Survival after liver transplant in recipients older than 70 years: A systematic review and meta-analysis

Background/Objectives: More elderly patients with end-stage liver disease are receiving liver transplantation. However, data on outcome of recipients older than 70 years are still limited. The current systematic review and meta-analysis was conducted with the aim to better describe the survival outcome of liver transplant in recipients older than 70 years compared to younger recipients. Methods: A comprehensive literature review was conducted utilizing the MEDLINE and EMBASE databases through March 2019 to identify all cohort studies that compared the long-term survival outcome between patients who underwent liver transplantation at age of >70 years versus younger recipients. Effect estimates from each study were extracted and combined together using the random-effects, generic inverse variance method of DerSimonian and Laird. Results: A total of 5 studies with 19,757 participants fulfilled the eligibility criteria and were included in the meta-analysis. The mortality rate was significantly increased among recipients who were 70 years or older compared to younger recipients with the pooled hazard ratio of 1.72 (95% confidence interval: 1.43-2.06; I²: 16%). Conclusions: The current study demonstrated a significantly increased risk of mortality postliver transplantation among recipients older than 70 years. This could be useful information to be considered along with other factors to establish graft allocation policy.