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Liver Transplantation in the Elderly: Indications and Outcomes

 

Douglas Thorburn, MD, MRCP and Paul J. Marotta, MD, FRCPC, Multi-Organ Transplant Unit, London Health Sciences Centre, University of Western Ontario, London, ON.

Liver transplantation improves survival for selected patients with chronic liver disease, fulminant hepatic failure and hepatocellular carcinoma. There is no absolute upper age limit for liver transplantation and the proportion of patients undergoing liver transplantation who are older than 60 years is increasing. Although the indications for liver transplantation in elderly patients do not differ from those in younger patients, the prevalence of comorbidities that are contraindications to liver transplantation are higher among the elderly. Outcomes after transplantation for selected patients over 60 years of age with Child-Pugh class B cirrhosis who are well nourished and at home are comparable to those for younger patients.
Key words: liver transplantation, fulminant hepatic failure, hepatocellular carcinoma, indications.