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Do older patients utilize excess health care resources after liver transplantation?
Annals of Hepatology (2011)
  • Neil Shankar, University of Western Ontario
  • Mamoon AlBashir, University of Western Ontario
  • Paul Marotta, University of Western Ontario
  • William Wall, University of Western Ontario
  • Vivian C. McAlister
  • Natasha Chandok, University of Western Ontario

INTRODUCTION: Liver transplantation is a highly effective treatment for end-stage liver disease. However, there is debate over the practice of liver transplantation in older recipients (age ≥ 60 years) given the relative shortage of donor grafts, worse post-transplantation survival, and concern that that older patients may utilize excess resources postoperatively, thus threatening the economic feasibility of the procedure.

AIM: To determine if patients ≥ 60 years of age utilize more health resources following liver transplantation compared with younger patients.

MATERIAL AND METHODS: Consecutive adult patients who underwent primary liver transplantation (n = 208) at a single center were studied over a 2.5-year period. Data were collected on clinico-demographic characteristics and resource utilization. Descriptive statistics, including means, standard deviations, or frequencies were obtained for baseline variables. Patients were stratified into 2 groups: age ≥ 60 years (n = 51) and < 60 years (n = 157). The Chi-Square Test, Mantel-Haenszel Test, 2-sample test and odds ratios were calculated to ascertain associations between age and resource utilization parameters. Regression analyses were adjusted for model for end-stage liver disease score, location before surgery, diabetes mellitus, donor age, cold ischemia time, albumin, and diagnosis of hepatitis C.

RESULTS: Recipients ≥ 60 years of age have similar lengths of hospitalization, re-operative rates, need for consultative services and readmission rates following liver transplantation, but have longer lengths of stay in the intensive care (hazard ratio 1.97, p = 0.03).

CONCLUSION: Overall, liver transplant recipients ≥ 60 years of age utilize comparable resources following LT vs. younger recipients. Our findings have implications on cost-containment policies for liver transplantation.

Publication Date
Citation Information
Neil Shankar, Mamoon AlBashir, Paul Marotta, William Wall, et al.. "Do older patients utilize excess health care resources after liver transplantation?" Annals of Hepatology Vol. 10 Iss. 4 (2011)
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