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首页> 外文期刊>Liver transplantation: official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society >Evolving Role of Liver Transplantation in Elderly Recipients
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Evolving Role of Liver Transplantation in Elderly Recipients

机译：肝移植在老年人接受者中不断发展的作用

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The need for liver transplantation (LT) among older patients is increasing, but the role of LT in the elderly (>= 70 years) is not well defined. We retrospectively reviewed all primary LTs from 1998 through 2016 at our center. Survival and associated risk factors were analyzed with Cox regression and Kaplan-Meier methods for LT recipients in 3 age groups: <60, 60-69, and >= 70 years. Among 2281 LT recipients, the median age was 56 years (range, 15-80 years), and 162 were aged >= 70 years. The estimated 5- and 10-year patient survival probabilities for elderly LT recipients were lower (70.8% and 43.6%) than for recipients aged 60-69 years (77.2% and 64.6%) and <60 years (80.7% and 67.6%). Patient and graft survival rates associated with LT improved over time from the pre-Model for End-Stage Liver Disease era to Share 15, pre-Share 35, and Share 35 for the cohort overall (P < 0.001), but rates remained relatively stable in septuagenarians throughout the study periods (all P > 0.45). There was no incremental negative effect of age at LT among elderly patients aged 70-75 years (log-rank P = 0.32). Among elderly LT recipients, greater requirement for packed red blood cells and longer warm ischemia times were significantly associated with decreased survival (P < 0.05). Survival of LT recipients, regardless of age, markedly surpassed that of patients who were denied LT, but it was persistently 20%-30% lower than the expected survival of the general US population (P < 0.001). With the aging of the population, select older patients with end-stage liver diseases can benefit from LT, which largely restores their expected life spans.
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