Survival after liver transplant in recipients older than 70 years: A systematic review and meta-analysis

Abstract

Background/Objectives: More elderly patients with end-stage liver disease are receiving liver transplantation. However, data on outcome of recipients older than 70 years are still limited. The current systematic review and meta-analysis was conducted with the aim to better describe the survival outcome of liver transplant in recipients older than 70 years compared to younger recipients. Methods: A comprehensive literature review was conducted utilizing the MEDLINE and EMBASE databases through March 2019 to identify all cohort studies that compared the long-term survival outcome between patients who underwent liver transplantation at age of >70 years versus younger recipients. Effect estimates from each study were extracted and combined together using the random-effects, generic inverse variance method of DerSimonian and Laird. Results: A total of 5 studies with 19,757 participants fulfilled the eligibility criteria and were included in the meta-analysis. The mortality rate was significantly increased among recipients who were 70 years or older compared to younger recipients with the pooled hazard ratio of 1.72 (95% confidence interval: 1.43–2.06; I2: 16%). Conclusions: The current study demonstrated a significantly increased risk of mortality postliver transplantation among recipients older than 70 years. This could be useful information to be considered along with other factors to establish graft allocation policy.

Keywords

• liver transplant
• meta-analysis
• outcome
• septuagenarian
• survival