Doctors remove the patient’s liver and transplant it after treatment

Swiss doctors successfully removed a liver from a cancer patient after three days of treatment on the device before transplanting it back into his body.

The multidisciplinary Liver4Life team at the University of Zurich Hospital (USZ) claims that this procedure is the first of its kind in the world, and they believe that their in-house perfusion machine made this feat possible.

The USZ said in a statement on May 31: “The Liver4Life multidisciplinary Zurich research team has achieved something that has never been achieved in the history of medicine: first treating the injured person’s liver in a car. implanted.

They added: “After a year, the patient is in good condition.”

Professors Pierre-Alain Clavien and Philly Dutkovsky underwent liver transplantation.
USZ / Zenger

They also said, “The Liver4Life research team is committed to making it possible for a human organ to be implanted in a home-made perfusion device after it has been stored outside the body for three days.”

According to them, the machine imitates the human body very precisely to provide the best conditions for the human liver. They added: “The pump replaces the heart, and instead of the oxygenator’s lungs, the dialysis machine performs the functions of the kidneys.

“In addition, many hormones and nutrient infusions perform the functions of the intestine and pancreas. Like the diaphragm in the human body, the device moves the liver according to the rhythm of human respiration.”

In January 2020, a multidisciplinary Zurich research team in collaboration with the University Hospital of Zurich (USZ), ETH Zurich and the University of Zurich (UZH) demonstrated that the experimental procedure was theoretically possible, and now they have demonstrated it “for the first time”. Perfusion technology allows the liver to be kept outside the body for several days. “

Professor Pierre-Alain Clavien and Liver Patient
The surgeon, Professor Pierre-Alain Clavien, and then the patient were discharged from the hospital after a successful transplant.
USZ / Zenger

They explained: “The team prepared the liver with a variety of drugs. In this way, it was possible to transform the liver into a good human organ, even if the transplant was not initially approved because of its poor quality.

“Multi-day perfusion, i.e. mechanical rotation of the body, such as antibiotics or hormonal therapies, allows you to optimize the metabolism in the liver. In addition, long-term laboratory or tissue tests can be performed without the pressure of time.

“Under normal circumstances, this is not possible, because the organs are stored on ice and in commercial perfusion machines for only 12 hours,” he said.

“As part of an approved individual treatment effort, doctors queued up to choose to use human liver from a Swisstransplant cancer patient. 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 he is fine.”

An unnamed patient said: “I am very grateful for the organ that saved my life. Because my tumor was growing so fast, I had little chance of being removed from the liver waiting list in a reasonable amount of time.”

Pierre-Alain Clavien, director of the Department of Visceral Surgery and Transplantation at the University Hospital of Zurich (USZ), said: “Our therapy shows that treating the liver with a perfusion machine can alleviate human organ failure. save lives. “

Mark Tibbitt, professor of macromolecular engineering at ETH Zurich, added: “The disciplinary approach to solving the complex biomedical problems contained in this project is the future of medicine. This will allow us to apply new discoveries more quickly to treat patients.”

The Zurich Hospital said in 2020: “Until now, the livers can only be kept safe outside the body for a few hours. With the new perfusion technology, the livers, even the injured ones, can now be kept alive outside the body for a whole week.”

“This is a major breakthrough in transplant medicine, which can increase the number of organs available for transplantation and save the lives of patients with severe liver disease or various cancers. Damaged dead livers may not be suitable for transplantation at first. can be obtained.

“The basis of this technology is a complex perfusion system that mimics the basic functions of the body close to physiology. The relevant study was published in the January 13 issue of the journal Nature Biotechnology.”

Clavien said at the time, “The success of this unique perfusion system, developed by a team of surgeons, biologists and engineers over four years, opens the door to many new applications in transplant and cancer medicine that help patients without liver transplants.”

USZ explained in 2020: “When the project began in 2015, it was possible to keep the livers in the car for only 12 hours. Successful seven-day perfusion of poor quality livers now allows for a wide range of strategies, such as repairing existing livers. Cleanse the fat layers or partially restore the liver.

USZ said: “The Liver4Life project was developed under the auspices of the Wyss Zurich Institute of the University of Zurich (USZ), which combines the highly specialized technical know-how and biomedical knowledge of ETH Zurich and Zurich University experts.

Professor Philipp Rudolf von Rohr, professor of technological engineering at ETH Zurich, said: “The biggest challenge in the initial phase of our project was to find a common language that would allow communication between clinics and engineers.”

The USZ added: “Preliminary research shows that six of the ten low-quality livers that all transplant centers in Europe refuse to transplant have fully restored within a week after machine perfusion. The next step is to use them. opens a wide path for the many apps it offers. “

Their study was then published in the academic journal Nature Biotechnology, entitled “An Integrated Perfusion Machine Saves the Affected Liver for a Week.” The authors of the study in 2020 were Dilmurodjon Eshmuminov, Dustin Becker, Lucia Bautista Borrego, Max Hefti, Martin J. Schuler, Catherine Hagedorn, Xavier Müller, Matteo Müller, Christopher Onder, Rolf Graf, Achim Weber, Philipp Dutkowski, Philip Dutkowski. Rohr and Pierre-Alain Clavien.

The next step in the Liver4Life project is to “review the procedure in other patients and demonstrate its effectiveness and safety in the form of a multicenter study.”

USZ said: “This means that the next success will be transformed into a planned elective transplant, usually surviving an emergency procedure, while a generation of machines is being developed.

“In addition, participants in fundamental research continue to look for ways to treat other liver diseases with drugs, molecules or hormones outside the body.”

The results of the successful transplant were published in the journal Nature Biotechnology on May 31 under the title “Transplantation of the human liver after 3 days of ex-situ normothermal conservation.” Its authors are Pierre-Alain Clavien, Philippe Dutkovsky, Matteo Müller, Dilmurodjon Eshmuminov, Lucia Bautista Borrego, Achim Weber, Beet Mulhaupt, Richard X. Souza Da Silva, Brian R. Burg, Philip Rudolf von Rohr, Martin J. Schuler, Dustin Becker, Max Hefty, and Mark W.

This story was reported by Newsweek magazine Zenger News.

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