Number of elderly on U.S. liver transplant list rising

Number of elderly on U.S. liver transplant list rising

(HealthDay)—The proportion of U.S. elderly patients in need of liver transplant (LT) is sharply increasing, according to a study presented at The Liver Meeting, the annual meeting of the American Association for the Study of Liver Diseases, held virtually from Nov. 12 to 15.

Maria Stepanova, Ph.D., from the Center for Outcomes Research in Liver Diseases in Washington, D.C., and colleagues assessed recent trends among elderly Americans requiring LT using data from the Scientific Registry of Transplant Recipients (2002 to 2020).

The researchers identified 31,209 LT candidates ages 65 years and older on the wait list during the study period, with the proportion of patients 65 years and older increasing over time from 9 percent (2002 to 2005) to 23 percent (2018 to 2020). Among older wait-list candidates, the proportion with nonalcoholic steatohepatitis increased from 13 percent (2002 to 2005) to 39 percent (2018 to 2020), while the proportion with hepatitis C virus decreased from 27 to 18 percent. Elderly candidates had a lower crude rate and higher rate of removal due to deterioration but similar on-list mortality compared with younger LT candidates. Independent predictors of receiving LT included more recent years of listing, male sex, , higher Model for End-Stage Liver Disease score, and hepatocellular carcinoma. Being Hispanic, being covered by Medicaid, and having pretransplant diabetes were associated with a lower chance of receiving LT among elderly.

"By studying the outcomes of transplantation in the elderly, we can provide evidence to support the expansion of the transplant candidate pool," one of the authors said in a statement. "In fact, we believe it is more about the physiologic age of the patient than their chronologic age."

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