Doctors Successfully Transplant Treated Human Liver In Machine

  • Every day, 17 people waiting for organ donation die in the United States.
  • Research shows the potential drawbacks of the traditional method of cold storage of donated organs.
  • In a first, the Liver4Life research team in Zurich, Switzerland, reports the successful transplantation of a liver stored in an infusion machine for three days into a human recipient, who is doing well a year later.

Organ transplant is a very complicated medical procedure. The organ must be compatible with the recipient, and the process also involves moving a living organ from the donor to the recipient and keeping the organ in working order until surgery.

The traditional method of moving transplant organs is to store them at very low temperatures. However, this process is time-limited and can damage organ tissues.

For this reason, scientists are working on new ways to maintain the viability of donated organs without resorting to extreme cold.

One such group is the Liver4Life research team in Zurich, Switzerland, who used an infusion machine to keep a human liver alive for three days.

The doctors then implanted the liver in a human patient, who now, a year after the procedure, is doing well.

The results of this procedure recently appeared in the journal Natural biotechnology.

According to the United Network for Organ Sharing, more than 41,000 grafts happened in 2021 in the United States. The liver is the second most frequently transplanted organ after the kidney.

Every 9 minutes, a person is placed on a waiting list for an organ transplant. Although UNOS reports that the percentage of people donating their organs has increased, there is still a shortage of available organs.

And an average of 17 people die every day while waiting for an organ transplant.

Traditionally, harvested organs moved for transplantation are stored at a very cold temperature. This process is called cold ischemia time.

Different organs can be kept in a cold room for different lengths before their tissues begin to break down. For example, the cold ischemia time of a heart is 4-6 hours, while a kidney lasts much longer, 24-36 hours. The liver can be stored in a cold room between 8 and 12 hours.

Regarding the liver, past searches shows a prolonged time of cold ischemia may adversely affect liver transplantation. Other research found that cold ischemia time prolongs a patient’s post-transplant hospital stay.

Researchers are studying infusion sets as an alternative method of storing organs outside the body. The machine mimics the functions of the body’s heart and lungs, pumping blood and oxygen into the organ.

In addition, medical professionals administer a cocktail of hormones and nutrients to the organ, just as it would receive intestines and pancreas in the body.

Professor Pierre-Alain Clavienchairman of the department of visceral surgery and transplantation at the University Hospital of Zurich (USZ) in Switzerland, and lead author of this study, said that the infusion machine preserves a liver transplant not for a few hours but for several days .

“It makes it possible to transform liver transplantation from an emergency operation into an elective operation”, he explained for Medical News Today. “Secondly, such an extended time on the perfusion machine allows deep treatment of the liver before transplantation, which has not been possible until now.”

“There are many ways to use the infusion machine,” Professor Clavien added. “The main objective is to treat patients by offering them a good graft or even a segment of regenerated liver for autograft after treatment. [It’s also] very interesting the possibility offered by this platform for toxicological studies without the need for human probands.

As for the next steps of this new technology, Professor Clavien specifies that his team is currently planning a multicenter clinical trial for the transplantation of liver grafts stored long term on their infusion device.

He also thinks the infusion machine technology could one day be used for other organs. “This technology is theoretically suitable for all transplanted organs today, although some adjustments would have to be made in the circuit,” explained Clavien.

“In particular, we are also interested in the perfusion of the kidney and the uterus, which has already shown to be feasible in our preclinical experiments,” he added.

DTM also spoke with Dr. Robert S. Brown, Jr.Vincent Astor Distinguished Professor of Medicine and Chief of the Division of Gastroenterology and Hepatology at Weill Cornell Medicine, about this study.

He said machine-based organ infusion has enormous potential to increase the number of organs available for transplantation:

“These long durations really offer the possibility of taking an organ that would work, but no one has confidence in its functioning, and increases the confidence that it would work. And a future ability to maybe even manipulate the organ with drugs or […] future gene therapy to then remove non-transplantable organs and make them transplantable.

“This has the potential to have a significant impact on the patient in terms of increasing organ access by making more organs available for transplants and increasing organ quality by taking previously untransplantable organs and by making them transplantable, or marginally transplantable organs and turning them into good organs,” Professor Brown added.

“I would consider this an exciting proof of concept that needs further validation, but if validated, it would be a big step forward.”

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