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.
About the Health in Aging Foundation
This research summary was developed as a public education tool by the Health in Aging Foundation. The Foundation is a national non-profit established in 1999 by the American Geriatrics Society to bring the knowledge and expertise of geriatrics healthcare professionals to the public. We are committed to ensuring that people are empowered to advocate for high-quality care by providing them with trustworthy information and reliable resources. Last year, we reached nearly 1 million people with our resources through HealthinAging.org. We also help nurture current and future geriatrics leaders by supporting opportunities to attend educational events and increase exposure to principles of excellence on caring for older adults. For more information or to support the Foundation's work, visit http://www.
About the Journal of the American Geriatrics Society
Included in more than 9,000 library collections around the world, the Journal of the American Geriatrics Society (JAGS) highlights emerging insights on principles of aging, approaches to older patients, geriatric syndromes, geriatric psychiatry, and geriatric diseases and disorders. First published in 1953, JAGS is now one of the oldest and most impactful publications on gerontology and geriatrics, according to ISI Journal Citation Reports®. Visit wileyonlinelibrary.com/journal/JGS for more details.
About the American Geriatrics Society
Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals that has--for 75 years--worked to improve the health, independence, and quality of life of older people. Its nearly 6,000 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists. The Society provides leadership to healthcare professionals, policymakers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information, visit AmericanGeriatrics.org.