A Century-Old Liver Saves a Life

Liver transplantation is a life-saving procedure that has advanced significantly over the years. It's not just about finding a suitable donor; it's also about pushing the boundaries of medical science. A recent paper titled "First-in-human liver transplantation from a centenarian deceased donor after brain death" by Paolo De Simone and his colleagues has brought to light a remarkable feat in transplantation medicine. 

The donor in this case was a 100-year-old female, a centenarian, who unfortunately met with a road accident leading to brain death. Despite her age, her medical records were surprisingly impressive. She had medically treated hypertension and diabetes mellitus, but her lab tests and CT scans were within the normal range. Her liver function was excellent, with liver enzymes and bilirubin levels well within the healthy range. These factors made her a suitable candidate for liver donation.

The recipient, on the other hand, was a 60-year-old male suffering from hepatocellular carcinoma (HCC) due to non-alcoholic fatty liver disease (NAFLD). The match between the donor's liver and the recipient was facilitated by their comparable liver volumes.

The paper discusses the meticulous transplantation procedure. The liver was procured using portal and aortic perfusion with University of Wisconsin (UW) solution, and arterial cannulation was performed through the aorta. The procurement biopsy showed promising results, with normal histology, minimal steatosis, mild inflammatory infiltrates, and slight fibrotic expansion. The graft was procured en bloc with the duodenum, pancreas, and spleen, preserved at 4°C, and transported to the transplant center.

The recipient, nine months after the transplant, is not just alive but also has a functioning graft. There is no evidence of acute rejection or tumor recurrence. This success story challenges conventional norms and demonstrates that age alone should not be the sole determinant of organ suitability for transplantation.



REFERENCE

De Simone P, Ghinolfi D, Palladino S, Catalano G, Martinelli C, Ducci J, Bronzoni J, Tincani G, Balzano E, Carrai P, Petruccelli S, Campani D, Crocetti L, Lazzeri C, Biancofiore G, Peris A. First-in-human liver transplantation from a centenarian deceased donor after brain death. Am J Transplant. 2023 Sep 25:S1600-6135(23)00702-5. doi: 10.1016/j.ajt.2023.09.014. Epub ahead of print. PMID: 37757913.

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