Session Name: Liver: Recipient Selection
Session Date & Time: None. Available on demand.
*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.
To cite this abstract in AMA style:Gruessner R, Renz J, Gruessner AC. Can an Organ Survive for More Than 100 Years Between Donor and Recipient [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/can-an-organ-survive-for-more-than-100-years-between-donor-and-recipient/. Accessed July 24, 2021.
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