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 until now: it treated a human liver originally damaged in a machine for three days outside a body and then implanted the recovered organ. in a cancer patient. A year later, the patient is fine.
The Liver4Life research team owes its infusion machine, which was developed at home, to the fact that it was possible to implant a human organ in a patient after a three-day storage period outside a cos. The machine mimics the human body with the utmost precision, in order to provide the ideal conditions for human livers. A pump serves as a replacement heart, an oxygenator replaces the lungs, and a dialysis unit performs the functions of the kidneys. In addition, numerous infusions of hormones and nutrients perform the functions of the intestine and pancreas. Like the diaphragm of the human body, the machine also moves the liver to the rhythm of human breathing. In January 2020, the multidisciplinary research team in Zurich, in collaboration with the University Hospital of Zurich (USZ), ETH Zurich and the University of Zurich (UZH), demonstrated for the first time that infusion allows a liver to be stored outside the body. for several days (see January 13, 2020 press release).
From poor to good in three days
The team prepared the liver in the machine with various drugs. In this way, the liver could be transformed into a good human organ, although it was not originally approved for transplantation due to its poor quality. The infusion of several days, that is to say, the mechanical circulation of the organ, allows to do antibiotic or hormonal therapies or the optimization of the hepatic metabolism, for example. In addition, long-term laboratory or tissue tests can be performed without time pressure. Under normal circumstances, this is not possible because the organs can only be stored for 12 hours if they are conventionally stored on ice and commercial infusion machines.
Successful treatment attempt
As part of an approved individualized treatment attempt, doctors gave a cancer patient on the Swisstransplant waiting list the option to use the treated human liver. After 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 well: “I am very grateful for the life-saving organ. of my rapidly progressing tumor, I had little chance of getting a liver on the waiting list in a reasonable amount of time. “
Saving more lives
The article on the first transplant of a prepared liver into an infusion machine was published in one of the most recognized scientific journals, Nature Biotechnology, on May 31, 2022. “Our therapy shows that by treating the liver in the infusion machine, it is possible to alleviate the lack of functioning human organs and save lives, “explains Professor Pierre-Alain Clavien, director of the Department of Visceral Surgery and Transplantation at the University Hospital of Zurich (USZ).
The interdisciplinary approach to solving complex biomedical challenges incorporated in this project is the future of medicine. This will allow us to use the new findings even faster to treat patients. “
Mark Tibbitt, 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 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 planned elective procedure. At the same time, a new generation of machines is 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 a dozen medical professionals, biologists and engineers. The project is funded by donations from Wyss Zurich initiator Dr. hc much. Hansjörg Wyss.
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Magazine reference:
Clavien, PA., Et al. (2022) Transplantation of a human liver after 3 days of ex situ normothermic conservation. Nature’s biotechnology. doi.org/10.1038/s41587-022-01354-7.