Human livers kept alive for one week outside the body

Swiss researchers have developed a machine that repairs injured human livers and keeps them alive outside the body for one week. Described in the journal Nature Biotechnology, their breakthrough may increase the number of available organs for transplantation, saving patients with severe liver diseases or cancer.

Until recently, livers could be stored safely outside the body for only a few hours. This changed with the launch of the Liver4Life project under the umbrella of Wyss Zurich, which brought together the technical know-how and biomedical knowledge of experts from the University Hospital Zurich (USZ), ETH Zurich and the University of Zurich (UZH). As noted by ETH Zurich’s Professor Philipp Rudolf von Rohr, co-leader of the study, “The biggest challenge in the initial phase of our project was to find a common language that would allow communication between the clinicians and engineers.”

The basis for the team’s technology is a complex perfusion system, mimicking most core body functions close to physiology. With the novel perfusion technology, livers — even injured livers — can now be kept alive outside of the body for an entire week. When the project started in 2015, livers could only be kept on the machine for 12 hours.

“The success of this unique perfusion system — developed over a four-year period by a group of surgeons, biologists and engineers — paves the way for many new applications in transplantation and cancer medicine helping patients with no liver grafts available,” said Professor Pierre-Alain Clavien, study co-leader and Chairman of the Department of Surgery and Transplantation at USZ.

The inaugural study shows that six of 10 perfused poor-quality human livers, declined for transplantation by all centres in Europe, recovered to full function within one week of perfusion on the machine. The seven-day successful perfusion of poor-quality livers now allows for a wide range of strategies, eg, repair of pre-existing injury, cleaning of fat deposits in the liver or even regeneration of partial livers.

The study has been described as a major breakthrough in transplantation medicine, which may increase the number of available organs for transplantation and save the lives of patients suffering from severe liver disease or a variety of cancers. The technology therefore opens a large avenue for many applications offering a new life for many patients with end-stage liver disease or cancer.

Image caption: A surgeon connects the donor liver to the perfusion machine. Image credit: beamue/USZ.

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