Perfusion machine keeps livers alive outside the body for a week

14 Janvier, 2020, 17:54 | Auteur: Yves Courtet
  • A surgeon connects the donor liver to the perfusion machine

Built by researchers from the University Hospital Zurich, ETH Zurich, Wyss Zurich, and the University of Zurich, the machine is a major breakthrough in transplantation medicine.

Now experts have pushed such an approach even further, revealing a system that allows human livers to be stored for a week just below body temperature.

The machine has been in development since 2015, and at the project's outset the system could keep removed livers alive for around 12 hours.

In the United States alone, Columbia Surgery reports that there are almost 17,000 people awaiting a transplant for a variety of reasons, including when a person's liver fails due to injury or illness or to treat rare disorders.

The perfusion machine in operation.

Throughout the four-year period, they were able to integrate a number of physiological functions into the machine, including automated control of glucose levels and oxygenation, along with waste-product-removal and management of hematocrit, or red blood cell concentration in the blood.

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Remarkably, the system can take an otherwise unsuitable donor liver and bring it back to apparently normal health, remedying problems caused by severe liver disease. Pierre-Alain Clavien, Chairman of the Department of Surgery and Transplantation at the University Hospital Zurich (USZ). The seven-day successful perfusion of poor-quality livers now allows for a wide range of strategies, e.g. fix of preexisting injury, cleaning of fat deposits in the liver or even regeneration of partial livers. With the added time ex vivo, the scientists could fix the damaged livers, clearing them of fat deposits and facilitating tissue regeneration, for example. Six of the 10 perfused human lives, which were deemed of poor quality and declined for transplantation by all centers in Europe, recovered to full function in just one week. For example, a patient with liver cancer could have a healthy section of their liver removed, grown using the machine, and then reimplanted with the remaining cancerous liver removed.

That said, the livers lost weight during the seven days, dropping to around 25 per cent of their original mass. As of now the success of the machine made by surgeons, biologists and engineers in collaboration is commendable and would allow many on the waiting line for donated livers to benefit, say researchers.

None of the livers have been successfully transplanted into a living human.

The study has limitations, including that some aspects of liver function can only be assessed many months after transplantation.

Prof John Forsythe, Medical Director of Organ Donation and Transplantation for NHS Blood and Transplant, said: "To be able to keep a liver functioning for a week is fantastic, it allows time for natural recovery of the organ as well as medical interventions which could make an initially unusable organ, transplantable". In the meantime, you can help the ongoing organ donor shortage by becoming a donor yourself.

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