The multidisciplinary Zurich research team Liver4Life during a treatment effort succeeded in doing something that had never been achieved until now in the history of medicine: it allowed a basically damaged human being in a machine for three days outside a body. Treated the liver and then transplanted the recovered organ. in a cancer patient. A year later, the patient is doing well.
The Liver4Life research team credits their perfusion machine, which was developed in-house, to the fact that it became possible to transplant a human organ into a patient after a three-day storage period outside the body. The machine mimics the human body as accurately as possible in order to provide ideal conditions for the human liver. A pump serves as a replacement heart, an oxygenator replaces the lungs and a dialysis unit serves as the kidney. In addition, many hormones and nutrient transitions affect the function of the gut and pancreas. Like the diaphragm in the human body, the machine also moves the lever to match the rhythm of human breathing. In January 2020, a multidisciplinary Zurich research team in collaboration with 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 the liver outside the body. for several days (see press release dated January 13, 2020).
went from poor to good in three days
The team prepared the liver in the machine from various drugs. In this way, it was possible to turn the liver into a good human organ, even though it was not originally approved for transplantation due to its poor quality. For example, multi-day perfusion, ie mechanical circulation of the organ, enables antibiotic or hormonal treatment or optimization of hepatic metabolism. In addition, lengthy laboratory or tissue tests can be performed without time pressure. Under normal circumstances, this is not possible because organs can only be stored for 12 hours if they are traditionally stored on ice and in commercially available perfusion machines.
successful treatment attempt
As part of an approved personalized treatment effort, doctors gave a cancer patient on a Swiss transplant waiting list the option of using a 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. Because of my rapidly growing tumour, there was little chance of me getting the liver off the waiting list within a reasonable amount of time,
saving more lives
The article on the first transplant of a liver prepared in a perfusion machine was published in one of the most famous scientific journals, nature biotechnologyOn May 31, 2022. “Our therapy shows that by treating the liver in a perfusion machine, it is possible to reduce the function of human organs and save lives,” said Prof. Pierre-Alain Clavien explains. Surgery and Transplantation at the University Hospital Zurich (USZ).
The interdisciplinary approach to solving the complex biomedical challenges embodied in this project is the future of medicine. This will allow us to use the new findings to treat patients even more quickly.”
Prof. Mark Tibitt, Professor of Macromolecular Engineering at ETH Zurich
The next step in the Liver4Life project is to review the procedure in other patients and demonstrate its efficacy and safety as a multicentre study. Its success would mean that in the future, a liver transplant, which usually constitutes an emergency procedure, will be turned into a planable elective procedure. Also, next generation machines are being developed. In addition, those involved in basic research continue to look for 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 umbrella of the Wyss Zurich Translational Center (Wyss Zurich). It brings together the highly specialized technical knowledge and biomedical knowledge of approximately ten medical professionals, biologists and engineers. The project is being financed with a donation from the initiator of Wyss Zurich, Dr. HC Multi. Hansjörg Vice.
Klavian, PA, and others. (2022) Human liver transplantation after 3 days of ex situ normothermic protection. Nature Biotechnology. doi.org/10.1038/s41587-022-01354-7.