The second life of a damaged liver

R. I.

Updated:06/01/2022 09:26h

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A team of Swiss researchers has reused a damaged human liver stored for three days in a machine for later transplantation into a cancer patient. One year later, the liver continues to function in the patient.

The key lies in the perfusion machine designed by the Liver4Life team. The machine mimics the human body as accurately as possible to provide ideal conditions for the human liver. A pump serves as a replacement for the heart, an oxygenator replaces the lungs, and a dialysis unit performs the functions of the kidneys. In addition, numerous infusions of hormones and nutrients perform the functions of the intestine and pancreas. And, like the diaphragm in the human body, the machine also moves the liver to the rhythm of human breathing.

In May 2021, this Zurich-based team, in collaboration with the University Hospital Zurich (USZ), carried out the intervention and has now published the results in “Nature Biotechnology”.

A pump serves as a replacement for the heart, an oxygenator replaces the lungs, and a dialysis unit performs the functions of the kidneys.

The team prepared the liver in the machine with different drugs. In this way, it was possible to transform the liver into a healthy human organ, although it had not originally been approved for transplantation due to its poor quality. The perfusion of several days, that is, the mechanical circulation of the organ, allows antibiotic or hormonal therapies or the optimization of hepatic metabolism. In addition, lengthy laboratory or tissue analyzes can be carried out without time pressure, which would not be possible under normal circumstances because organs can only be stored for 12 hours if stored conventionally on ice and in perfusion machines. commercially available.

As part of an approved individual treatment trial, doctors transplanted the liver to cancer patients on the waiting list with their consent.

The patient was able to leave the hospital a few days after the transplant and is doing well now.

Our therapy demonstrates that by treating livers in the perfusion machine, it is possible to alleviate the malfunction of human organs and save lives.

“Our therapy demonstrates that by treating livers in the perfusion machine, it is possible to alleviate the malfunction of human organs and save lives,” he explains. Pierre-Alain Clavienof the University Hospital of Zurich (USZ).

The next step in the Liver4Life project is to review the procedure in other patients and demonstrate its efficacy and safety in the form of a multicenter study. Its success would mean that in the future, a liver transplant, which is usually an emergency procedure, would become an elective procedure that can be planned.

At the same time, a next generation of machines is being developed. In addition, those involved in basic research continue to search for ways to treat other liver diseases outside the body with drugs, molecules, or hormones.

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