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A world first: for the first time, a human liver has been processed in a machine and then successfully transplanted

A world first: for the first time, a human liver has been processed in a machine and then successfully transplanted
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image: Pr Pierre-Alain Clavien and Pr Philipp Dutkowski during machine-treated liver transplantation.
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Credit: USZ

The Liver4Life research team owes its infusion machine, developed in-house, to the fact that it became possible to implant a human organ in a patient after a three-day storage period outside the body. The machine mimics the human body as closely as possible, to provide ideal conditions for the human liver. A pump serves as a replacement heart, an oxygenator replaces the lungs, and a dialysis unit performs the functions of the kidneys. In addition, many infusions of hormones and nutrients 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 research team from Zurich – involving the collaboration of University Hospital Zurich (USZ), ETH Zurich and the University of Zurich (UZH) – demonstrated for the first time that infusion 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 transform the liver into a good human organ, even though it was not initially approved for transplantation due to its poor quality. The infusion over several days, ie the mechanical circulation of the organ, allows for example antibiotic or hormonal therapies or the optimization of hepatic metabolism. In addition, lengthy laboratory or tissue tests can be performed without time constraints. Under normal circumstances this is not possible as organs can only be stored for 12 hours if stored conventionally on ice and in commercially available infusion machines.

Successful treatment attempt

As part of an approved individual treatment attempt, doctors gave a cancer patient on the Swisstransplant waiting list the choice to use 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 transplant and is now doing well: “I am very grateful for the life-saving organ. Due to the rapid evolution of my tumor, I had little chance of getting a liver on the waiting list in a reasonable time. »

save more lives

The article about the first transplant of a liver prepared in an infusion machine was published in one of the most renowned scientific journals, Natural biotechnology, May 31, 2022. “Our therapy shows that by treating the livers in the infusion machine, it is possible to overcome the lack of functional human organs and save lives”, explains Prof. Pierre-Alain Clavien, Director from the Department of Visceral Medicine. Surgery and transplantation at the University Hospital of Zurich (USZ). Professor Mark Tibbitt, Professor of Macromolecular Engineering at ETH Zurich, adds: “The interdisciplinary approach to solving the complex biomedical challenges embodied in this project is the future of medicine. This will allow us to use new discoveries even more quickly to treat patients.

The next step of the Liver4Life project is to review the procedure on other patients and demonstrate its efficacy and safety in the form of a multicenter study. Its success would mean that in the future, a liver transplant, which is usually an emergency procedure, would be transformed into a plannable elective procedure. At the same time, a new generation of machines is being developed. In addition, basic research actors continue to seek ways to treat other liver diseases outside the body with drugs, molecules or hormones.

Liver4Life: a Wyss Zurich project

The Liver4Life project was launched in 2015 under the aegis of the Wyss Zurich Translational Center (Wyss Zurich). It brings together the highly specialized technical know-how and biomedical knowledge of a dozen health professionals, biologists and engineers. The project is funded by donations from the initiator of Wyss Zurich, Dr. hc mult. Hansjörg Wyss.


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