Inferior outcomes in young adults undergoing liver transplantation - a UK and Ireland cohort study.
adult
age
liver
transplant
young
Journal
Transplant international : official journal of the European Society for Organ Transplantation
ISSN: 1432-2277
Titre abrégé: Transpl Int
Pays: Switzerland
ID NLM: 8908516
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
revised:
08
07
2021
received:
13
04
2021
accepted:
01
09
2021
pubmed:
7
9
2021
medline:
15
12
2021
entrez:
6
9
2021
Statut:
ppublish
Résumé
Graft loss incidence is reported to be inversely related to recipient age. We used a national cohort of liver transplant (LT) recipients from the United Kingdom and Ireland to compare the age-dependent risk of graft failure in different post-transplantation time-periods ('epochs'). A cohort of first-time LT recipients (1995-2016) were identified (11 006). Cox regression was used to estimate hazard ratios (HR) comparing graft loss between age-groups (18-29, 30-39, 40-49, 50-59 and 60-76 years) and graft loss in different post-transplant epochs: 0-90 days, 90 days-2 years and 2-10 years. The risk of graft failure was highest in those transplanted between age 18 and 29 (adjusted HR 1.25, 95% CI: 1.00-1.57, P = 0.04) and in those aged 30-39 (adjusted HR 1.31, 95% CI: 1.11-1.55, P = 0.02). Graft failure in those under the age of 40 was similar in the first 90 days but worse 2-10 years' post-LT (18-29 years HR 1.36, 95% CI: 0.96-1.93, P < 0.001). Graft failure because of chronic rejection (CR) was more common in recipients aged 18-29 (P < 0.001). Adults transplanted between age 18 and 39 are at risk of late graft loss. CR is a concern for young adults (18-29 years). Our data highlights the need for specialist young adult services within adult healthcare.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2274-2285Subventions
Organisme : Wellcome Trust
ID : 208812/Z/17/Z
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/S020470/1
Pays : United Kingdom
Informations de copyright
© 2021 Steunstichting ESOT. Published by John Wiley & Sons Ltd.
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