Survival After Liver Transplantation in Recipients Aged ≥65 Years: A Single-Center Cohort and Contextualization With...

Liver transplantation (LT) is increasingly performed in recipients ≥65 years. However, indications in this age group remain variably defined and long-term survival data are limited.

To evaluate survival in patients ≥65 years undergoing LT at a tertiary care center.

We conducted a retrospective observational study of 114 recipients aged ≥65 years who underwent LT. The primary outcome was median overall survival (months). Secondary variables included underlying liver disease, ABO blood group, hospital length of stay, and cause of death. For context, outcomes were compared with the 2023 "Memoria General de Resultados" of the Spanish Liver Transplant Registry (RETH).

Median overall survival was 112.0 ± 22.6 months, with a median follow-up of 42.5 months. Survival did not differ significantly by underlying disease or ABO group. Compared with age-matched data from RETH, our cohort showed a similar survival trajectory without statistically significant differences. When contrasted with the nationwide overall LT population, survival in recipients ≥65 years was lower at 3 years (70.0% vs 81.0%; p < .05), 5 years (64.9% vs 76.1%; p < .05), and 10 years (48.2% vs 64.7%; p < .05).

Survival outcomes in recipients ≥65 years at our center are consistent with the national registry data for this age group. LT, in carefully selected older adults, appears to be an appropriate therapeutic option, offering substantial life-expectancy gains for patients with advanced liver disease, despite lower survival compared with the overall national LT population.