The mean age was 52.2 ± 9.0 years. Most LT were performed on patients in their 50s (n = 4290, 45.6%) and 0.9% (n = 84) of the LT was performed on patients older 70 years. The overall in-hospital mortality was 6.3%, and the 3-year mortality was 11.3%.
Is there an age limit for liver transplantation? The age limit is individualized as it varies with a patient's overall health condition. However, it is rare to offer liver transplant to someone greater than 70 years old.
The long-term outlook for a liver transplant is generally good. More than 9 out of every 10 people are still alive after 1 year, around 8 in every 10 people live at least 5 years, and many people live for up to 20 years or more.
After 1-year, survival was 82 percent for patients over 65, 86 percent for patients 60-64 years old, and 83 percent for patients under 60. After 5 years, the survival rates were 73 percent, 80 percent and 78 percent respectively (these differences were not statistically significant).
The number of liver transplant recipients aged ≥70 years has increased since 2010 and therefore, the importance of knowing the risks and potential outcomes of liver transplant in this age group has become increasingly necessary [2].
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.
You may not be eligible to receive a liver transplant due to: The presence of some other life-threatening disease or condition that would not improve with transplantation. This would include certain cancers, infections that cannot be treated or cured, or significant brain damage that is not thought to be reversible.
Overall, infections are the most frequent cause of mortality in males and females, though they are significantly higher in females. In our cohort, the main causes of mortality within the first year after transplantation were infections and surgical complications in both sexes.
Liver transplantation is an ultra-major operation and probably the most difficult of all transplant operations. The hospital mortality rate after liver transplantation has ranged from 2% to 16% 1, 2, 3, 4, 5, 6, most series reporting a rate of about 10%.
Infection has remained the most common cause of death at all time points, comprising 28.4% of the deaths. This was followed with recurrent or de novo cancers (11.6%), cardiovascular (8.3%), and respiratory (7.0%) causes.
If the previous problem with your liver was caused by alcohol misuse, you are advised not to drink alcohol again. It may also be a good idea not to drink alcohol even if your liver problem was not alcohol-related, although in some cases it may be fine to do so in moderation. Speak to your care team for advice.
Liver transplant can have excellent outcomes. Recipients have been known to live a normal life over 30 years after the operation.
Their analysis revealed that 25 of them had survived for more than 100 years. Fourteen of these were still in their recipient, and the oldest liver the researchers found was 108 years old, per New Scientist's Carissa Wong.
People with higher MELD scores are generally offered donated livers first. Time spent on the liver transplant waiting list is used to break ties among people with the same MELD scores and blood types. Some liver conditions, such as liver cancer, may not result in a person getting a high MELD score.
In the U.S., a widespread practice requires patients with alcoholic liver disease to complete a period of sobriety before they can get on the waiting list for a liver. This informal policy, often called “the 6-month rule,” can be traced to the 1980s.
The waiting period for a deceased donor transplant can range from less than 30 days to more than 5 years. How long you will wait depends on how badly you need a new liver.
The cumulative incidence of wait-list mortality in frail vs nonfrail candidates at 6 months was 8.0% (23 of 290) vs 4.0% (33 of 818), at 1 year was 16.5% (48 of 290) vs 8.4% (68 of 818), and at 3 years was 32.0% (93 of 290) vs 17.0% (139 of 818).
Patients with compensated cirrhosis have a median survival that may extend beyond 12 years. Patients with decompensated cirrhosis have a worse prognosis than do those with compensated cirrhosis; the average survival without transplantation is approximately two years [13,14].
A liver transplant can affect your kidney function. A small number of patients may require temporary dialysis in the early days after the operation. Chronic or long-term kidney problems can occur in up to 40% of patients. This may be due to the immunosuppressant medication you need to take.
Infections continue to be one of the main complications that can contribute to the patient's death. More than half of transplanted patients have at least one infections complication and an infection is responsible of more than half of the deaths in liver transplant recipients.
Recovery after liver transplantation depends in part on how ill the patient was prior to surgery. Most patients are hospitalized for seven to 10 days after liver transplant. Afterward, they generally recuperate at home and typically return to work or school after about three months.
Living Donor Liver Transplantation
Posttransplant patient survival has been satisfactory: 91% at 5 years. In adult recipients the primary indications have been HCC and ALF, situations where the risk of delisting or death on the waiting list are significant.
Cirrhosis is said to have progressed from compensated to decompensated cirrhosis when serious conditions develop as it worsens. These complications can be life-threatening and requires a new liver to replace the diseased one through a liver transplant.
Advancing age, sarcopenia, acute on chronic liver failure, and non-liver-related medical co-morbidities are common conditions that arise while on the wait-list that can render a patient too sick for transplant.