Abstract:Objective To evaluate the clinical features and outcome of liver transplantation (LT) in the elderly patients over sixty years of age.
Methods Clinicopathological data and treatment results of 31 elderly patients (≥=60 yr) with HCC (HCC group)and 26 elderly patients with benign hepatic disease (BHD group ) who received liver transplantation between Dec 2003 and Dec 2005 were retrospectively collected and compared.
Results Of 31 elderly patients in HCC group, 28 were male and 3 were female, with a mean age of 63.5+3.2 years，whereas in BHD group, 22 were male and 4 were female, with a mean age of 64.8+3.26 years. There was no difference between the two groups regarding recipients age or sex, pre-LT comorbidity, pre-LT HBsAg positive rate, blood loss, major infections and post-LT complication rate (P>0.05). Compared with BHD group,HCC group had better liver function as assessed by Child-Pugh scores. Postoperatively, the period of artificial respiration was shorter in HCC group(P<0.05). the 1-,2-y overall survival rates were 77.4% and 71.0% for HCC group, and 69.2% and 69.2% for BHD group respectively (P>0.05). Elderly HCC patients meeting Milan criteria(n=12) had 1-,2-y overall and disease-free survival equivalent to patients exceeding Milan criteria (n=19).
Conclusions Liver transplantation is safe and feasible in elderly patients. The prognosis of elderly patients with HCC after LT is comparable to those with benign hepatic disease. Milan criteria for selecting HCC patients for LT may be too restrictive and could be expanded in the elderly over sixty years of age.