Donated liver stored for record time

Surgeons have successfully transplanted a human liver donated by a severely ill patient after keeping it in a novel storage machine for three days, it has been announced.

Living donation has helped reduce the shortage of donor organs, explain Professor Pierre-Alain Clavien of the University Hospital Zurich, Switzerland, in Nature Biotechnology.

But currently, organ preservation methods allow a short window of less than 12 hours to implant donor liver grafts.

The researchers, part of a research team called Liver4Life, found a way of transplanting a human liver that had been discarded by all transplant centres. They preserved it for three days using ‘ex-situ normothermic machine perfusion’.

This method recreates the human body, with a pump acting as a heart, an oxygenator replacing the lungs, and a dialysis unit mimicking the kidneys. It also provides hormone and nutrient infusions and moves the liver similarly to a diaphragm.

Following this storage method, the liver graft was transplanted successfully into a cancer patient and functioned normally, they report, "with minimal reperfusion injury and the need for only a minimal immunosuppressive regimen".

The team writes: "The patient rapidly recovered a normal quality of life without any signs of liver damage, such as rejection or injury to the bile ducts, according to a one-year follow up.

"This inaugural clinical success opens new horizons in clinical research and promises an extended time window of up to ten days for assessment of viability of donor organs as well as converting an urgent and highly demanding surgery into an elective procedure."

The patient, who received the graft in May 2021, said: “I am very grateful for the life-saving organ. Due to my rapidly progressing tumour, I had little chance of getting a liver from the waiting list within a reasonable period of time.”

Clavien, P. A. et al. Transplantation of a human liver following 3 days of ex situ normothermic preservation. Nature Biotechnology 31 May 2022 doi: 10.1038/s41587-022-01354-7


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