211.10: Liver Function for Over 100 Years in 2 Different Individuals - the Centennial Liver Allograft has Arrived

Abstract

Background: Previously we studied the occurrence of deceased-donor liver (DDLT), deceased-donor renal (DDRT), and living-donor renal allografts (LDRT) that have achieved or come close to 100 years of function in 2 different individuals. We reported that extended longevity is higher among liver vs. kidney allograft recipients. Purpose: We investigated the incidence, demographics and function of DDLT allografts that have achieved or come close to 100 years of physiologic function in 2 different individuals. Methods: Liver allograft survival was calculated according to the equation: Allograft Survival = Allograft Age at Donation + Allograft Survival. The following age groups were studied: (1) 90-94 years, (2) 95-99 years, or (3) 100 years and longer. Graft survival was defined as function time to date, most recent follow-up or death, re-listing for transplant. Multivariate analysis assessed predictors of physiologic allograft survival > 90 years. In total, there were 502 deceased donor liver allografts > 90 years of age reported to UNOS/OPTN from 10/87 to 05/21; There are were no LDLT with >90 year of allograft function. Results: Table 1 shows the characteristics and outcomes. Outcome of DDLT increased over time in general and 502 grafts showed physiological function > 90 years. In 19 cases, the duration of function was > 100 years; the longest graft function time was 108.3 years. Of the 19 recipients, 10 still have a functioning allograft (longest survival: 106.9 years and counting in a 69-year old recipient who received a 92-year old donor liver); donor age was >90 years in 5 donors; >80-89, in 12; >70-79 in 2. Of allografts with >95 years, donor age was >90 in 5 and >80-89 in 51 cases. Multivariate analysis of each cohort verified that good donor and recipient management factors are potential predictors of allograft longevity. Conclusion: (1) Organ longevity in 2 different individuals exceeding 100 physiologic years is possible: We identified 19 liver recipients with >100 years in liver function and 502 recipients >90 years. This represents a small but increasing minority of grafts in liver transplant recipients. It is expected that more grafts will reach this mark with increasing follow-up time. (2) Over half of the recipients with >95 years of liver function received a donor liver >80 years of age; this indicates that older donor livers are still underutilized.