.8–73.2; I2=99%); respectively. Descriptive p-values of comparison were statistically significant at 1-year and 5-years (p = 0.02 and <0.001). The pooled rate of perioperative complications in patients ≥70 years was 40.7% (26.2–57; I2=93%). The pooled rate of graft failure in patients ≥70 years was 6.7% (3.3–13.1; I2=93%) and in patients <70 years was 3.7% (1–12.4; I2=99%). The pooled rate of perioperative mortality in patients ≥70 years was 16.6% (7.6–32.5; I2=99%) and in patients <70 years was 0.8% (0–33.1; I2=88%). Conclusion: Patients ≥70 years undergoing liver transplantation seem to demonstrate significantly lower 1-year and 5-year survival rates as compared to patients <70 years, albeit limited by heterogeneity.http://www.sciencedirect.com/science/article/pii/S1665268122000837agesurvivalgraft |
| spellingShingle | Babu Pappu Mohan Sentia Iriana Shahab Rasool Khan Pradeep Yarra Suresh Ponnada Juan Fernando Gallegos-Orozco Outcomes of liver transplantation in patients 70 years or older: a systematic review and meta-analysis Annals of Hepatology age survival graft |
| title | Outcomes of liver transplantation in patients 70 years or older: a systematic review and meta-analysis |
| title_full | Outcomes of liver transplantation in patients 70 years or older: a systematic review and meta-analysis |
| title_fullStr | Outcomes of liver transplantation in patients 70 years or older: a systematic review and meta-analysis |
| title_full_unstemmed | Outcomes of liver transplantation in patients 70 years or older: a systematic review and meta-analysis |
| title_short | Outcomes of liver transplantation in patients 70 years or older: a systematic review and meta-analysis |
| title_sort | outcomes of liver transplantation in patients 70 years or older a systematic review and meta analysis |
| topic | age survival graft |
| url | http://www.sciencedirect.com/science/article/pii/S1665268122000837 |
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