There is a small, but growing, subset of livers that have been transplanted and have a cumulative age of more than 100 years, researchers said.
The researchers said they studied these livers to identify characteristics to determine why these organs are so resilient, paving the way for considering the potential expanded use of older liver donors.
"Livers are incredibly resilient organs," said lead study author Yash Kadakia from the University of Texas (UT) Southwestern Medical Center, Dallas.
"We are using older donors, we have better surgical techniques, we have advances in immunosuppression, and we have better matching of donor and recipient factors. All these things allow us to have better outcomes," Kadakia added.
For the study, presented their findings at the Scientific Forum of the American College of Surgeons (ACS) Clinical Congress 2022, the team 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.
Of 253,406 livers transplanted between 1990-2022, 25 livers met the criteria of being centurion livers --those with a cumulative age over 100 years.
"We looked at pre-transplant survival -- essentially, the donor's age -- as well as how long the liver went on to survive in the recipient," said Kadakia.
"We stratified out these remarkable livers with over 100-year survival and identified donor factors, recipient factors, and transplant factors involved in creating this unique combination where the liver was able to live to 100 years," Kadakia added.
For these centurion livers, the average donor age was significantly higher, 84.7 years, compared with 38.5 years for non-centurion liver transplants.
The researchers noted that for a liver to make it to 100, they expected to find an older average donor age and healthier donors. Notably, the donors from the centurion group had a lower incidence of diabetes and fewer donor infections.