Revista: | Annals of hepatology |
Base de datos: | PERIÓDICA |
Número de sistema: | 000406022 |
ISSN: | 1665-2681 |
Autores: | Croome, Kristopher P1 Lee, David D1 Burns, Justin M1 Perry, Dana K1 Nguyen, Justin H1 Keaveny, Andrew P1 Taner, C. Burcin1 Wadei, Hani M1 |
Instituciones: | 1Mayo Clinic, Department of Transplant, Jacksonville, Florida. Estados Unidos de América |
Año: | 2016 |
Periodo: | Nov-Dic |
Volumen: | 15 |
Número: | 6 |
Paginación: | 870-880 |
País: | México |
Idioma: | Inglés |
Tipo de documento: | Artículo |
Enfoque: | Analítico, descriptivo |
Resumen en inglés | Many transplant programs have expanded eligibility to include patients previously ineligible because of advanced age. Outcomes of simultaneous liver-kidney transplantation (SLK) in recipients with advanced age are not known. Material Material and methods. and methods. Data and methods. from patients undergoing transplantation between 2002 and 2015 were obtained from the UNOS Standard Analysis and Research file. Results. Results. SLK Results. recipients aged ≥ 65 years (N = 677), SLK recipients aged < 65 years (N = 4517), and recipients of liver transplant alone(LTA) aged ≥ 65 years(N = 8495) were compared. Recipient characteristics were similar between the SLK groups. Similar patient and graft survival were observed in SLK recipients aged ≥ 65 years compared to SLK recipients aged < 65 years and LTA recipients aged ≥ 65 years. Importantly, in a subgroup analysis, superior survival was seen in the SLK group aged ≥ 65 years compared to LTA recipients aged ≥ 65 years who underwent dialysis in the week prior to transplantation (p < 0.001). A prediction model of patient survival was developed for the SLK group aged ≥ 65 years with predictors including: age ≥ 70 years (3 points), calculated MELD score (-1 to 2 points), and recipient ventilator status at the time of SLK (4 points). The risk score predicted patient survival, with a significantly inferior survival seen in patients with a score ≥ 4 (p < 0.001). Conclusions. Conclusions. Age Conclusions. should not be used as a contraindication for SLK transplantation. The validated scoring system provides a guide for patient selection and can be used when evaluating elderly patients for SLK transplantation listing |
Disciplinas: | Medicina |
Palabras clave: | Cirugía, Gastroenterología, Geriatría, Nefrología, Trasplante simultáneo, Riñones, Hígado, Ancianos, Riesgo clínico, Selección de pacientes |
Keyword: | Medicine, Gastroenterology, Geriatrics, Nephrology, Surgery, Simultenous transplantation, Kidneys, Liver, Aged, Clinical risk, Patients selection |
Texto completo: | Texto completo (Ver PDF) |