PHILADELPHIA, Pa. (Ivanhoe Newswire) – Fatty liver disease, Hepatitis, and cancer are creating a continued need for liver donors. Ex-Vivo.
Peter Abt, MD, says “There’s about 2,000 people a year who die on the waiting list.”
Researchers are testing a new protocol that would potentially increase the number of organs available for patients in need.
April is “Donate Life Month”, dedicated to raising awareness about the need for organ donation. Every year, surgeons perform more than 9,000 liver transplants. Those transplants are often a race against time, as a liver from a deceased donor only survives outside of the human body for about 12 hours. Now, scientists are testing a new protocol that may not only keep livers viable longer but improve their function after transplantation.
Every year in the United States, as many as 11,000 people get on a waiting list for a new liver. Now, scientists are studying a liver preservation procedure called liver Ex-Vivo, which means “outside of the living body.”
“The idea is that a liver, or an organ, is placed on a pump device, and it’s given warm oxygenated blood, or sometimes just preservation solution,” Dr. Abt, who is a professor of surgery at the Hospital of the University of Pennsylvania, explains.
A medical team removes the liver from a deceased donor and instead of preserving it in ice, the liver is placed in a machine that passes fluid through the organ at body temperature while it’s on the way to the donor’s hospital.
Dr. Abt tells Ivanhoe, “The goal is twofold. One is to help that organ work better in the recipient. Another goal is to make it last longer.”
Dr. Abt and his colleagues have successfully transplanted the Ex-Vivo livers in a small number of patients. He says the next step is to take livers that are turned down for transplant and see if the Ex-Vivo perfusion can improve their function.
“We look to make sure the livers are they’re clearing acid, metabolizing glucose, and things like that. We make sure they’re making bile, and then use them for transplant if they appear to be working on the pump,” Dr. Abt adds.
The Ex-Vivo perfusion is being tested at a half dozen U.S. medical centers. In addition, Dr. Abt says the United Network for Organ Sharing, or UNOS, is overseeing the implementation of a living liver transplant paired exchange program. The liver is the only internal human organ that has the ability to regenerate. The organ grows back in both the donor and the recipient.
Contributors to this news report include: Cyndy McGrath, Producer; Kirk Manson, Videographer: Roque Correa, Editor.
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Sources:
https://www.donors1.org/patients/resources-for-transplant-patients/the-waiting-list/
https://www.mayoclinic.org/tests-procedures/liver-transplant/about/pac-20384842
MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY
TOPIC: EX VIVO: IMPROVING DONATED LIVERS AND SAVING LIVES
REPORT: MB #5040
BACKGROUND: A liver transplant is a surgical procedure that removes a liver that no longer functions properly (liver failure) and replaces it with a healthy liver from a deceased donor or a portion of a healthy liver from a living donor. Your liver is your largest internal organ and performs several critical functions, including processing nutrients, medications, and hormones, producing bile, which helps the body absorb fats, cholesterol, and fat-soluble vitamins, making proteins that help the blood clot, removing bacteria and toxins from the blood, and preventing infection and regulating immune responses. Liver transplant is usually reserved as a treatment option for people who have significant complications due to end-stage chronic liver disease. In 2017, about 8,000 liver transplants were performed in the U.S. among both adults and children. Of those, about 360 involved livers from living donors. At the same time, approximately 11,500 people were registered on the waiting list for a liver transplant.
(Source: https://www.mayoclinic.org/tests-procedures/liver-transplant/about/pac-20384842)
DIAGNOSING: Liver failure occurs when your liver isn’t working well enough to perform its functions (for example, manufacturing bile and ridding the body of harmful substances). Symptoms include nausea, loss of appetite, and blood in the stool. As liver failure advances, symptoms become more severe. In later stages, symptoms of liver failure may include jaundice (yellowing of the skin and eyes), extreme tiredness, disorientation, and fluid buildup in the abdomen and extremities. Chronic liver failure may be caused by a variety of conditions. The most common cause of chronic liver failure is scarring of the liver (cirrhosis). When cirrhosis occurs, scar tissue replaces normal liver tissue and causes the liver to not function properly. Cirrhosis is the most frequent reason for a liver transplant.
(Source: https://my.clevelandclinic.org/health/diseases/17819-liver-failure)
NEW TECHNOLOGY: Liver transplantation is the accepted treatment for end-stage-liver failure and is the last option for the patient. There is therefore a big need for increasing the number of organs that are suitable for transplantation as many patients will die while waiting for an organ to become available. Currently, organs are stored on ice before being transplanted; however, this can lead to damage of the organ before it is transplanted, making it unusable and further reducing the number of available organs. A hospital has become the first in the UK to start using a perfusion machine routinely before liver transplantation. The perfusion machine maintains the liver in a physiological state, keeping it warm and pumping it with blood, nutrients and, if required, medicine. A study published in Nature showed that there was 50% lower level of injury in livers that had been kept warm compared with those stored on ice.
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Dan Fower
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