Why you may be the perfect liver donor

You liver has the potential to function for more than 100 years, according to researchers.

The team, from the University of Texas (UT) Southwestern Medical Center in Dallas and TransMedics in Andover, Massachusetts, looked at transplanted livers with a cumulative age of more than 100 years. They examined the organs in an effort to identify any characteristics that would explain why they were so resilient. This in turn led to a reappraisal of older liver donors.

The researchers, whose findings were presented at the Scientific Forum of the American College of Surgeons Clinical Congress 2022, used the United Network for Organ Sharing (UNOS) STARfile to identify livers with a cumulative age (total initial age at transplant plus post-transplant survival) of at least 100 years. Of 253,406 livers transplanted between 1990–2022, 25 livers met the criteria of being centurion livers – those with a cumulative age of more than 100 years.

“We looked at pre-transplant survival – essentially, the donor’s age – as well as how long the liver went on to survive in the recipient,” said lead study author Yash Kadakia, a medical student at UT Southwestern Medical School. “We stratified out these remarkable livers with over 100-year survival and identified donor factors, recipient factors, and transplant factors involved in creating this unique combination where the liver was able to live to 100 years.”

Centurion livers came from older donors

For these centurion livers, the average donor age was significantly higher, 84.7 years compared with 38.5 years for non-centurion liver transplants. The researchers noted that for a liver to make it to 100, they expected to find an older average donor age as well as healthier donors. Notably, the donors from the centurion group had lower incidence of diabetes and fewer donor infections.

“We previously tended to shy away from using livers from older donors,” said study co-author Dr Christine Hwang.  “If we can sort out what is special among these donors, we could potentially get more available livers to be transplanted and have good outcomes.” 

Dr Hwang noted that using older liver donors more often could potentially expand the liver donor pool.

Further study details

Centurion liver donors had lower transaminases, enzymes that play a key role in the liver. Elevated transaminases can cause problems in liver transplantation. Additionally, the recipients of centurion livers had significantly lower Model for End-Stage Liver Disease (MELD) scores (17 for the centurion group, 22 for the non-centurion group). A higher MELD score indicates that a patient is more urgently in need of a transplant. 

“Livers are incredibly resilient organs,” said Mr Kadakia. “We’re using older donors, we have better surgical techniques, we have advances in immunosuppression, and we have better matching of donor and recipient factors. All these things allow us to have better outcomes.”

How to keep your liver healthy

Don’t overdo paracetamol

Paracetamol is in more than 600 medications, including many cold and flu drugs. Most adults shouldn’t take more than 4000 milligrams per day. More could harm your liver. Try not to take more than one product with acetaminophen per day, and never take more than what the package instructions recommend.

Check your supplements

Supplements cause almost a quarter of all liver damage. Herbs such as borage, comfrey, groomwell and coltsfoot have pyrrolizidine alkaloids that can gum up the tiny blood vessels inside the organ, either over time or all at once if you take a lot. Other herbs such as atractylis gummifera, celandine, chaparral, germander, and pennyroyal oil (used in tea) can also cause liver problems.

Drink in moderation

When you drink, your liver stops doing other things so it can break down the alcohol and remove it from your blood. If you overdo it, it’s really hard on the organ and could harm it. Over time, this often leads to fatty liver, an early sign of disease. It also might cause bad bacteria to grow in your gut that can travel to your liver and cause damage.

Eat a varied diet

Eat fruits and vegetables from all the colours of the rainbow, which helps ensure you get all the nutrients and fibre you need. Avoid refined carbs such as doughnuts and white bread in favour of wholegrain rice, breads, and cereals. A bit of meat, dairy, and fat can also help.

Keep a healthy body weight

Exercise and a well-balanced diet are the best way to help maintain a good-for-you weight and lower your chances of non-alcoholic fatty liver disease.

Get vaccinated

Talk to your doctor about being vaccinated for hepatitis. It might be especially important if your immune system is weak, or your liver already shows some damage.

Would you consider being a live liver donor? Why not share your thoughts in the comments section below?

Also read: The best (and worst) foods for your liver

Ellie Baxter
Ellie Baxter
Writer and editor with interests in travel, health, wellbeing and food. Has knowledge of marketing psychology, social media management and is a keen observer and commentator on issues facing older Australians.
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