Ex-Vivo: Improving donated livers and saving lives

Researchers are testing a new protocol that would potentially increase the number of organs available for patients in need.

PHILADELPHIA – Fatty liver disease, hepatitis, and cancer are creating a continued need for liver donors.

“There’s about 2,000 people a year who die on the waiting list,” said Peter Abt, MD, a professor of surgery at the Hospital of the University of Pennsylvania.

Researchers are testing a new protocol that would potentially increase the number of organs available for patients in need.

April is “Donate Life Month,” which is 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,” Abt said.

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.

“The goal is twofold. One is to help that organ work better in the recipient. Another goal is to make it last longer,” Abt said.

Abt and his colleagues have successfully transplanted the Ex-Vivo livers in a small number of patients. He said 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,” Abt said.

The Ex-Vivo perfusion is being tested at a half dozen U.S. medical centers. In addition, Abt said 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.