In what's being called a medical first, doctors were able to keep a liver functioning outside the body and then transplant it into a patient. The device is much better at preservation than the current method, cooling livers with ice. By extending the health of donated livers, the new device could not only increase the chances those who desperately need the organs will receive them, it could also improve the outcome of recipients.
OrganOx was developed by Peter Friend, director of Oxford Transplant Centre, and Constantin Coussios, biomedical engineering professor at Oxford University. It keeps livers alive by keeping them at body temperature and circulating red blood cells through them that deliver nutrients and oxygen. The functioning liver breaks down sugar for energy and produces bile, a fluid released into the digestive tract that aids in digestion, as a normal liver does.
Right now preserving livers for transplant involves cooling them with an ice cold liquid, which slows cell metabolism and minimizes decay. It’s a technique that has worked for decades, but even so, the liver only lasts up to about 20 hours on ice, and complications often occur if it is kept for more than 14. OrganOx can keep a liver healthy outside the body for up to 24 hours.
Cirrhosis caused by chronic hepatitis C or long-term alcohol abuse are the most common reasons for needing a liver transplant. About 13,000 liver transplants are performed each year in the US and Europe. Unfortunately, that means less than half of the 30,000 from the two regions who needs a liver receives one. About a quarter of these patients will die while they wait. Part of the problem is the inability of ice to preserve the health of the livers – about 2,000 are disposed of each year because of damage due to insufficient oxygen and other cell death.
But OrganOx has had a promising start – it’s two for two. Last month such a liver was transplanted into a patient at London’s King’s College Hospital. The 62-year-old patient, Ian Christie, had cirrhosis of the liver and doctors told him last year that he had only 12 to 18 months to live. Although he’s still recovering from the surgery, Christie says he hasn’t felt this good in the last 10 to 15 years, “even allowing for the pain and wound that’s got to heal.” And another patient who received a liver preserved by OrganOx is also doing well.
“For the first time, we now have a device that is designed specifically to give us extra time to test the liver to help maximize the chances of the recipient having a successful outcome,” Wayel Jassem, Consultant Liver Transplant Surgeon at King’s College London who was involved in both surgeries, said in a press release.
Regenerative medicine continues to make strides. Recently scientists were able to regrow a rat kidney – a complex organ with many specialized structures – and transplant it into a rat where it functioned nearly as well as a donor kidney. And while the 3D printing of organs is still a long way off, inspired scientists are working hard to make it a reality. The King’s College surgeons said the OrganOx preservation technique could be used by hospitals around the world in just a few years. By extending the health of the livers to 24 hours, they estimate that twice as many could be available for transplants. The intersection of organ manufacturing and preservation has already begun saving and improving lives, and the future only promises to bring more of the same.