Ex Vivo Organ Perfusion Increases Number of Transplantable Organs (Video)

Transporting organs between donors and recipients hasn’t changed much in 40 years. Packing the organ into an ice chest is still standard procedure. But too many times, iced organs — which are cut off from oxygen, nutrients and medication — never fully regain viability. In 2015, more than 2,000 procured livers were deemed marginal or unusable while patients on waiting lists died.

In 2016, Cleveland Clinic liver transplant surgeon Cristiano Quintini, MD, introduced a new way to protect and transport these organs. His ex vivo organ perfusion device is essentially a miniature cardiopulmonary bypass machine. It maintains temperature and oxygenation and can supply nutrients and medication to revive the organ while in transit.

The machine also can assess the function of a donor organ and predict its viability before it’s transplanted. According to Dr. Quintini, having an objective way to assess organs will allow more of them — possibly 60 to 70 percent of donor livers previously considered marginal or unusable — to be accepted for transplant.

“Ex vivo organ perfusion is certainly a game changer. We’re going from a very old technology for preserving organs, which is ice. With the current organ preservation modality, we can only preserve a liver for six to eight hours,” Dr. Quintini says. “After that, the damage that the organ receives is exponential. With ex vivo organ preservation, you can actually keep a liver alive and functional for up to 86 hours.”

This new technology may enable organ sharing across continents, and possibly better matches, he adds. In 2016, Cleveland Clinic became the first hospital in the United States to transplant a human liver using ex vivo liver perfusion.

“This new technology allows us to be extremely more aggressive in pursuit of every single organ that is offered,” he says.