In a world-first operation, a human liver has been kept outside a body for three days and then successfully transplanted into a person thanks to the miraculous invention of a new perfusion machine.
The operation was carried out in May 2021, but the researchers have just published the study in Nature Biotechnology this week.
The liver was taken from the donor and hooked up to the recently developed "ex-situ normothermic preservation" machine. This took care of all the organ’s survival needs: maintaining normal body temperature, oxygenating the tissue through a heart-like pump, and infusing it full of numerous hormones and nutrients to mimic the functions of the intestine and pancreas.
The organ was initially damaged when it was taken from the donor and not approved for transplantation due to its poor quality. However, the team managed to return it to a perfectly healthy state after being treated for three days via the machine.
While the organ is outside the body and hooked up to the machine, it’s also possible to treat the organ with drugs and carry out tissue tests without time pressure.
The liver was then successfully transplanted into a man who was able to leave the hospital just a few days after the operation.
“I am very grateful for the life-saving organ. Due to my rapidly progressing tumor, I had little chance of getting a liver from the waiting list within a reasonable period of time,” the patient said in a statement.
The researchers believe that it may be possible to keep livers alive on the machine even longer than three days. Back in 2020, the team showed the machine could keep a liver outside the body for up to a week, although this organ was not transplanted into another person.
Since donor organs can typically only be held for a maximum of 12 hours, the researchers believe their machine has the potential to save lives by easing the much-needed demand for donor organs to transplant. Some 75,000 people in the US are on the active waiting list for organs at any given time, but there are just 8,000 deceased organ donors each year and living donors only provide around 6,000 organs annually, according to the CDC.
Although the team and patient are extremely pleased with the results, a next generation of perfusion machines is already in the works.
“Our therapy shows that by treating livers in the perfusion machine, it is possible to alleviate the lack of functioning human organs and save lives,” explained Professor Pierre-Alain Clavien, lead study author and Director of the Department of Visceral Surgery and Transplantation at the University Hospital Zurich.
“The interdisciplinary approach to solving complex biomedical challenges embodied in this project is the future of medicine. This will allow us to use new findings even more quickly for treating patients,” added Professor Clavien.