The Liver4Life research team owes the fact that it was possible to implant a human organ in a patient after three days of storage outside of the body to their specially developed perfusion device. The machine mimics the human body as closely as possible to create ideal conditions for the human liver. A pump serves as a replacement heart, an oxygenator replaces the lungs and a dialysis unit takes over the functions of the kidneys. In addition, numerous hormone and nutrient infusions take over the functions of the intestines and pancreas. Like the diaphragm in the human body, the machine also moves the liver to the rhythm of human breathing. In January 2020, the multidisciplinary Zurich research team – in collaboration with the University Hospital Zurich (USZ), ETH Zurich and the University of Zurich (UZH) – showed for the first time that perfusion technology makes it possible to store a liver outside the body for several days ( see press release of January 13, 2020).
From bad to good in three days
The team prepared the liver in the machine with various drugs. In this way, it was possible to turn the liver into a good human organ, although originally it was not approved for transplantation because of its poor quality. The multi-day perfusion, i.e. the mechanical blood flow through the organ, enables, for example, antibiotic or hormone therapies or the optimization of the liver metabolism. In addition, lengthy laboratory or tissue tests can be carried out without time pressure. Normally this is not possible because organs can only be stored for 12 hours if they are stored conventionally on ice and in commercially available perfusion devices.
Treatment attempt successful
As part of an approved single treatment trial, doctors gave a cancer patient on Swisstransplant’s waiting list the choice to have the treated human liver transplanted. After his consent, the organ was transplanted in May 2021. The patient was able to leave the hospital a few days after the transplant and is now doing well: “I am very grateful for the life-saving organ. Because of my rapidly progressing tumor, I had little chance of getting a liver from the waiting list in a reasonable amount of time.”
Save more lives
The article about the first transplant of a liver prepared in a perfusion device was published in one of the most prestigious scientific journals, natural biotechnology, on May 31, 2022. “Our therapy shows that by treating livers in the perfusion device, it is possible to alleviate the lack of functioning human organs and save lives,” explains Prof. Pierre-Alain Clavien, Director of the Department of Visceral surgery and transplantation at the University Hospital Zurich (USZ). Prof. Mark Tibbitt, Professor of Macromolecular Engineering at ETH Zurich, adds: “The interdisciplinary approach to solving complex biomedical challenges embodied in this project is the future of medicine. This allows us to use new findings even faster to treat patients.”
The next step in the Liver4Life project is to test the procedure on other patients and demonstrate its effectiveness and safety in the form of a multi-center study. Its success would transform what would normally be an emergency liver transplant into a planned, elective procedure in the future. At the same time, a next generation of machines is being developed. In addition, basic research continues to look for ways to treat other liver diseases extracorporeally with drugs, molecules or hormones.
Liver4Life: a project by Wyss Zurich
The Liver4Life project was launched in 2015 under the umbrella of the Wyss Zurich Translational Center (Wyss Zurich). It bundles the highly specialized technical know-how and biomedical knowledge of around ten physicians, biologists and engineers. The project is financed with donations from the initiator of Wyss Zurich, Dr. hc mult. Hansjoerg Wyss.
Randomized controlled/clinical study
subject of research
Human liver transplantation after 3 days of normothermic ex situ preservation.
Article publication date
May 31, 2022
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