Comparative outcomes of living donor liver transplantation in elderly recipients: A study on morbidity and survival in 1018 recipients

Given the increasing demand of patients requiring liver transplants who are 70 years or older and may have health conditions, this study aimed to assess the outcomes of recipients of living donor liver transplants (LDLTs) in this age group. We conducted an analysis using a prospective registry that included all recipients of LDLT from January 2011 to May 2023. Patients were divided into 2 age groups, 18-69 years and 70 years or older, and their short-term and long-term outcomes were compared. We considered complications as major if they were grade ≥3a (Dindo-Clavien). Among 1018 recipients of LDLT, 71 (7%) were aged 70 years or older. The rates of posttransplant complications of any severity were comparable between the younger and older age groups (46.7% vs. 46%, p = 0.983), as were the rates of major complications (25% vs. 25%, p = 0.995) and in-hospital mortality (6% vs. 7%, p = 0.800). The 1-, 3-, and 5-year graft survival rates were 94%, 86%, and 81% in the younger group and 92%, 87%, and 65% in the older group ( p = 0.090). Similarly, the overall 1-, 3-, and 5-year recipient survival rates were 90%, 85%, and 86% in the younger group and 88%, 86%, and 65% in the older group ( p = 0.100). This study suggests that carefully selected elderly patients can undergo LDLT and achieve comparable short-term outcomes to their younger counterparts.