Journal
NATURE BIOTECHNOLOGY
Volume 38, Issue 2, Pages 189-+Publisher
NATURE PORTFOLIO
DOI: 10.1038/s41587-019-0374-x
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Funding
- Swisstransplant
- Swiss Donor Care Association
- Wyss Zurich
- Helmut Horten Foundation
- PROMEDICA Foundation
- Liver and Gastrointestinal foundation (LGID)
- Swiss National Science Foundation [320030_182764/1]
- Swiss National Science Foundation (SNF) [320030_182764] Funding Source: Swiss National Science Foundation (SNF)
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Livers are stored long term in a sophisticated perfusion system. The ability to preserve metabolically active livers ex vivo for 1 week or more could allow repair of poor-quality livers that would otherwise be declined for transplantation. Current approaches for normothermic perfusion can preserve human livers for only 24 h. Here we report a liver perfusion machine that integrates multiple core physiological functions, including automated management of glucose levels and oxygenation, waste-product removal and hematocrit control. We developed the machine in a stepwise fashion using pig livers. Study of multiple ex vivo parameters and early phase reperfusion in vivo demonstrated the viability of pig livers perfused for 1 week without the need for additional blood products or perfusate exchange. We tested the approach on ten injured human livers that had been declined for transplantation by all European centers. After a 7-d perfusion, six of the human livers showed preserved function as indicated by bile production, synthesis of coagulation factors, maintained cellular energy (ATP) and intact liver structure.
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