For the first time in the world, the donor liver was mechanically treated and then successfully transplanted.

The Wyss Zurich team connects the donor’s liver to a clean room perfusion device. Credit: Wyss Zurich

In 2020, after five years of work, Swiss researchers have extended the amount of time a donor’s liver can stay outside the body from just one day to a week. That progress alone is meaningful enough to save many lives, but now the team takes it one step further and accomplishes something that has never been done in medicine.

In the study published today Nature biotechnologyThe same team successfully treated an originally injured human liver with a machine for three days outside the body and transplanted the recovered organs into a dying cancer patient. A year later, the patient is prosperous.

In 2015, researchers launched the Liver4Life project under the umbrella of the University of Zurich and the Wyss Zurich Translational Center at ETH Zurich. This project brings together highly specialized researchers from a variety of disciplines to solve biomedical challenges. Their first challenge? Liver liver outside the body for a week.

The The team has achieved this In January 2020, a newly developed perfusion machine will be introduced. Machines imitate the human body as much as possible. The pump acts as a replacement for the heart, the artificial lung replaces the lung, and the dialysis unit replaces the kidney. In addition, injections of many hormones and nutrients take over the function of the intestines and pancreas. Like the diaphragm of the human body, machines also move the liver to the rhythm of human breathing.

The perfusion device extended the survival of the donor’s liver to 7 days and, most importantly, expanded the possibilities of treatment such as liver regeneration and tumor treatment.

The treated human liver approach was tested in May 2021 as part of an approved individualized treatment program for cancer patients on the Swiss Transplant Waitlist. His tumor was so rapid that the patient had little chance of receiving the liver from the list. So he was approved for another approach.

Researchers used the liver, which was considered too poor quality for transplantation, and mechanically prepared the liver using a cocktail of medicines for three days. According to the team, perfusion for several days allows for optimization of antibiotic and hormonal therapy, as well as liver metabolism.

With the patient’s consent, the treated liver was transplanted in May 2021. He was discharged a few days after surgery and is still doing well a year later.

Pierre Alain Clavien, Head of Visceral Surgery and Transplantation at the University Hospital of Zurich, said:

The United States is doing more organ transplants than ever before, but more than 100,000 are still waiting for life-saving transplants. Every 9 minutes someone is added to the national organ transplant waiting list. Of the waiting patients, about 85% need a kidney and 11% need a liver transplant. The more organs that can be treated, from poor to good, the more lives can be saved.

“The interdisciplinary approach to solving the complex biomedical challenges embodied in this project is the future of medicine,” said Mark Tibitt, a professor of polymer engineering at ETH Zurich. “This will allow us to use new findings more quickly to treat patients.”

The next step in the Liver4Life project is to identify the procedures of other patients and demonstrate their efficacy and safety in the form of multicenter collaborative research. Its success will ensure a future in which the current emergency procedure, liver transplantation, will become a planned and selective procedure. Liver4Life’s research team says they are also working on next-generation biomedical machines.

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