Tokyo (SCCIJ) – A Zurich research team has written medical history by implanting a damaged human organ into a patient after storage outside the body and treating it in a machine for three days. A cancer patient received a recovered liver a year ago, and he is doing well.
The Wyss Zurich Team connects the donor liver to the perfusion machine in the clean room (Picture: UZH).
Mimicking human body
The Liver4Life research team owes its achievement to a perfusion machine developed in-house. The machine mimics the human body as accurately as possible, to provide ideal conditions for the human liver.
A pump serves as a heart, an oxygenator replaces the lungs and a dialysis unit takes over the kidney work. In addition, numerous hormone and nutrient infusions perform the functions of the intestine 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 – involving the collaboration of the University Hospital Zurich (USZ), ETH Zurich, and the University of Zurich (UZH) – demonstrated for the first time that perfusion technology makes it possible to store a liver outside the body for several days.
From poor to good in three days
The team prepared the liver in the machine with various drugs. In this way, it was possible to transform the liver into a good human organ, even though it was originally not approved for transplantation due to its poor quality. The multi-day perfusion, i.e. the mechanical circulation of the organ, enables antibiotic or hormonal therapies or the optimization of liver metabolism, for example. In addition, lengthy laboratory or tissue tests can be carried out without time pressure. Under normal circumstances, organs can only be stored for 12 hours if done conventionally on ice and in commercially available perfusion machines.
As part of an approved individual treatment attempt, the doctors gave a cancer patient on the Swisstransplant waiting list the choice of using the treated human liver. Following his consent, the organ was transplanted in May 2021. The patient was able to leave the hospital a few days after the transplantation and is now doing well: “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 time”, he said.
“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,” 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.”
Text: ETHZ News (editing by SCCIJ)
