Resumen

Introduction and aim: Many transplant programs have expanded eligibility to include patients previously ineligible because of advanced age. Outcomes of simultaneous liver-kidney transplantation (SLK) in recipients with advanced age are not known. Material and methods: Data from patients undergoing transplantation between 2002 and 2015 were obtained from the UNOS Standard Analysis and Research file. Results: SLK recipients aged > 65 years (N = 677), SLK recipients aged < 65 years (N = 4517), and recipients of liver transplant alone(LTA) aged > 65 years(N = 8495) were compared. Recipient characteristics were similar between the SLK groups. Similar patient and graft survival were observed in SLK recipients aged > 65 years compared to SLK recipients aged < 65 years and LTA recipients aged > 65 years. Importantly, in a subgroup analysis, superior survival was seen in the SLK group aged > 65 years compared to LTA recipients aged > 65 years who underwent dialysis in the week prior to transplantation (p < 0.001). A prediction model of patient survival was developed for the SLK group aged > 65 years with predictors including: age > 70 years (3 points), calculated MELD score (-1 to 2 points), and recipient ventilator status at the time of SLK (4 points). The risk score predicted patient survival, with a significantly inferior survival seen in patients with a score > 4 (p < 0.001). Conclusions: Age should not be used as a contraindication for SLK transplantation. The validated scoring system provides a guide for patient selection and can be used when evaluating elderly patients for SLK transplantation listing.

Palabras clave: SLK combined transplant.

2016-11-18   |   431 visitas   |   Evalua este artículo 0 valoraciones

Vol. 15 Núm.6. Noviembre-Diciembre 2016 Pags. 870-880 Ann Hepatol 2016; 15(6)