Li Hong Yu, Wei Yong Gang, Yan Lv Nan, Li Bo
From the Department of pancreatic Surgery (HYL), Department of Liver Surgery, Center of Liver Transplantation, West China Hospital, Sichuan University, Chengdu, China (YW, LY).
Medicine (Baltimore). 2016 Feb;95(5):e2499. doi: 10.1097/MD.0000000000002499.
Although older age theoretically might be a negative risk factor for liver transplantation (LT) outcomes, age alone should not exclude a patient from waiting list. This study is to investigate the outcomes of elderly hepatocellular carcinoma (HCC) living donor liver transplantation (LDLT) recipients which meet Milan criteria.A retrospective study was performed in a single liver transplantation center. Demographic and clinical data of 110 HCC LDLT recipients from January 2004 to December 2012 were collected and analyzed, including 31 elderly recipients in group E (≥ 60 years) and 79 younger recipients in group Y (<60 years).Recipients' age between 2 groups were significantly different (65.4 ± 4.8 vs 49.9 ± 5.9, P = 0.000). There was no significant difference in preoperative demographic data as well as postoperative liver function. Complication rates, length of ICU and hospital stay, graft loss, and mortality were similar in both groups, as well as the 1-, and 3-year overall and disease-free survival rates (77.4%, and 64.5% vs 82.8%, and 44.6%, P = 0.458; 94.7%, and 80.7% vs 98.6%, and 85.9%, P = 0.661). When recipients were further stratified into group E1, E2, Y1, and Y2, no significant difference was found in 1-, and 3-year overall and disease-free survival rates. In multivariate analysis, recipients' age was not a predictor for long-term survival.Following rigorous listing criteria, if overall clinical conditions and comorbidities allowed, elderly HCC recipients achieved similar LDLT outcomes and survival rates with the younger HCC recipients.
虽然从理论上讲，较高年龄可能是肝移植（LT）预后的一个负面风险因素，但仅年龄一项不应将患者排除在等待名单之外。本研究旨在调查符合米兰标准的老年肝细胞癌（HCC）活体肝移植（LDLT）受者的预后情况。
在一个单一的肝移植中心进行了一项回顾性研究。收集并分析了2004年1月至2012年12月期间110例HCC-LDLT受者的人口统计学和临床数据，其中E组（≥60岁）有31例老年受者，Y组（<60岁）有79例年轻受者。
两组受者的年龄有显著差异（65.4±4.8岁 vs 49.9±5.9岁，P = 0.000）。术前人口统计学数据以及术后肝功能方面无显著差异。两组的并发症发生率、重症监护病房（ICU）住院时间和住院总时长、移植物丢失率及死亡率相似，1年和3年的总生存率及无病生存率也相似（77.4%和64.5% vs 82.8%和44.6%，P = 0.458；94.7%和80.7% vs 98.6%和85.9%，P = 0.661）。当将受者进一步分层为E1、E2、Y1和Y2组时，1年和3年的总生存率及无病生存率无显著差异。在多变量分析中，受者年龄并非长期生存的预测因素。
遵循严格的入组标准，如果总体临床状况和合并症允许，老年HCC受者的LDLT预后和生存率与年轻HCC受者相似。
