Perfusion machine keeps livers alive outside the body for a week

Surgeon connecting liver donor to perfusion machine

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. With the study, the scientists showed that six of ten perfused poor-quality human livers, declined for transplantation by all centres in Europe, recovered to full function within one week of application of the machine. Pierre-Alain Clavien, Chairman of the Department of Surgery and Transplantation at the University Hospital Zurich (USZ).

The human liver is hooked to tubes in the machine that pumps oxygen-filled blood through it, as well as remove old blood from it.

The perfusion machine while in operation, with the liver in the white container at left.

Next steps: The researchers still have some way to go to prove that the invention can work in practice, and that livers stored this way would be safe when transplanted into patients. Experts in transplantation medicine have hailed this new study.

In addition the machine that perfuses the organs outside the body could be used to bring to life injured livers from cadavers after perfusing them for several days. Now the donated as well as damaged livers could be preserved for a seven day period. 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. Liver as an organ is capable of regeneration.

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The researchers say the system could also offer new approaches to tackling a range of diseases.

Wyss Zurich institute led a project called the Liver4Life project. Prof. Philipp Rudolf von Rohr, Professor of Process Engineering at ETH Zurich and co-leader of the project said, "The biggest challenge in the initial phase of our project was to find a common language that would allow communication between the clinicians and engineers".

However, Clavien said the system would be used for livers initially stored on ice but deemed too poor quality for immediate transplantation, and that in future it may also be used to boost the quality of marginal livers. These livers had been refused by all centres across Europe due to their poor functional qualities. They noted that six of the livers, by the end of the week were fully functional and ready for transplant onto recipients.

The team found that all 10 livers lost weight during the course of the week and four deteriorated. Lab tests were positive, showing normal function, robust cellular energy and intact liver structure. When placed in the device for a a few days, these livers may regain full function.

The week-long storage, the researchers say, would not only increase the distance over which organs can be transported, but offers another crucial advantage: it gives damaged livers more time to fix themselves, boosting the number of livers that could be used for transplant, while allowing doctors to reject those that are unsuitable.

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