{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T23:08:24Z","timestamp":1789513704023,"version":"build-2803163510"},"reference-count":25,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T00:00:00Z","timestamp":1707868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: In Italy, data on long-term survivors after liver transplantation are lacking. Materials and Methods: We conducted a hybrid design study on a cohort of 359 adult recipients who received transplants between 1996 and 2002 to identify predictors of survival and the prevalence of co-morbidities among long-term survivors. Results: The actuarial (95% CI) patient survival was 96% (94.6\u201398.3%), 69% (64.2\u201373.6%), 55% (49.8\u201359.9%), 42.8% (37.6\u201347.8%), and 34% (29.2\u201338.9%) at 1, 5, 10, 15, and 20 years, respectively. The leading causes of death were hepatitis C virus recurrence (24.6%), extrahepatic malignancies (16.9%), infection (14.4%), and hepatocellular carcinoma recurrence (14.4%). The factors associated with the survival probability were younger donor and recipient ages (p = 0.001 and 0.004, respectively), female recipient sex (p &lt; 0.001), absence of HCV (p &lt; 0.01), absence of HCC (p = 0.001), and absence of diabetes mellitus at one year (p &lt; 0.01). At the latest follow-up, the leading comorbidities were hypertension (53.6%), obesity (18.7%), diabetes mellitus (17.1%), hyperlipidemia (14.7%), chronic kidney dysfunction (14.7%), and extrahepatic malignancies (13.8%), with 73.9% of patients having more than one complication. Conclusions: Aging with a liver graft is associated with an increased risk of complications and requires ongoing care to reduce the long-term attrition rate resulting from chronic immunosuppression.<\/jats:p>","DOI":"10.3390\/jcm13041087","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T11:18:46Z","timestamp":1707909526000},"page":"1087","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Aging with a Liver Graft: Analysis of Very Long-Term Survivors after Liver Transplantation"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6713-6170","authenticated-orcid":false,"given":"Paolo","family":"De Simone","sequence":"first","affiliation":[{"name":"Liver Transplant Program, University of Pisa Medical School Hospital, Via Paradisa 2, 56124 Pisa, Italy"},{"name":"Department of Surgical, Medical, Biochemical Pathology and Intensive Care, University of Pisa, Via Savi 20, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Bronzoni","sequence":"additional","affiliation":[{"name":"Hepatobiliary Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Via Paradisa 2, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Martinelli","sequence":"additional","affiliation":[{"name":"Hepatobiliary Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Via Paradisa 2, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juri","family":"Ducci","sequence":"additional","affiliation":[{"name":"Hepatobiliary Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Via Paradisa 2, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Campani","sequence":"additional","affiliation":[{"name":"Department of Surgical, Medical, Biochemical Pathology and Intensive Care, University of Pisa, Via Savi 20, 56126 Pisa, Italy"},{"name":"Department of Pathology, University of Pisa Medical School Hospital, Via Paradisa 2, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Gitto","sequence":"additional","affiliation":[{"name":"Internal Medicine and Liver Unit, University Hospital Careggi, Largo Brambilla 3, 50134 Florence, Italy"},{"name":"Department of Experimental and Clinical Medicine, University of Florence, Piazza San Marco 4, 50121 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piero","family":"Marchetti","sequence":"additional","affiliation":[{"name":"Diabetology Unit, University of Pisa Medical School Hospital, Via Paradisa 2, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giandomenico","family":"Biancofiore","sequence":"additional","affiliation":[{"name":"Department of Surgical, Medical, Biochemical Pathology and Intensive Care, University of Pisa, Via Savi 20, 56126 Pisa, Italy"},{"name":"Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Savi 20, 56126 Pisa, Italy"},{"name":"Intensive Care Unit, University of Pisa Medical School Hospital, Via Paradisa 2, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1111\/tri.13358","article-title":"2018 annual report of the European liver transplant registry (ELTR)\u201450-year evolution of liver transplantation","volume":"31","author":"Adam","year":"2018","journal-title":"Transpl. 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