Lack of Grafted Liver Rejuvenation in Adult-to-Pediatric Liver Transplantation

A grafted donor liver should grow and survive under the different conditions presented by a liver transplantation recipient. It has remained unclear, however, whether the age of a grafted liver can be modulated by recipient factors. This study investigated whether a grafted aged donor liver can be rejuvenated in a pediatric recipient. Of 119 living donor liver transplants, ten pairs were adult-to-pediatric combinations. Senescence marker protein-30 (SMP-30), which is a protein that is remarkably reduced upon aging, was used as a senescence marker. Immunohistochemical staining for SMP-30 was performed in biopsy specimen after living donor liver transplantation (LDLT). Re-expression of SMP-30 was investigated in a biopsied adult liver (n = 6) that had been transplanted in a pediatric recipient. A remarkable expression of SMP-30 was seen in a control pediatric normal liver in comparison with that in an aged adult donor biopsy. Re-expression or an increase in SMP-30 was not observed in the liver of any pediatric recipient who had received an adult liver. An adult grafted liver does not appear to rejuvenate in a pediatric recipient.