Perioperative treatment of liver transplantation in elder recipients: a report of 12 cases

Objective To investigate preoperatively and postoperatively the assess,treatment and complications of elderlytransplant recipients(aged≥60 years).Methods Between June 2002 to March 2012 there were 110 patients received liver transplantation in one single center,of which Age≥ 60 years was 12 cases (10.9％,older group),and of which Age＜60 years was 98 cases (control group).The preoperative and postoperative states were recorded.The surgery and use of immunosuppressant application were compared between two groups.Results Model for end-stage liver disease(MELD) score of older group was 16.4 ± 5.7,which in control group was 24.1 ± 10.2(P ＜0.05).Control group had a significantly higher incidence of gastrointestinal bleeding,hepatic encephalopathy and renal dysfunction(P＜0.05).The postoperatively extubation time in older group was 12-72 hours,and which was 6～48 hours in control group.There were 3 cases of pulmonary infection in older group,and 8 cases in control group.The dosage of corticosteroids in older group was reduced,immunosuppression was delayed and individualized used.There was no rejection in older group,while there were 5 cases of rejection in contral group,which was recovered after treatment.In older group,one case died due to lung aspergillosis at one month postoperatively,one case died due to tumor recurrence at 16 months postoperatively,rest 10 case was health survival.In contral group,3 case died due to lung aspergillosis perioperatively,23 case died due to tumor recurrence postoperatively,4 case died due to liver failure,3 case died due to biliary complications,other reasons died 2 cases,rest 63 case was health survival.During follow-up,the incidence of cardiovascular and cerebrovascular disease in older group was significantly higher than control group (P ＜ 0.05).Conclusion After strict selection and careful preparation,liver transplantation of older patients can get better results.In conclusion,older liver transplant recipients have a higer incidence of infection and cardio-cerebral vascular incidence,and attention must be give to them. Key words: Liver transplantation;  Aged;  Prognosis