Liver transplants have saved thousands of lives around the world. The procedure itself can be extremely challenging and resource intensive though, as it often requires specialized machinery and the input of dozens of high-level specialists.
Furthermore, donor livers are scarce, and doctors often have a narrow window of eight to twelve hours before they have to transplant a liver after extraction. This means that liver transplants often require precise coordination to ensure the donor liver is still viable by the time it reaches the recipient.
Researchers from Wyss Zurich and the University Hospital Zurich have discovered a way to keep livers viable and healthy for days after they are extracted by a donor. This comes after they were able to preserve a liver for three days and successfully implant it into a patient. One year after the procedure, the patient is enjoying optimum liver function and is perfectly healthy.
Pierre-Alain Clavien, the lead author of the study, wrote that the shortage of viable organs was a major hindrance to transplantation success. Clavien, who is also a surgeon, explained that their research opened up new possibilities and had shown that it was possible to keep donor organs preserved for up to 10 days. He noted that this would essentially turn what was a highly demanding and urgent operation into an elective surgery that could be scheduled.
The researchers used a technique known as ex-situ normothermic perfusion to preserve the liver for three days. It involves placing an organ in a sterile setting at 37o C to mimic body temperature. The organ is then flushed with liquids that contain blood, hormones and nutrients to mimic normal body functions and keep it alive.
This method allowed Wyss Zurich to keep the liver working normally and alive for seven days outside a human body.
Last year, the researchers were provided with a graft of a liver from a woman who suffered from recurrent sepsis caused by antibiotic-resistant bacteria as well as invasive tumors in the abdomen and abscesses. In addition to this, the liver was also infected with a tumor.
The researchers received the liver on May 19, 2021, and they kept it preserved until May 22 the same year. They then implanted it into a man in his sixties who suffered from recurrent liver cancer, advanced cirrhosis and severe portal high blood pressure. The procedure went as smoothly as regular transplantation, the researchers say, noting that in the weeks after the surgery, the patient showed no signs of bile duct injury or organ rejection.
Twelve months later, the patient is still in good health. Researchers are confident that long-term ex-situ perfusion could allow urgent, time-reliant surgeries such as organ transplants to become elective procedures.
While more research is definitely needed before this new preservation method goes into clinical trials, it opens the door to a future where far fewer livers are deemed unsuitable for transplantation.
This team’s research adds onto the work being done by other companies sech as Aditxt Inc. (NASDAQ: ADTX) to find ways of modulating the immune system so that transplanted organs aren’t rejected by the host.
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