A donor liver that breaks all records


Innsbruck is one of the most important transplant centers in Europe. About 130 kidneys, 15 to 20 hearts, 10 to 15 lungs and more than 80 livers are transplanted here every year. Thanks to a special technique, the organs can be kept outside the body for longer and longer. This opens up unprecedented possibilities.

“A week in the experimental area, up to 40 hours already regular.” Stefan Schneeberger, chief of transplant surgery at the university clinic in Innsbruck, speaks with the calmness of a stress-tested surgeon about world records currently set in his field, in his department. What is the doctor quantifying here? Schneeberger describes the durability of a donor liver when it is connected to a so-called perfusion machine. A very complex device that can provide the organ conditions (almost) like those in the body.

“It saves us a lot of time”
A liver can now be stored on this machine for up to a week. A sensation that would not only revolutionize transplant surgery. Schneeberger: “We save a lot of time with our work. Five years ago we had a maximum of eight to ten hours. If it took longer, the organ was too badly damaged. The removal, transportation, recipient preparation and transplantation had to work within this time window.”

A cool box used to be the only possible connection between donor and recipient. However, an organ cannot be supplied with blood and nutrients. A critical stage in which sensitive cells can become severely damaged. With machine perfusion, the liver remains warm, supplied with blood and supplied with nutrients. Evidence shows that this keeps the organs in better condition.

“But not only that”, makes Schneeberger curious, “the new technology gives us the opportunity to see organs up close for the first time.” This has opened up an internationally renowned field of research at the Medical University of Innsbruck. Schneeberger and his team have developed a method for assessing and treating organs separate from the body.

The organ is cared for as an intensive care patient
“We take care of livers like patients in intensive care,” the surgeon begins to explain. There the organ is put to the test. This means that doctors have significantly more guarantees for the success of a transplant than in the past. But what is actually revolutionary has only just begun. “This new procedure has made it possible to treat a liver before transplantation and thus to transplant organs that we previously had to discard,” explains Schneeberger.

Discard – in the past this was required 20 to 30 percent of the time. Currently, the rejection rate is 10 to 15 percent. In a subject where every day is a matter of life and death, every percentage point can work wonders.

Eleven perfusion devices are now in use at the clinic. Not just for livers. Hearts and kidneys can also be stored longer with these machines. Last year, thanks to new technology, a beating heart was transplanted for the first time in Innsbruck. The time saved has a one-to-one effect on quality. This is confirmed by the first evaluations.

Treating Tumors Outside the Body
What will the future bring? “A lot still needs to be done”, Schneeberger is convinced, and he also has an example ready: “If an organ is affected by a tumor, it can be treated outside the body thanks to perfusion and then reinserted into the patient. the rest of the organism is spared from the side effects of the often aggressive cancer therapies.” A utopia that will soon no longer be true, as little as that of an organ bench. This could be a reality in Innsbruck as early as 2030. Organs on request.

“The horizon is much wider than previously assumed”, the otherwise relaxed transplant specialist is emotional by these descriptions. The liver, the heart, the kidneys – is it conceivable that the technology will soon work with all organs? “Why not?” Schneeberger poses the counter question. Why not? A plausible answer.

Source: Krone


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