It would therefore be necessary to be able to clarify the characteristics of these longer-lived livers and at the same time take advantage of the latest surgical techniques and advances in immunosuppression to obtain more positive results, even in the case of donating the liver of an older donor. In summary, factor optimization
“donor”, “recipient”, “clinician”
it can greatly expand liver donation and transplant opportunities.
I study: These surgeons at the University of Texas (UT) Southwestern Medical Center (Dallas) analyze data associated with “old” liver transplants. The aim is to clarify the characteristics of old but resistant livers, in order to be able to resort to older donors in the long term. Analysis of data from the United Network for Organ Sharing (UNOS) STAR file identified livers that had a cumulative age (total initial age at transplant plus posttransplant survival) of at least 100 years. Of the 253,406 livers transplanted between 1990 and 2022, 25 met the criteria.
Livers “over a hundred years old” come from older donors:
- the mean donor age for these hyperresistant livers is significantly higher, 84.7 years versus 38.5 years for the “younger” liver transplants;
- the incidence of diabetes or any infections is also lower in elderly liver donors;
- older livers have lower levels of transaminases, which are enzymes that play a key role in the liver. Elevated transaminases can cause problems during a liver transplant;
- finally, recipients of aged livers have significantly lower MELD scores (17% vs 22%, a higher MELD score indicating that the patient needs a larger amount of transplant more quickly;
- no “centenary” (or older) liver has been found to be unsuitable for transplantation due to primary non-functioning or vascular or biliary complications;
- no significant differences were found in the 12-month rejection rates between the aged and non-aged liver group.
More livers to transplant?
Regardless of the country considered, tens of thousands of patients are on the waiting list for a liver transplant. This possible expansion of liver donations therefore carries immense hope:
“We can use older donors, we have better surgical techniques, we have made tremendous progress in immunosuppression, and we have a better donor-recipient match. All these conditions lead to better results”.
