98-year-old American donates liver, where is the limit?

Jem Boet

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He survived the Vietnam War and the Korean War, but a fall in his garden finally killed Orville Allen. The 98-year-old man hit his head and suffered irreparable brain damage. When his family wanted to say goodbye at the hospital, the doctors asked them what they thought about liver donation. Before suffering a fatal brain injury, the veteran was remarkably fit.

Although Allen did not fill out a donation document while he was alive, his relatives believed he would be happy with such a donation. Typical of a man who is the first to arrive at the door to help neighbors, according to the American newspaper ABC News, which interviewed the relatives.

Before a transplant, doctors estimate the condition of the organs and tissues. Although donors of any age are welcome, not all organs stand the test of time equally well. For example, the heart of the average person over 80 years old is often no longer suitable for a transplant. The liver and kidneys wear out less quickly and there is no upper age limit.

In the Netherlands, for example, eighteen livers from donors over 80 years of age are used, according to the Dutch Transplant Foundation (NTS). The oldest was 88 years old. The special thing about the liver is that it is a so-called regenerative organ: a part is removed from living donors and grows back in about a month and a half.

The donated organ can last a long time

Doctors do take into account the age of the recipient of an organ; a retired patient is more likely to receive an “old” liver or kidney than a 30-year-old patient. Although exceptions are possible, for example, because a relatively young patient is in danger of death and only a slightly older organ is available.

The duration of an organ is clear from the story of a Dutch woman who in the 70s received a new kidney from a donor that functioned well for half a century. This was an exceptional case, given the state of medical science at the time and the fact that the donor had already died.

Shorter waiting times

Last year, 1,417 patients in the Netherlands received a donated organ. Sick patients are waiting less time than before to receive an organ, the NTS reports. For example, the waiting time for kidney patients on the active waiting list was reduced from 29 months in 2022 to 27 months in 2023. Some patients have to wait longer for medical reasons, for example because they have a rarer blood group.

More organ donors can shorten waiting lists even further. Medical innovations also help. For example, a new cooling method, used among others at the UMC in Amsterdam, increases the chances that a liver can be used.

Scientists are also trying to make organs from specially bred animals suitable for human use. This year, for the first time in the United States, a human being received a pig kidney. The 62-year-old died two months after the operation, although doctors saw no connection to the new kidney.

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