Volume 150, Issue 2, Pages 441-453.e6 (February 2016) Aging of Liver Transplant Registrants and Recipients: Trends and Impact on Waitlist Outcomes, Post-Transplantation Outcomes, and Transplant-Related Survival Benefit  Feng Su, Lei Yu, Kristin Berry, Iris W. Liou, Charles S. Landis, Stephen C. Rayhill, Jorge D. Reyes, George N. Ioannou  Gastroenterology  Volume 150, Issue 2, Pages 441-453.e6 (February 2016) DOI: 10.1053/j.gastro.2015.10.043 Copyright © 2016 AGA Institute Terms and Conditions

Figure 1 Trends in age among liver transplant registrants and recipients in the United States, 2002−2014. (A) Mean age of liver transplant registrants and recipients overall and by HCC status. (B) Proportion of registrants and recipients ≥60, ≥65, and ≥70 years old. (C) Mean age of registrants and recipients by HCV status. (D) Proportion of registrants and recipients ≥60 years old by HCV status. (E) Proportion of HCV-positive registrants and recipients in different age groups. (F) Proportion of HCV-negative registrants and recipients in different age groups. Gastroenterology 2016 150, 441-453.e6DOI: (10.1053/j.gastro.2015.10.043) Copyright © 2016 AGA Institute Terms and Conditions

Figure 2 Waitlist outcomes in patients listed for liver transplantation (A−C) and post-transplantation survival (D) presented by age group (2002−2014). (A) Waitlist outcomes in registrants without HCC by age group. (B) Waitlist outcomes in registrants with HCC by age group. (C) Adjusted (adjusted by competing risks analysis for all the characteristics listed at the footnote of Table 2) subhazard ratios for death on the waitlist by age group, presented separately for patients with and without HCC. Error bars denote 95% confidence intervals. (D) Kaplan-Meier post-transplantation survival by age group. Gastroenterology 2016 150, 441-453.e6DOI: (10.1053/j.gastro.2015.10.043) Copyright © 2016 AGA Institute Terms and Conditions

Figure 3 Five-year waitlist and post-transplantation life expectancy and 5-year survival benefit as a function of MELD score shown separately for different age groups. (A) Five-year waitlist life expectancy as a function of MELD score, by age group. (B) Five-year post-transplantation life expectancy as a function of MELD score, by age group. (C) Five-year transplant-related survival benefit as a function of MELD score, by age group. Gastroenterology 2016 150, 441-453.e6DOI: (10.1053/j.gastro.2015.10.043) Copyright © 2016 AGA Institute Terms and Conditions

Supplementary Figure 1 Trends in age among liver transplant registrants and recipients from 2002 to 2014, by HCC and HCV status. (A) Proportion of transplant registrants and recipients aged ≥60 years by HCC status. (B) Mean age of liver transplant registrants by HCV and HCC status. (C) Proportion of liver transplant registrants aged ≥60 years from by HCV and HCC status. (D) Mean age of liver transplant recipients by HCV and HCC status. (E) Proportion of transplant recipients ≥60 years old by HCV and HCC status. Gastroenterology 2016 150, 441-453.e6DOI: (10.1053/j.gastro.2015.10.043) Copyright © 2016 AGA Institute Terms and Conditions

Supplementary Figure 2 The association between age and waitlist outcomes presented separately by MELD score at listing. (A) Waitlist outcomes for transplant registrants listed at MELD ≤16. (B) Waitlist outcomes for transplant registrants listed at MELD >16. (C) Adjusted subhazard ratios (ASHR; all adjusted ASHRs are adjusted by competing risks analysis for all the characteristics listed at the footnote of Table 2) for the association between age and waitlist mortality calculated separately for patients with listing MELD ≤16 vs listing MELD >16. (D) ASHRs for the association between age and waitlist mortality calculated separately for patients with listing MELD ≤20 vs listing MELD >20. (E) ASHRs for the association between age and waitlist mortality calculated separately for patients with listing MELD ≤25 vs listing MELD >25. (F) ASHRs for the association between age and waitlist mortality calculated separately for patients with listing MELD ≤30 vs listing MELD >30. Gastroenterology 2016 150, 441-453.e6DOI: (10.1053/j.gastro.2015.10.043) Copyright © 2016 AGA Institute Terms and Conditions

Supplementary Figure 3 The association between age and waitlist outcomes presented separately by HCV status, HCC status, and UNOS regions with short wait times (3 and 10) vs regions with long wait times (5 and 9). (A) Adjusted subhazard ratios (ASHR; all adjusted ASHRs are adjusted by competing risks analysis for all the characteristics listed at the footnote of Table 2) for the association between age and waitlist mortality calculated separately for patients with and without HCV. (B) ASHRs for the association between age and transplantation calculated separately for patients with and without HCV. (C) ASHRs for the association between age and waitlist mortality calculated separately for patients with and without HCC. (D) ASHRs for the association between age and transplantation calculated separately for patients with and without HCC. (E) ASHRs for the association between age and waitlist mortality calculated separately for patients in long vs short wait-time regions. (F) ASHRs for the association between age and transplantation calculated separately for patients in long vs short wait-time regions. Gastroenterology 2016 150, 441-453.e6DOI: (10.1053/j.gastro.2015.10.043) Copyright © 2016 AGA Institute Terms and Conditions

Supplementary Figure 4 Five-year waitlist and post-transplantation life expectancy and 5-year survival benefit as a function of MELD score presented by age group and plotted separately for patients without HCC (A−C) and with HCC (D−F). (A) Five-year waitlist life expectancy as a function of MELD score, by age group in patients without HCC. (B) Five-year post-transplantation life expectancy as a function of MELD score, by age group in patients without HCC. (C) Five-year transplantation-related survival benefit as a function of MELD score, by age group in patients without HCC. (D) Five-year waitlist life expectancy as a function of MELD score, by age group in patients with HCC. (E) Five-year post-transplantation life expectancy as a function of MELD score, by age group in patients with HCC. (F) Five-year transplantation-related survival benefit as a function of MELD score, by age group in patients with HCC. Gastroenterology 2016 150, 441-453.e6DOI: (10.1053/j.gastro.2015.10.043) Copyright © 2016 AGA Institute Terms and Conditions