*Purpose: It has been hypothesized that parenchymal grafts have a longer life expectancy than the cardio-cerebro-vascular system. We investigated the occurrence of deceased-donor liver (DDOLT), deceased-donor renal (DDRT), and living-donor renal allografts (LDRT) that have achieved or come close to 100 years of physiologic function in the donor and recipient.

*Methods: All adult single-organ transplants from donors > 70 years of age, DDOLT (n=5,427), DDRT (n=2605), and LDRT (n=616) reported to UNOS/OPTN from 10/87 to 03/20 were evaluated. LDOLT were not considered due to the relative novelity of this procedure. Allograft survival was calculated according to the equation: Overall Survival = Allograft Age at Donation + Allograft Survival; it was categorized as age of 90-<95 years, 95-<100 years, or >=100 years and longer. Graft survival was defined as function time to date, most recent follow-up or death, re-listing for transplant, or (for kidney transplants) initiation of renal replacement therapy. Multivariate analysis assessed predictors of physiologic allograft survival in liver and kidney transplants.

*Results: Table 1 shows the characteristics and outcomes. Outcome of DDOLT increased over time in general and 336 grafts showed physiological function > 90 years; in 14 cases the duration of function was > 100 years. The longest function time is 106.3 years and counting. Likewise, DDRT and LDRT allograft survival improved throughout the study period: 33 DDRT and 12 LDRT were still functioning at 90 years. In contrast to DDOLT, only 2 LDRT graft reached the 100 year mark. Multivariate analysis of each cohort verified that good donor and recipient management factors are potential predictors of allograft longevity.$$Table1

*Conclusions: Organ longevity in 2 different individuals exceeding 100 physiologic years is possible. It represents a small but increasing minority of grafts in transplant recipients. It is expected that more grafts will reach this mark with increasing follow-up time. The observation of extended longevity is higher among liver vs. kidney allograft recipients. Increases in allograft longevity between DDRT and LDRT are similar over time but more common in LDRT.

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