Abstract： Objective To investigate the features and treatment outcome of liver transplantation in patients over 60 years old.Methods From April 2001 to August 2005,36 patients over 60 years old(senile group)and 214 patients under 60 years of age(control group)received liver transplantation in our liver transplantation unit.The Child-Pugh Score of the senile group was 7.86±2.06.Thirtyfour aged patients received standard orthotopic liver transplantation without bypass and the other two aged patients received piggyback liver transplantion.Postoperative immunosuppression was based on the combination of tacrolimus,hormone and daclizumab.The differences between the senile group and control group in preoperative,intraoperative and postoperative variables,including main clinical and laboratory features.were analyzed.Results The proportion of female and morbidity of hepatitis C and diabetes were higher in older liver transplant recipients(P＜0.05,P＜0.05,P＜0.01),while the morbidity of hepatitis B was lower than in control group(P＜0.01).There were no significant differences between two groups in the surgical techniques,ischemia duration of donor liver,or other intra operative data(P＞0.05).The time of postoperative incubation in senile group was about(9.0±12.1)h,longer than in control group,which was about(5.8±6.8)h(P＜0.05).Intubation duration over 12 h occurred in 36.1%(13/36)of senile group and 17.8 %(38/214)of control group respectively(P＜0.05).The postoperative incidence of cardiovascular disease and infection was about 13.9 % and 77.8 % in senile group,while about 1.9%(P＜0.01)and 59.3%(P＜0.05)in control group,respectively.However,the incidence of acute rejection in senile group was 5.6%,lower than 19.6 % in control group(P＜0.05).The 1-,2- and 3- year actuarial survival rate was 77.8%,71.8 % and 61.6 % in senile group,and 85.5 %,72.2 % and 65.5 % in control group,respectively (P＞0.05).In cases of liver carcinoma exceeding Milan criteria survival rate was markedly lower in senilc group than in control group(1-,2- and 3-year survival rate of 56.3 %,56.3 % and 36.5 % in senile group and 78.0 %,62.8 % and 62.8 % in control group respectively,P＜0.05).The pulmonarv infection was the most important cause of death in senile patients accounting for 41.7% and marklv higher than 14.9 % of control group(P<0.05).Conclusion The postoperative incidence of cardiovascular disease and infection of senile group was higher and pulmonary infection was the most common cause of mortality in elderly liver recipients.Liver transplantation for the older patients with hepatoeellular carcinoma over Milan criteria should be prudent.