July 25, 1990

Successful Liver Transplantation in Older Patients Raises New Hopes, Challenges, Ethics Questions

JAMA. 1990;264(4):428-430. doi:10.1001/jama.1990.03450040016003

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BEING in one's 60s or even 70s is no longer reason enough to be denied orthotopic liver transplantation, two new studies suggest.

The latest findings indicate that patients in their seventh or eighth decades of life do as well as younger adults. Moreover, similar success has been recorded with elderly kidney recipients in the last several years (Transplantation. 1989;47:259 and 1989;48:689, Am J Kidney Dis. 1988;12:516, Transplant Proc. 1989;21:2018, 2020, 2024).

While donor organ shortages unfortunately persist, the positive results recorded for older recipients of livers are likely to confound even more the decision as to who should receive a liver transplant. That is, when both young and older adults face similar chances for success, who should receive the scarce organs?

"Our data make the debate even more difficult," says John Pirsch, MD, assistant professor of medicine and transplant physician at the University of Wisconsin Hospital and Clinics, Madison. "It's