来源：《新科学家》
原文见刊日期：2022年10月22日
本文适合2024考生
Livers transplanted from older donors can last a century in total and sometimes outlive ones from younger people.
从老年捐献者身上移植的肝脏可以存活一个世纪之久，有时甚至比年轻人捐献的肝脏存活更长。
Transplanting livers from older donors after they die is generally avoided because livers tend to accumulate more scarring over time, caused by factors such as drinking alcohol, obesity and viral infections. Now, researchers have provided evidence that transplants from older donors can work very well.
通常避免在老年捐献者死后移植他们的肝脏，因为随着时间的推移，肝脏往往会积累更多的疤痕，这是饮酒、肥胖和病毒感染等因素造成的。现在，研究人员提供的证据表明，老年捐献者的器官移植效果非常好。
Christine Hwang and Yash Kadakia at the University of Texas Southwestern Medical Center and their colleagues analysed data on 253,406 liver transplants from dead donors that occurred in the US between 1990 and 2022. The team found that 25 livers had lasted for at least 100 years across both the donors’ and recipients’ lifetimes, with 14 still remaining in their recipients. The oldest liver was aged 108. “We do not know of any other types of organ transplants that have lasted 100 years,” says Hwang.
德克萨斯大学西南医学中心的克里斯汀·黄和亚什·卡达基亚及其同事分析了1990年至2022年间在美国发生的253406例已故捐献者肝移植的数据。研究小组发现，在捐赠者和受者的一生中，有25个肝脏至少存活了100年，其中14个仍留在受者体内。最老的肝脏是108岁。黄教授说：“我们不知道还有什么其他类型的器官移植可以存活100年。”
All livers that eventually reached the age of 100 lasted for at least a decade in the recipient, while 60 per cent of livers that didn’t reach 100 lasted for a decade after transplantation, the team told the American College of Surgeons Clinical Congress in San Diego, California, on 16 October. This provides evidence that older donors can sometimes contribute more successful liver transplants than younger ones.
该研究小组10月16日在加州圣地亚哥举行的美国外科医生学会临床大会上说，所有最终达到100岁的肝脏在受者体内至少能存活10年，而未达到100岁的肝脏在移植后还能存活10年的只有60%。这提供了证据，表明老年捐献者有时能比年轻捐献者更有利于肝移植。
By analysing blood sample data collected from donors soon after they died, the team found that donors of livers that survived for a century had a lower level of blood enzymes called transaminases – associated with inflammation and liver injury – than people who donated livers that didn’t make it to 100.
通过分析捐献者死后不久采集的血液样本数据，研究小组发现，肝脏存活了一个世纪的捐献者的血液中被称为转氨酶(与炎症和肝损伤有关)的酶水平低于那些肝脏寿命未到达到100年的捐献者。
Using a mathematical model that aids transplant decisions in the clinic, the team found that livers that made it to 100 lasted longer than expected based on a variety of donor and transplant recipient factors, such as the presence of other diseases, age, sex, ethnicity and body mass index.
研究小组利用一个有助于临床移植决策的数学模型发现，根据捐赠者和移植受者的各种因素，如是否存在其他疾病、年龄、性别、种族和体重指数，最终寿命达到100年的肝脏在受者体内存活的时间比预期的长。
This suggests the model may not account for key unknown factors that determine how long livers last. It isn’t known if the findings would apply to liver transplants that take place outside the US.
这表明该模型可能无法解释决定肝脏寿命的关键未知因素。目前尚不清楚这项研究结果是否适用于美国以外的肝移植。
“Studying these livers that made it to age 100 could reveal new biomarkers that are important for liver lifespan,” says Kadakia. “Manipulating such markers in livers before transplantation could help us improve the outcome.”
卡达基亚说：“研究这些存活100年的肝脏可以揭示对肝脏寿命很重要的新的生物标志物。在移植前操纵肝脏中的这些标记可以帮助我们改善移植结果。”
“It is important that this study shows that good quality donor livers that are older can go on to do very well in their new recipients,” says Patricia Lalor at the University of Birmingham, UK. “We need as many donor organs as possible to address increasing requirements for transplantation.”
英国伯明翰大学的帕特里夏·拉勒表示：“这项研究表明，年龄较大的优质供体肝脏可以在新的受者身上继续发挥作用，这一点很重要。我们需要尽可能多的捐赠器官来满足日益增长的移植需求。”