*Purpose: We investigated the occurrence of deceased-donor liver transplants (DDLT) that have achieved or came close to 100 years of function first in the donor and then in the recipient.

*Methods: We investigated the incidence, demographics and function of DDLT allografts that have achieved or come close to 100 years of physiologic function first in the donor and continued to function in the recipient. Liver allograft survival was calculated according to the equation: Total Allograft Survival = Allograft Age at Donation + Years of Allograft Survival. Total Allograft Survival was categorized as total age of 90-94 years, 95-99 years, or 100 years and longer. Graft survival was defined as transplant survival time to date, most recent follow-up or death, re-listing for transplant. Multivariate analysis assessed predictors of physiologic allograft survival > 90 years.

*Results: In total, there were 502 DDLT with total Allograft Survival Time > 90 years of reported to UNOS/OPTN from 10/87 to 05/21; There were no LDLTs with >90 year of allograft function.

Table 1 shows the basic characteristics and outcomes for transplants performed from deceased donors over the age of 60 years. Outcome of DDLT increased over time in general and 502 grafts showed total physiological function over 90 years. In 19 cases, the duration of function was over 100 years; the longest graft function time was 108.3 years at time of analysis. Of the 19 recipients, 10 still have a functioning allograft (longest still functioning survival: 106.9 years and counting in a 69-year-old recipient who received a 92-year-old donor liver); donor age was over 90 years in 5 donors with total function over 100 years; function of 80 to 89years in 12 recipients. Multivariate analysis of each cohort verified that good donor and recipient management factors are potential predictors of allograft longevity, but donor and recipient age carried still an increased risk of failure.

*Conclusions: (1) Total organ longevity 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 may still be underutilized.

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