Introduction: According to our and other experiences, with careful selection good results have been obtained using octogenarian liver grafts for liver transplantation. Following the same criteria, the results can be reproduced using liver grafts from nonagenarian donors, having in mind that octogenarian liver grafts can reach centennial age after LT, as we have recently reported. We analyze three cases of LT using nonagenarian grafts
Case Reports: We present three LT using liver grafts from nonagenarian donors (90, 90 and 94 years old, respectively), with the following characteristics:  two were females and one male that died because of cerebrovascular accident, needing a ICU stay between 8 and 36 hours, that did not required vasopressors use, and the liver biopsy did not showed steatosis or preservation injury.
Liver grafts were implanted in recipients of 58, 65 and 68-year old, respectively, that were diagnosed of VHB-cirrhosis (1 case), VHC+VHB-cirrhosis+hepatocarcinoma (1 case), and alcoholic+autoimmune cirrhosis (1 case). MELD-scores were 15, 15 and 18, respectively. Cold ischemia times ranged between 455 and 510 minutes, while warm ischemia times ranged between 45 and 55 minutes. Recipient hepatectomy was performed according to piggy-back technique, and choledocho-choledochostomy was performed without T-Tube. Both recipients were transfused intraoperatively with 1500 mL of PRBC, 300 mL and 600 mL, respectively. Post-transplant ICU stays were 3, 4 and 5 days, respectively. All recipients normalized their liver function tests between 7 and 15 days post-LT. Hospital stay was 7, 12 and 15 days, respectively. Immunosuppression regimen consisted in steroids and tacrolimus. Currently, after a follow-up period of 31, 12 and 12 months, respectively, none of the patients has developed graft rejection, maintaining normal liver function tests.
Conclusion: This is a preliminary study that comprises only three cases of nonagenarian liver grafts with successful results, concluding that the age per se do not represents a contraindication for using these livers if there is a prior good selection.