Zurich’s multidisciplinary research team Liver4Life has managed to do something during a treatment attempt that has never been achieved in the history of medicine: it treats an initially damaged human liver in a machine for three days outside the body and then implants the restored organ into a diseased from cancer. One year later, the patient feels well.
Liver4Life’s research team owes its perfusion machine, which was developed at home, 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 accurately as possible to provide ideal conditions for the human liver. A pump serves as a replacement heart, an oxygenator replaces the lungs, and the dialysis unit performs the functions of the kidneys. In addition, multiple infusions of hormones and nutrients perform the functions of the intestines and pancreas. Like the diaphragm in the human body, the machine also moves the liver to the rhythm of human respiration. In January 2020, Zurich’s multidisciplinary research team – involving the University of 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 for several days outside the body. . *
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 turn the liver into a good human organ, although it was not originally approved for transplantation due to its poor quality. Multi-day perfusion, i.e. mechanical circulation of the organ, allows antibiotic or hormone therapy or optimization of hepatic metabolism, for example. In addition, long laboratory or tissue tests can be performed without time pressure. Under normal circumstances, this is not possible, as organs can only be stored for 12 hours if they are stored conventionally on ice and in commercially available perfusion machines.
The treatment attempt was successful
As part of an approved individual treatment trial, doctors gave a cancer patient on the waiting list of Swisstransplant the choice to use the treated human liver. With his consent, the organ was transplanted in May 2021. The patient was able to leave the hospital a few days after the transplant and now feels well: “I am very grateful for the life-saving organ. Due to my rapidly progressing tumor, I had a small chance of getting a liver from the waiting list within a reasonable period of time. “
Saving more lives
The article about the first liver transplant prepared in a perfusion machine has been published Natural biotechnology, on May 31, 2022. “Our therapy shows that by treating the liver 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 Tibit, Professor of Macromolecular Engineering at ETH Zurich, added: “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 faster to treat patients. “
The next step in the Liver4Life project is to review the procedure in other patients and demonstrate its efficacy and safety in the form of a multicenter study. Its success would mean that in the future, liver transplantation, which is usually an emergency procedure, will be transformed into a planned elective procedure. At the same time, the next generation of machines is being developed. In addition, participants in basic research continue to look for ways to treat other liver diseases outside the body with drugs, molecules or hormones.
Liver4Life: a project by Wyss Zurich
The Liver4Life project was launched in 2015 under the auspices of the Wyss Zurich Translation Center. It combines the highly specialized technical know-how and biomedical knowledge of about ten medical specialists, biologists and engineers. The project is funded by donations from the initiator of Wyss Zurich, Dr. hc mult. Hansorg Vis.
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Materials provided by University of Zurich. Note: Content can be edited for style and length.