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Novel machine increases availability of human liver transplants

By University Hospital Zurich
January 17, 2020

ZURICH, Switzerland: Researchers from the University Hospital Zurich (UHZ), Swiss Federal Institute of Technology in Zurich (ETH Zurich), Wyss Zurich and the University of Zurich (UZH) have developed a machine that repairs injured human livers and keeps them alive outside the body for one week. This breakthrough may increase the number of available organs for transplantation.

Up until now, livers could be stored safely outside the body for only a few hours. With the novel perfusion technology, livers—and even injured livers—can now be kept alive outside of the body for an entire week. This is a major breakthrough in transplantation medicine, which may increase the number of available organs for transplantation and save many lives of patients suffering from severe liver disease or a variety of cancers. Injured cadaveric livers, initially not suitable for use in transplantation, may regain full function while perfused in the new machine for several days. The basis for this technology is a complex perfusion system, mimicking most core body functions close to physiology.

Offering what other machines cannot

“The success of this unique perfusion system, developed over a four-year period by a group of surgeons, biologists and engineers; paves the way for many new applications in transplantation and cancer medicine helping patients with no liver grafts available,” explained Prof. Pierre-Alain Clavien, Chairman of the Department of Surgery and Transplantation at the UHZ. When the project started in 2015, livers could only be kept on the machine for 12 hours. The seven-day successful perfusion of poor-quality livers now allows for a wide range of strategies, e.g. repair of pre-existing injury, cleaning of fat deposits in the liver or even regeneration of partial livers.

Liver4Life: A project from Wyss Zurich

The Liver4Life project was developed under the umbrella of Wyss Zurich institute, which brought together the highly specialised technical know-how and biomedical knowledge of experts from the UHZ, ETH Zurich and the UZH. “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,” said Dr Philipp Rudolf von Rohr, Professor at the Department of Mechanical and Process Engineering at ETH Zurich and together with Clavien co-leader of the study.

Technology with great potential

The inaugural study shows 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 perfusion on the machine. The next step will be to use these organs for transplantation. The proposed technology opens a large avenue for many applications offering a new life for many patients with end stage liver disease or cancer.

The study, titled “An integrated perfusion machine preserves injured human livers for 1 week”, was published online on 13 January in Nature Biotechnology, ahead of inclusion in an issue.

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