Transplantacija jetre u bolesnika starije životne dobi

master's thesis

• Title (english): Liver transplantation in elderly patients
• Author: Tin Vučković
• Mentor: Nikola Sobočan (mentor)
• Committee member: Tajana Filipec Kanižaj (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Nikola Sobočan (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Transplantacija jetre terapija je izbora za bolesnike sa završnim stadijem jetrene bolesti. S obzirom na povećanje očekivanog životnog vijeka te starenje opće populacije, sve češće se pojavljuje potreba za transplantacijom jetre u bolesnika starije životne dobi. Budući da ovi bolesnici često imaju komorbiditete koji utječu na rezultate transplantacije te su u većoj opasnosti od malignih bolesti zbog visoke životne dobi, postavlja se pitanje opravdanosti transplantacije ove skupine bolesnika. Cilj ovog rada je analizirati prosječno preživljenje bolesnika starije i mlađe životne dobi nakon transplantacije jetre pomoću Kaplan-Meierove metode te hi-kvadrat testa kako bi se utvrdilo postoji li statistički značajna razlika u njihovom preživljenju. U istraživanje je uključeno 873 bolesnika od čega njih 667 (76,4%) pripada mlađoj dobnoj skupini, a 206 (23,6%) starijoj. Dobiveni rezultati pokazuju da postoji statistički značajna razlika između ukupnog preživljenja bolesnika mlađe i starije životne dobi nakon transplantacije jetre (p<0,01) pri čemu mlađa dobna skupina u prosjeku preživi 11,9 godina, a starija 7,2 godine. Međutim, pokazalo se da ne postoji statistički značajna razlika u preživljenju jetrenih presadaka između starijih i mlađih primatelja (p>0,05). Neke analizirane podskupine pokazale su statistički značajnu razliku u preživljenju, kao što su bolesnici s PSC-om i HCV-om, bolesnici s MELD bodovima u rasponu 15-22 te jetreni presadci čiji primatelji imaju PSC. Ovaj rad je pokazao da transplantacija jetre ima odlične rezultate s petogodišnjom stopom preživljenja mlađih bolesnika 87,9%, a starijih 77,7% što upućuje na to da je transplantacije jetre dobra terapijska opcija i za bolesnike starije životne dobi.

Abstract (english)

Liver transplantation is a therapy of choice for patients with end-stage liver disease. Due to the increase in life expectancy and aging of the general population, the need for liver transplantation in elderly patients is becoming more common. As these patients usually have comorbidities that affect the results of transplantation and they are at a higher risk for malignant diseases due to advanced age, it is questionable whether transplantation is a reasonable option. The aim of this paper is to analyse the average survival time in younger and older patients after liver transplantation using the Kaplan-Meier method and chi-square test and to determine whether there is a statistically significant difference in their survival. The study included 873 patients, of which 667 (76.4%) patients were in the younger age group and 206 (23.6%) in the older age group. The results of the study show that there is a statistically significant difference in overall survival between younger patients and older patients (p<0.01), where younger patients on average survived for 11.9 years after transplantation and elderly patients survived for 7.2 years. However, a statistically significant difference was not found in overall survival of liver grafts between the older and younger recipients (p>0.05). Some analysed subgroups showed statistically significant difference in survival, such as the patients with PSC and HCV, the patients with MELD score in the range of 15-22 and the liver grafts whose recipients have PSC. This paper shows that liver transplantation has excellent results where five-year survival rate of younger patients is 87,9% and 77,7% for elderly patients which suggests that liver transplantation is a good therapeutic option for elderly patients.

• Keywords: transplantacija jetre; starija životna dob; preživljenje; etiologija jetrene bolesti; MELD bodovi
• Keywords (english): liver transplantation; elderly patients; survival; etiology of liver disease; MELD score
• Language: croatian
• URN:NBN: urn:nbn:hr:105:011924
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-03-23 08:54:16