ArticleLiver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society2020
Differential Impact of Age Among Liver Transplant Candidates With and Without Hepatocellular Carcinoma.
Article in Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 20 citations in OpenAlex.
- Tumor burden and frailty: No association in liver transplantation candidates with hepatocellular carcinoma.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2026Article
- Outcomes of Liver Transplantation in Patients With Severe Obesity: The Impact of Performance Status.Transplantation direct · 2025Article
- The value of acetylation reader YEATS2 in hepatocellular carcinoma management.Scientific reports · 2025Article
- Differential aging trends among candidates for liver transplant with and without HCC.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2025Article
- Survival Outcomes Among Patients With Hepatocellular Carcinoma in a Large Integrated US Health System.JAMA network open · 2024Article
- Review
- Reduction in Racial and Ethnic Disparity in Survival Following Liver Transplant for Hepatocellular Carcinoma in the Direct-acting Antiviral Era.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2023Article
- Outcome of liver transplantation in elderly patients: an Italian multicenter case-control study.Updates in surgery · 2023Article
- Management of hepatocellular carcinoma in patients who are 70 years or older.Surgery open science · 2022Article
- Improving the Model for End-Stage Liver Disease with sodium by incorporating kidney dysfunction types.Hepatology (Baltimore, Md.) · 2022Article
- Medicare/Medicaid Insurance, Rurality, and Black Race Associated With Provision of Hepatocellular Carcinoma Treatment and Survival.Journal of the National Comprehensive Cancer Network : JNCCN · 2021Article
- Transplant of Elderly Patients: Is There an Upper Age Cutoff?Clinics in liver disease · 2021Review
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
Hepatocellular carcinoma (HCC) is the fastest-rising cause of cancer-related mortality in the United States and is a leading indication for liver transplantation (LT). Changes have been noted in the age of the population with chronic liver disease, but how this change affects patients with HCC is unknown. This study aims to characterize trends and transplant-associated outcomes among patients ≥65 years old listed for LT with HCC. Using the United Network for Organ Sharing database, we analyzed all patients ≥18 years old listed for LT during 2003-2017 in the United States in 2 groups (<65 or ≥65 years). Time trends between HCC and non-HCC patients were compared and stratified by disease etiology. Competing-risks and Cox proportional hazards regressions associated HCC and age with wait-list and post-LT survival. There were 161,724 LT candidates included: 14% were ≥65 years old at listing and 25% had HCC. The proportion of patients ≥65 years old rose significantly faster among those with HCC, as compared with those without HCC (Δ = 0.80; P < 0.001). Age ≥65 years was significantly associated with both wait-list mortality (adjusted subhazard ratio, 1.51; 95% confidence interval [CI], 1.40-1.64) and post-LT mortality (adjusted hazard ratio, 1.50; 95% CI, 1.41-1.60) in the multivariate analysis. There were significant interactions between age and HCC on both wait-list (P < 0.001) and post-LT mortality (P = 0.04), suggesting that older age does not impact patients with HCC as much as patients without HCC. The proportion of older adults with HCC listed for LT has nearly tripled from 2003 to 2017, and the rapidly growing population of older adults with HCC may provide an opportunity to expand LT access without compromising outcomes.
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Registered trials
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