Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.02.040
Brazilian Journal of Anesthesiology
Clinical Research

Impact of age on the incidence of complications after liver transplantation: A single-center retrospective study

Impacto da idade na incidência de complicações após o transplante de fígado: um estudo retrospectivo de centro único

Ju Yeon Park, Yoon Ji Choi, Hyun-Su Ri, Jung Min Lee, Hyo Jung Son, Yoon Sook Lee, Je ho Ryu, Kwang Ho Yang

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Abstract

Background and objective
Advances in surgical technique, postoperative management, and immunosuppressive therapy have led to a steady increase in the number of patients undergoing organ transplantation. This study aimed to compare the incidence of postoperative complications between young and elderly patients undergoing liver transplantation (LT) at a single university hospital.

Method
The medical records of 253 patients who underwent LT between January 2010 and July 2017 were retrospectively reviewed. The patients were divided into two groups: those younger than 65 years (group Y, n = 231) and those older than 65 years (group O, n = 22). Data on patient demographics, perioperative management, and postoperative complications were collected.

Results
The patients’ baseline characteristics, including underlying diseases and the Model for End-Stage Liver Disease scores, were not different between groups. Preoperative laboratory findings were not significantly different between the two groups, except for hemoglobin level. The total amounts of infused fluid and packed red blood cells were higher in group O than in group Y. The postoperative plasma creatinine level was higher in group O than in group Y; however, the incidence of postoperative complications was not considerably different between the two groups. In addition, there was no difference in the survival rate after LT depending on age.

Conclusion
With the development of medical technology, LT in elderly patients is not an operation to be avoided, and the prognosis is expected to improve. Therefore, continuous efforts to understand the disease characteristics and physical differences in elderly patients who require LT are essential.

Keywords

Age;  Elderly;  Liver transplantation;  Postoperative complications

Resumo

Justificativa e objetivo: Os avanços na técnica cirúrgica, no acompanhamento pós-operatório e na terapia imunossupressora levaram a um aumento constante no número de pacientes submetidos ao transplante de órgãos. O objetivo deste estudo foi comparar a incidência de complicações pós-operatórias entre pacientes jovens e idosos submetidos ao transplante hepático (TH) em um único hospital universitário. Método: Os prontuários de 253 pacientes submetidos a TH entre janeiro de 2010 e julho de 2017 foram revisados retrospectivamente. Os pacientes foram divididos em dois grupos: menores de 65 anos (grupo Y, n = 231) e maiores de 65 anos (grupo O, n = 22). Dados sobre dados demográficos do paciente, acompanhamento perioperatório e complicações pós-operatórias foram coletados. Resultados: as características basais dos pacientes, incluindo doenças subjacentes e os escores do modelo para doença hepática em estágio terminal, não foram diferentes entre os grupos. Os achados laboratoriais pré-operatórios não foram significativamente diferentes entre os dois grupos, exceto para o nível de hemoglobina. As quantidades totais de fluido infundido e concentrado de hemácias foram maiores no grupo O do que no grupo Y. O nível de creatinina plasmática pós-operatória foi maior no grupo O do que no grupo Y; no entanto, a incidência de complicações pós-operatórias não foi consideravelmente diferente entre os dois grupos. Além disso, não houve diferença na taxa de sobrevivência após o TH dependendo da idade. Conclusão: Com o desenvolvimento da tecnologia médica, o TH em pacientes idosos não é uma operação a ser evitada e espera-se que o prognóstico melhore. Portanto, esforços contínuos para compreender as características da doença e diferenças físicas em pacientes idosos que necessitam de TH são essenciais.

Palavras-chave

Idade; Idoso; Transplante de fígado; Complicações pósoperatórias.

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