New Liver Preservation Technique Aimed at Improving Transplant Outcomes

Jan 22, 2015

Hoping to increase the number of successful liver transplants, a new organ preservation system is being tested which uses what’s called a “machine perfusion” technique.

Researchers at the University of Pittsburgh School of Medicine say the new system pumps cooled, oxygen-rich fluid into donor livers. This keeps the organs in excellent condition for up to nine hours before transplantation.

“If you don’t provide good oxygenation, or if you don’t provide any oxygenation for nine hours, it’s a huge insult to the organs,” said Dr. Paulo Fontes, UPMC transplant surgeon and senior investigator on the project.

The findings are from a series of animal studies by researchers at Pitt and the McGowan Institute for Regenerative Medicine. The team transplanted six pigs with livers that had been kept for nine hours with the new system, and six other pigs with livers placed in the standard containers used now.

“What we saw in this group is two-thirds of the animals will die within five days because of the significant damage of the liver after this nine hours of preservation,” Fontes said.

The findings were completely different using the new machine profusion technique.

“One hundred percent of the animals lived through the five days,” Fontes said. “They were very healthy, the liver function was very good and the animals didn’t even look like they were operated on, which is an amazing finding for myself, doing this now for 24 years.”

The ultimate goal is to expand the number of high-quality livers available for transplant and reduce waiting times and patient mortality. With the current preservation system, 20 to 40 percent of donor livers cannot be transplanted because of oxygen deprivation during storage and transport- factors that can affect tissue, and worsen any damage. Plus, Fontes said, the current system is very outdated.

“The way that we preserve organs is something called an ice box that looks like a picnic cooler,” he said. “Then you have a plastic bag with an organ inside with a solution that keeps the cells alive at a low temperature without oxygen, without any other technology, I mean we’ve been using this for 40 years – it’s embarrassing.”

Cost may be a factor though, as a machine perfusion technique could cost considerably more than the traditional preservation method. But, Fontes said they are finding ways to make it more affordable so that cost does not become a barrier.

The study is being reviewed by federal regulators; the hope is to launch clinical human trials at UPMC later this year to test the system.