Drug & Device Development

Device keeps liver "alive" outside the body in medical first

Last Updated: 2013-03-15 14:40:19 -0400 (Reuters Health)

By Kate Kelland

LONDON (Reuters) - Donated human livers have been kept alive, warm and functioning outside a human being on a newly-developed machine and then successfully transplanted into patients in a medical first.

"This device is the very first completely automated liver perfusion device of its kind," said Constantin Coussios, a professor of biomedical engineering at Oxford University and one of the machine's co-inventors.

"These first clinical cases confirm that we can support human livers outside the body, keep them alive and functioning on our machine and then, hours later, successfully transplant them into a patient."

A British team of doctors, engineers and surgeons announcing the achievement on Friday said it could be common practice in hospitals across the developed world within a few years, up to doubling the number of livers available for transplant.

So far the procedure has been performed on two patients on Britain's liver transplant waiting list and both are making excellent recoveries, the medical team told a news conference.

"It was astounding to see an initially cold, gray liver flushing with color once hooked up to our machine and performing as it would within the body," Coussios said. "What was even more amazing was to see the same liver transplanted into a patient who is now walking around."

Currently livers destined for transplant are cooled to preserve them, but they often become damaged in the process and rendered unfit for transplant.

Surgeons say keeping livers "on ice" beyond 14 hours starts becoming risky, although they can last up to 20 hours.

Around 13,000 liver transplants are carried out each year in Europe and the United States, but there is a combined waiting list of around 30,000 patients who need a new liver.

Experts say up to a quarter of these patients die while they are waiting. At the same time, more than 2,000 livers are discarded every year because they are either damaged by oxygen deprivation or do not survive the cold preservation process.

The new technology, developed by Coussios together with Peter Friend, director of the Oxford Transplant Centre, preserves the liver at body temperature and supplies it with oxygenated red blood cells to keep it alive.

The device can keep a liver functioning normally - just as if in a person, with blood circulating through its capillaries and bile being produced - outside the body for 24 hours or more.

The results from the first two transplants using the new technology, carried out at King's College Hospital (KCH) in London last month, suggest the device could be useful for all patients needing liver transplants, Field told reporters.

The new device could also mean livers which would otherwise be discarded as unfit for transplantation could be preserved and made viable - potentially as much as doubling the number of organs available for transplant, he said.

"If we can introduce technology like this into everyday practice, it could be a real, bona fide game changer for transplantation as we know it," said Nigel Heaton, director of transplant surgery at KCH and part of the team that carried out the first two transplants using the device.

Coussios and Friend have been researching the technology for the device since 1994 and are developing it through an Oxford University spin-off company called OrganOx.

The first person to receive a transplanted liver kept alive on the OrganOx system was 62-year-old Briton Ian Christie. He is still recovering from the surgery but said in a statement he was getting better day by day.

The team now plans to run a pilot trial with 20 more liver transplant patients at KCH. Coussios said successful results of that trial would allow OrganOx to apply for marketing authority, meaning the device could be on the market by as early as 2014.