A new perfusion machine allows explanted livers to be kept alive much longer than now. And also to cure them
According to a study in Nature Biotechnology, a patient who received a donated liver that had been stored for three days in a new type of machine that mimics the human body is healthy one year after surgery. The technology could significantly increase the number of livers suitable for transplantationthe authors say, both by allowing organs to be preserved longer than the current standard, and by allowing livers that are already available but too damaged to be transplanted as they are to be repaired.
A team from the University Hospital of Zurich, led by Pierre-Alain Clavien, professor of the Department of Surgery, preserved the liver in a machine that recreates some of the conditions inside the human body: similar pressure levels and a temperature of 37 ° C. The machine eliminated the fluid left inside the liver and monitored the production of bile and protein. He also provided the liver with antibiotics and an antifungal drug to treat an infection that would normally have meant that he could not be used for donation.
The donor’s liver, which belonged to a 29-year-old woman, was rejected by all other transplant centers because it had a lesion. Ascertaining whether or not it was benign would take 24 hours, longer than the current maximum window between donation and transplant. The technique described in the study offered doctors time for a biopsy and effective wound treatment. This method could allow doctors to transplant other livers with similar problems, potentially saving more lives.
“In the United States, 70 percent of donor livers are not used. “I don’t think we will be able to recover them all,” says Clavien, “but saving the available organs is a very important step forward.” Once collected from the donor, livers are usually stored on ice for up to 12 hours to prevent the cells from being damaged by cold, which would reduce the chances of transplantation success. This narrow window makes it difficult to match organs to people in need of a liver donor, meaning many patients die before one can be found.
While more research is needed, the team believes the new technique could allow donor livers to be safely preserved for 12 days. If it works, it could also increase the likelihood of treating donor livers with medications before surgery. In the case of the 62-year-old male recipient, several severe liver diseases were presentincluding advanced cirrhosis and severe portal hypertension, an increase in blood pressure in a major blood vessel that carries blood from the intestines and spleen to the liver.
Once transplanted into his body, the liver began to function normally within three days. The patient took immunosuppressants to ward off the risk of infection after surgery and was discharged from the hospital 12 days after the operation. An evaluation one year after surgery found no signs of liver damage, injury, or rejection.
The demand for liver transplants is growing and more and more people are dying of liver disease, but the number of organs available remains limited. According to the Department of Health and Human Services, there are over 11,000 people in the United States awaiting a liver transplant, with waiting times varying enormously across the country.
Image by Yerson Retamal from Pixabay
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