Liver Transplantation Outcomes in Younger Versus Older Adult Recipients: The Edmonton Experience
Bibliographic record
Abstract
Introduction Liver transplantation (LT) offers a lifesaving treatment for patients with end‐stage liver disease (ESLD). There have been conflicting reports of outcomes in younger and elderly patients undergoing LT. This study assesses the outcomes of younger and elderly LT recipients by complications and graft survival at early and late time‐points, up to 10 years. Patients and Methods This retrospective study was conducted on a prospectively collected database of patients who underwent LT between January 2011 and December 2021 at the University of Alberta Hospital in Edmonton, Canada. Results A total of 696 patients who were 18 years and older were included and then classified into two groups: the younger adult group (YG; n = 631, < 65 years old) and the older adult group (OG; n = 65, > 65 years old). The YG was sicker, with a high model for ESLD (MELD) score, while the OG had a high incidence of coronary artery disease (CAD), hypertension, smoking, and hepatocellular carcinoma. The YG had a higher incidence of postoperative pleural effusion requiring drainage (108/631 [17%] versus 4/65 [6%]; p value < 0.02) and more rejection episodes (202/631 [32%] versus 10/65 [15%]; p value < 0.04). However, the OG had more hepatic artery thrombosis (HAT) (4/65 [6.1%] versus 10/631 [1.6%]; p value 0.03). CAD and smoking history were associated with lower patient and graft survivals; acute rejection episodes were also associated with significantly lower graft survival. Conclusion The patient and graft survival between the YG and OG are comparable at 30 days, 90 days, 1, 5 and 10 years. A history of CAD, smoking and rejection episodes decreased graft survival and age alone should not be a contraindication for LT.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".