News from the BioCity Campus

Blood, oxygen, food: modern organ perfusion equipment prepares donor livers

Machine simulates human organism and ensures more safety for patients, more time for transplanters and fewer organ rejections.
New hope for patients on the waiting list for liver transplantation: As one of currently only three centers in Germany, the University Hospital Leipzig (UKL) recently had a fully automated organ perfusion device available for liver transplantation. It enables the mechanical perfusion (flushing) of a donor liver. Thanks to this device, the experts at the transplant center at the UKL can assess organ function more precisely before the transplant and therefore have to reject fewer organs.

Livers have been successful at the UKL for over 25 years transplanted. Doctors are increasingly confronted with declining quality of donor organs. "As donors get older and sicker, so do their livers," explains Dr. Sebastian Rademacher, Senior Physician of the department hepatobiliary surgery and visceral transplantation. Added to this is the fact that Germany brings up the rear in Europe when it comes to the number of donors. 15 to 30 percent of all donated organs in western industrialized countries cannot currently be transplanted due to relevant previous damage to the donor liver, for example increased obesity: "We want and must counteract this."

Organ perfusion has been researched for many years, and the technology is now very advanced. "It's still a new but approved and safe procedure," emphasizes Dr. Rademacher therefore.

So far, transplanters have about 12 to 14 hours to replant a removed organ. In an organ perfusion device, however, the inside of the human body can be almost perfectly reproduced. The liver, which was previously stored at 4 degrees Celsius, is first put into the modern machine. Blood reserves and nutrients are placed in these beforehand. The organ is then connected to the device via cannulas and tubes and perfused with blood. A built-in “artificial lung” supplies this blood with oxygen. In this way, an almost complete organism is simulated.
"We also use this device to examine organs that we would not have taken before, which creates a lot of security for the patient," explains Senior Physician Rademacher. “After four hours we can see if the organ is working or not. If it works, after four hours we'll have a well-processed liver."

Another big advantage: The time pressure is much lower because the liver is well supplied by the machine - for up to 24 hours. This allows the physicians to prepare and carry out the actual transplantation in peace.

Despite the many advantages, the organ perfusion device is only used for those organs and patients for which it brings the greatest advantages for cost reasons, for example for organs that have already been stored for a relatively long time or for patients where the transplanters have more to do for logistical reasons Take time. The procedure is not cheap, the health insurance companies have not yet borne the costs for it, but the UKL itself. "But because of the great advantages for those affected, we would like to offer it," says Dr. Rademacher.

The new UKL device has already completed two runs. Both were successful, albeit in different directions: “The first case was successful for the patient who received a new liver transplant. The second case can also be classified as a success. Here the machine showed that the organ was not transplantable.

The experiences that have been made, for example in Münster, one of the three centers in Germany alongside Frankfurt and now Leipzig, where this special device is used, have also been very positive. "Actually, we wanted to get started months ago, but the corona virus messed everything up here too," says Rademacher.

Source: Press release from the Leipzig University Hospital of September 07.09.2020th, XNUMX

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