A study by American researchers says that the liver can remain functional for more than 100 years. There is a small, but growing subset of livers that have been transplanted and have a cumulative age of more than 100 years, said researchers from the University of Texas (UT) Southwestern Medical Center, Dallas, and TransMedics, Andover, Massachusetts.
The researchers studied these livers to identify characteristics to determine why the livers are resilient, paving the way for consideration of the potential expanded use of older liver donors.
The researchers used the United Network for Organ Sharing (UNOS) Starfile to identify livers that had a cumulative age (total initial age at transplant plus post-transplant survival) of at least 100 years.
The analysis found that out of 253,406 livers transplanted between 1990-2022, 25 met the criteria for being a Centurion liver – those with a cumulative age of more than 100 years.
“We looked at pre-transplant survival — essentially, the age of the donor — as well as how long the liver survived in the recipient,” said lead study author Yash Kadakia, a medical student at UT Southwestern Medical School. “We stratified these remarkable livers with more than 100 years of survival and identified donor factors, recipient factors and transplant factors involved in creating this unique combination where the liver was able to survive for 100 years.”
The researchers concluded that Centurion’s livers came from older donors. The median donor age was significantly higher –84.7 years compared to 38.5 years for non-centurion liver transplantation. Notably, donors in the Centurion group had a lower incidence of diabetes and fewer donor infections.
In addition, the researchers noted that Centurion liver donors had fewer transaminases, which are enzymes that play an important role in the liver, and that elevated transaminases can cause problems in liver transplants.
“We previously shyed away from using livers from older donors,” said study co-author Christine S. Hwang, MD, FACS, associate professor of surgery at UT Southwestern Medical Center. “If we can find out what’s special among these donors, we could potentially get more livers available to transplant and have good results.”
There are 11,113 patients on the liver transplant waiting list as of September 22, 2022. As Dr Hwang noted, using older liver donors more frequently could potentially expand the liver donor pool.
(with ANI inputs)
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