By Carissa Wong.
A damaged human liver has been repaired in a machine and successfully transplanted into a recipient. The technology could increase the number of transplants.
Human organs are in short supply. An adult in the UK waits an average of 65 days to receive one.
Pierre-Alain Clavien says people are dying on the waiting list.
One reason for the shortage is that the people who agree to donate must pass strict tests to be considered suitable for transplant.
The technology that Clavien and his colleagues have built can take a damaged liver and repair it over the course of several days to make it suitable for transplantation. The team has tested the device on pig and damaged human organs. This is the first time a device used to repair a human liver has been tested in people.
The machine contains tubes that carry donated blood into the body at a pressure and temperature that are found in the body. The flow of liquid also removes waste products from the body. The device has an artificial diaphragm that mimics movements in the body. It helps to prevent a build-up of pressure.
We give everything to keep the liver happy, because we hope it doesn't know it's outside of the body. This includes feeding the blood sugar to mimic normal eating patterns over the course of the day.
A 29-year-old donor had a reaction to multiple bacterial infections that caused their immune system to malfunction. The donor was unable to digest food, which damaged their liver. The donor's fate hasn't been revealed, but they had a small defect in their liver which was rejected by transplant clinics.
The standard procedure of storing the body's organs outside for less than 12 hours leaves insufficient time to take a biopsy.
The organ was rejected. The organ would have been thrown away if it wasn't used in the study.
The team connected the organ to the machine and monitored its production of a fluid that helps with digestion.
The group found that the liver was able to make useful bile and proteins. The team was able to clear harmfulbacteria from the liver using high dose antibiotics, and took a sample to check if it was cancer. This showed that the lesion was harmless and didn't pose a threat to the recipient.
After being taken out of the donor, the team noticed that the organ grew in size by 25 per cent, but the machine seemed to remove the swelling.
The man who received the transplant was 62 years old and had been diagnosed with cancer. He was not likely to survive long enough to get a transplant.
After just six days inside the man's body, the team found that the liver regenerated substantially.
One week after, we took a biopsy that showed the incredible regeneration of the liver. It grew to match the size of the recipient.
One year later, the liver was found to be functioning normally and the size of the lesion had been halved.
The machine can be adapted for other uses.
He says that they are doing tests in the kidneys and it looks good. In an ideal scenario, the machine could be available in the clinic within two years.
Nazia Selner at the University of Toronto says that the researchers have pioneered the field. It will change the landscape of organ preservation.
Nature Biotechnology is a journal.
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