Scientists are working on new ways to keep donated organs viable without the use of extreme cold.
The liver is the second most commonly transplanted organ following the kidney. Photo: Shutterstock.
The transplant Organ harvesting is a very complicated medical procedure. The organ must be compatible with the recipientand the process also involves moving a living organ from the donor to the recipient and keeping the organ in good working order until surgery.
The traditional method of moving organs for transplant involves storing them at a very low temperature. However, this process has a time limit and can damage organ tissues.
For this reason, scientists are working on new ways to keep donated organs viable without the use of extreme cold.
One such group is the Liver4Life research team in Zurich, Switzerland, which used a perfusion machine to keep a liver human for three days. Doctors then implanted the liver in a human patient, who now, a year following the procedure, is doing well.
Traditional organ transplant
Según United Network for Organ Sharing, more than 41,000 transplants occurred in 2021 in the United States. The liver it is the second most commonly transplanted organ following the kidney.
Every 9 minutes a person is placed on a waiting list for transplant of organs. Although UNOS reports that the percentage of people donating their organs has increased, there is still a shortage of available organs. And an average of 17 people die every day waiting for a transplant of organs.
Different organs can be kept in cold storage for different lengths of time before their tissues begin to break down. For example, the cold ischemia time of a heart is 4 to 6 hours, while a kidney lasts much longer, from 24 to 36 hours. The liver It can be kept cold for 8 to 12 hours.
With respect to liver, research Previous studies show that a prolonged time of cold ischemia can impair the Liver transplant. Others research found that cold ischemia time prolongs the patient’s hospital stay following transplant.
What is a perfusion machine?
Researchers are studying perfusion machines as an alternative method of storing organs outside the body. The machine mimics the functions of the body’s heart and lungs, pumping blood and oxygen to the organ.
In addition, medical professionals deliver a cocktail of hormones and nutrients to the organ, just as the intestines and pancreas would receive in the body.
Prof. Pierre-Alain Clavien, Chairman of the Department of Visceral Surgery and Transplant from the University Hospital of Zurich (USZ) Switzerland, and lead author of this study, said the perfusion machine preserves a graft hepaticnot for a few hours, but for several days.
“This makes it possible to transform the Liver transplant from an emergency operation to an elective one,” he explained. “Secondly, that extended time on the perfusion machine allows for in-depth treatment of the liver before the transplantwhich until now was not possible.
“There are many ways in which the perfusion machine can be used,” added Prof. Clavien. “The main goal is to treat patients by offering them a good graft or even a segment of liver regenerated for autotransplantation following treatment. [También es] The possibility offered by this platform for toxicological studies without the need to test in humans is very interesting”.
Looking to the future
As for the next steps in this new technology, Professor Clavien said his team is currently planning a multicentre clinical trial for the transplant of grafts of liver long-term storage in your infusion device.
He also thinks the perfusion machine technology might one day be used for other organs. “This technology is theoretically suitable for all transplanted organs today, although some adjustments to the circuit would have to be made,” Clavien explained.
“In particular, we are also interested in kidney and uterus perfusion, which has already been shown to be feasible in our preclinical experiments,” he added.
MNT also spoke with Dr. Robert S. Brown, Jr., the Vincent Astor Distinguished Professor of Medicine and chief of the Division of Gastroenterology and hepatology of Weill Cornell Medicine, regarding this study.
Said mechanical organ perfusion has enormous potential to increase the number of organs available for transplant:
“These long durations really offer the possibility of taking an organ that would work, but no one trusts that it works, and it increases confidence that it would work. And a future ability to maybe even manipulate the organ with drugs or […] a future gene therapy to then take non-transplantable organs and make them transplantable.
“This has the potential to have a huge impact on the patient in terms of increase access to organs by making more organs available for transplant and increasing organ quality by taking previously non-transplantable organs and making them transplantable, or marginally transplantable organs and turning them into good organs,” Prof. Brown added.
“I would see this as an exciting proof of concept that needs more validation, but if it does get validated it would be a big step forward.”
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