Organ donation: new technique can preserve human livers for a week

Henrietta Strickland
January 14, 2020

Researchers from the University Hospital Zurich, ETH Zurich, Wyss Zurich and the University of Zurich describe their long-term project in Nature Biotechnology, calling the machine a major breakthrough for transplantation medicine.

The technology could boost the number of livers available for transplantation and even offer new approaches to treating diseases such as liver cancer. For example, medical staff may be able to fix pre-existing injuries, clean fat deposits in the liver or even regenerate parts of the organ. Pierre-Alain Clavien, Chairman of the Department of Surgery and Transplantation at the University Hospital Zurich. The team found no difference in the function or tissues of the livers compared with livers stored for just a few hours. They write that they developed the machine that, "integrates multiple core physiological functions, including automated management of glucose levels and oxygenation, waste-product removal and hematocrit control".

A surgeon connects the donor liver to the perfusion machine. The team put all the ten livers onto the perfusion machine.

However in 2018 researchers in the United Kingdom reported a system that allows livers to be kept at body temperature for 24 hours, a move that the lead author said at the time "improved both the transplant success rate as well as the number of livers available for transplant". With the added time ex vivo, the scientists could fix the damaged livers, clearing them of fat deposits and facilitating tissue regeneration, for example. For the latest test the researchers used 10 human livers that were too damaged for transplant.

The complex perfusion system connects the liver to a machine that mimics core body functions to fix and successfully store livers. These livers now maintained cell energy or ATP and also showed an intact structure and anatomy of the liver. Now, the machine can fix a preexisting injury, clean fat deposits, and even regenerate partial livers. The scientists aren't sure why this happened but believe it shouldn't have a "negative impact" on normal function.

The team initially developed the system using pig livers and carried out three liver transplants on the animals using livers that had been stored for a week.

The researchers say that the machine opens up new possibilities for the treatment of damaged livers. "This device has the potential to dramatically improve transplant outcomes, allowing livers that were previously thought to be unsuitable to be used and increase the time that livers are able to be kept". If feasible, this could double or possibly even triple the number of livers available for transplant, according to the paper.

The study has limitations, including that some aspects of liver function can only be assessed many months after transplantation. In the meantime, you can help the ongoing organ donor shortage by becoming a donor yourself.

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