New device may keep donor livers healthy outside body for LT

In a phase 1 clinical trial, researchers from Toronto General Hospital tested a new device that allowed a deceased donor liver to be stored outside of the body until liver transplantation, according to a press release.

David R. Grant, MD, FRCSC, surgical director of the Multi-Organ Transplant Program at Toronto General Hospital, and colleagues, including Markus Selzner, MD, were able to preserve a donor liver and keep it healthy outside of the body through a device that “mimics the body’s physiological functions,” according to the release. The device, known as the OrganOx Metra (OrganOx), may be able to store a liver up to 24 hours. This device has been used in England, Spain and Germany, and was recently used on a liver that was then successfully transplanted into a human at Toronto General Hospital.

David R. Grant

According to the release, the device encloses the liver in a sterile environment while circulating oxygenated blood and nutrients into it at body temperature. This allows the liver to improve and repair itself, which may lead to better outcomes for patients. This new technology has advantages over typical cold storage procedures because when deceased donor liver is cooled to 4° C with no oxygen the repair process is stopped. The release stated: “The liver cannot survive longer than 12 hours in cold preservation.”

Markus Selzner

“This technique will change the landscape of organ donation by improving organ preservation, allowing us to assess or ‘test drive’ the liver on the device before we transplant it into a patient,” Selzner said in the release. “We will know how healthy that organ is before the transplant operation.”

Approximately 35% of deceased donor liver organs are not suitable for transplantation, according to the release, and Selzner stated that many donor livers could “benefit” from this new technology because it could potentially repair donor organs damaged by previous cold storage methods.

“Even with the shortage of donor organs, we have to decline some of our donor organs because of the damage they sustain in the retrieval process,” Grant said in the release. “This new technology can help us answer critical questions such as ‘Can we use organs which we currently decline? Can we repair and predict organ function before the transplant occurs?’”

According to the release, 1,500 people in Ontario, Canada, are waiting for a transplant. More than 200 are waitlisted for a liver and approximately 30% of these will die while on the list.

Disclosures: Grant and Selzner report being employed by Toronto General Hospital.