When an organ donation is made to someone in need of a transplant, health personnel need to act quickly.
It only takes a few hours for the ice crystals to expand to damage the delicate tissue, leaving less than 12 hours for examination, transplantation and transplantation of the new organ.
This not only creates a huge crunch time for a delicate operation, but also damages many organs.
But a new breakthrough could greatly improve the liver transplant environment: Scientists keep preserved livers in unfrozen conditions for three days before they are transferred to a patient.
In addition, transplant centers rated this liver as non-viable because it came from a patient with a tumor and required diagnosis and treatment with sepsis (a bacterial infection). A three-day window allows researchers to perform these procedures and clean the liver for transplantation.
One year later, the recipient had good health, normal liver function, and normal quality of life. Although more research is needed before widespread clinical acceptance, the results could mean an increase in the number of livers considered viable in the future.
A research team led by surgeon Pierre-Alain Clavian of University Hospital Zurich and Wyss Zurich in Switzerland wrote: “The success of liver transplantation over the past 30 years has led to a global organ deficiency and the lack of available organs remain the most important limiting factor. transplant success. .This initial clinical success opens new horizons in clinical research and promises an extended lead time of up to 10 days to evaluate the feasibility of organ donations and also make it an urgent and extremely challenging surgical intervention. changing the procedure to an elective procedure. ”
The technique used by the team to preserve the liver is getting increasing attention in the medical world. This is called off-site thermal natural exudation, and the principle is simple: the organ is placed in a sterile environment and maintained at 37 ° C, which is the normal temperature of the human body.
In this environment, nutrients constantly flow along with fluids that mimic the functions of the human body, such as hormones and blood. In 2020, Wyss Zurich proved the effectiveness of the perfusion procedure by keeping the human liver functioning normally outside the body for seven days.
On May 19, 2021, their research took a big step forward. They were shown the livers of a 29-year-old woman with abdominal tumors and abscesses, as well as recurrent sepsis from antibiotic-resistant bacteria.
The liver itself has a tumor of unknown origin, which requires a diagnostic procedure before the organ can be considered suitable for transplant.
On the other side was the recipient: a 62-year-old man with advanced cirrhosis, acute portal hypertension, and recurrent multiple liver cancer.
He was fully aware of the experimental nature of the procedure and accepted the risks, even though his chances of getting a timely liver transplant through the normal transplant menu were too advanced to be close to zero.
On May 22, 2021, the transplant took place at the beginning of the fourth day after the donor organ healed. The procedure is complex and requires a team of engineers, biologists, and doctors together.
And this is a huge success: When blood returns to the tissues after a period of no blood supply, there are absolutely no signs of damage that can occur, known as reperfusion damage.
When an organ transplant is received from a voluntary living donor and implanted directly into the recipient, the result is similar to a living donation, the researchers said.
The only intervention needed is a standard immunosuppression regimen for six weeks to prevent donor organ rejection by the recipient’s body. The transplanted liver works normally and has no side effects – no signs of rejection or damage to the common bile ducts.
A year later, it’s still fine. On the whole, an impressive and very promising result. Because liver transplant remains one of the most demanding and resource-intensive surgical procedures currently performed as an emergency off-schedule procedure, long-term off-site perfusion may allow this type of surgery to become an elective procedure, such as live donations, he says. researchers
The research was published in the journal Nature Biotechnology.
Source: Science Alert
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