Liver Transplant Survival Rate Sees Improvement Among Older Adults

Journal of the American Geriatrics Society Research Summary

An increasing number of older adults are diagnosed with end-stage liver disease. End-stage liver disease is a life-threatening condition in which the liver stops working normally. It can be caused by hepatitis, alcoholism, cancer, and other conditions. A liver transplant is the only treatment for end-stage liver disease.

Although older adults make up almost 24 percent of people waiting for liver transplants, they have often not been considered candidates for receiving this life-saving surgery. That’s because older adults often do poorly following liver transplant surgery. One reason for this is that older adults with liver disease often have many other health challenges which make recovery from transplant surgery more difficult.

However, researchers have recently reported successful liver transplants in older adults—even in people who are in their 80’s.

To learn more about older adults and liver transplants, a team of researchers studied information recorded by the Scientific Registry of Transplant Recipients (SRTR) from 2003 to 2016. The SRTR data system includes information about all liver donors, people on liver transplant wait lists, and people who have received transplants in the United States. The team’s study was published in the Journal of the American Geriatrics Society.

The researchers learned that out of the 58,598 adults who received liver transplants, 8,627 (14.7 percent) were older adults. Of them:

  • 78 percent were aged 65-69
  • 1 percent were aged 70-74
  • 6 percent were aged 75-79
  • 1 percent were aged 80 or over
  • 1 percent were women and 6.4 percent were African-American.

The number of liver transplants performed in older adults each year increased substantially from 2003 to 2016. In 2016, 1,144 older adults received liver transplants (20.7 percent of all liver transplant recipients), up from 263 older recipients in 2003 (when older adults made up just 9.5 percent of all liver transplant recipients).

Recently, older adults have been doing better following liver transplants. When the researchers took all factors into account, the one-year acute rejection rate in 2013-2016 was 30 percent lower than it was in 2003-2006. Also, the risk of death was 57 percent lower than in 2003-2006.

The researchers also reported that survival in older liver transplant recipients improved steadily over time.

Older patients with end-stage liver disease and their healthcare providers should be aware of these findings. The researchers suggested that increased age on its own should not prevent older adults and their healthcare providers from considering liver transplants.

This summary is from “Liver Transplantation Among Older Adults.” It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are Christine E. Haugen MD; Courtenay M. Holscher MD; Jacqueline Garonzik-Wang MD PhD; Marcos Pozo MD; Fatima Warsame BA; Mara McAdams-DeMarco PhD; and Dorry L. Segev, MD, PhD.

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