Re: age limits-in 2002, 6.8% of all transplant patients were over age 65

[Guest guest]

What coincidence, I just found this last night. A lot of assumption has been

made here that older people cannot get transplants. It is just not true. I

pasted this from a pdf. I will upload the PDF if anyone is interested in reading

the whole thing. love, Bobby

Management of Pre-Liver Transplantation Patients—

Part 1

Pratima Sharma1 and Rakela2

Advanced age is not an absolute contraindication for

LT. An early report in 1990 from UNOS found a 1-year

survival of 60% in candidates older than 65 years of age

compared to 72% in the general population.13 Thus, in

the early years of transplantation, many programs set an

upper limit of 50 years for candidates. However, in later

years, continued refinement in the selection criteria for LT

has led to increased performance of LT in patients over age

60 years, with generally good outcomes.14,15 Analysis of

UNOS data revealed that in 2002, 6.8% of all transplants

were received by patients over age 65 years, compared to

4.9% in 1991.16

Analysis of earlier data from the University of

Nebraska revealed a significantly poorer than expected

Pre-LT Patient Management: Part 1 125

outcome in patients identified preoperatively as being

high risk.17,18 A scoring system that takes in account

age, serum bilirubin, prothrombin time, encephalopathy,

ascites and nutrition was used to stratify patients

into low, medium, and high risk groups.19 Low risk

senior transplant patients had a 94.5% 1-year survival

compared to previous reports of 90.5% expected survival

for low risk adult patients. Seniors (age over 60

years) who were medium risk had a 60% survival compared

to 85.2% expected survival for medium risk

adults; high risk seniors had a 28% actual survival compared to 85.2% expected

survival for medium risk

adults; high risk seniors had a 28% actual survival compared

to 44.5% expected survival in high risk adults.

Older patients with major comorbidities have poorer

outcome and at many centers are not generally considered

for transplantation. Preoperative screening in this

population should be detailed to exclude coronary

artery disease, bone disease, and malignancy.

http://www.aasld.org/conferences/Documents/CAQ%20Corner%20Documents/Sharma1.pdf

________________________________

From: vickij777 <no_reply >

To: livercirrhosissupport

Sent: Sat, September 11, 2010 12:48:16 PM

Subject: age limits

I haven't seen too much on here about any age limits on a transplant. I'm sure

they are different in different states but does anyone have a general idea as to

how old is " too old " ?

[Guest guest]

Arizona may have changed their age restriction policy too since I was told

no transplants after 65, no donors after 60. But, for me it wouldn't make

any difference so haven't looked into it. I know I was told to try other

states, Florida is one which was doing transplants on people even into their

70s at that time I believe. But, Arizona has a severe shortage of donated

organs. Jan

On Sat, Sep 11, 2010 at 1:43 PM, Bob Aragon wrote:

> What coincidence, I just found this last night. A lot of assumption has

> been

> made here that older people cannot get transplants. It is just not true. I

> pasted this from a pdf. I will upload the PDF if anyone is interested in

> reading

> the whole thing. love, Bobby

>

> Management of Pre-Liver Transplantation Patients—

> Part 1

> Pratima Sharma1 and Rakela2

>

> Advanced age is not an absolute contraindication for

> LT. An early report in 1990 from UNOS found a 1-year

> survival of 60% in candidates older than 65 years of age

> compared to 72% in the general population.13 Thus, in

> the early years of transplantation, many programs set an

> upper limit of 50 years for candidates. However, in later

> years, continued refinement in the selection criteria for LT

> has led to increased performance of LT in patients over age

> 60 years, with generally good outcomes.14,15 Analysis of

> UNOS data revealed that in 2002, 6.8% of all transplants

> were received by patients over age 65 years, compared to

> 4.9% in 1991.16

> Analysis of earlier data from the University of

> Nebraska revealed a significantly poorer than expected

> Pre-LT Patient Management: Part 1 125

> outcome in patients identified preoperatively as being

> high risk.17,18 A scoring system that takes in account

> age, serum bilirubin, prothrombin time, encephalopathy,

> ascites and nutrition was used to stratify patients

> into low, medium, and high risk groups.19 Low risk

> senior transplant patients had a 94.5% 1-year survival

> compared to previous reports of 90.5% expected survival

> for low risk adult patients. Seniors (age over 60

> years) who were medium risk had a 60% survival compared

> to 85.2% expected survival for medium risk

> adults; high risk seniors had a 28% actual survival compared to 85.2%

> expected

> survival for medium risk

> adults; high risk seniors had a 28% actual survival compared

> to 44.5% expected survival in high risk adults.

> Older patients with major comorbidities have poorer

> outcome and at many centers are not generally considered

> for transplantation. Preoperative screening in this

> population should be detailed to exclude coronary

> artery disease, bone disease, and malignancy.

>

>

>

http://www.aasld.org/conferences/Documents/CAQ%20Corner%20Documents/Sharma1.pdf

>

>

> ________________________________

> From: vickij777 <no_reply >

> To: livercirrhosissupport

> Sent: Sat, September 11, 2010 12:48:16 PM

> Subject: age limits

>

>

> I haven't seen too much on here about any age limits on a transplant. I'm

> sure

> they are different in different states but does anyone have a general idea

> as to

> how old is " too old " ?

>

>

>

>

>

>

>