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New system preserves organ function after death

Spektrum der Wissenschaft
Heidelberg, on 10.08.2022

With a new perfusion system, researchers could briefly protect the organs of a dead pig from damage. The approach would be particularly interesting for organ transplants.

After the death of a living being, the organs quickly lose their function: The fact that oxygenated blood no longer circulates through the body sets off a cascade that leads to cell death and ultimately to severe damage to the heart, liver, kidneys and so on. A team led by Nenad Sestan from Yale University has now succeeded for the first time in stopping this process over a large area in the body of a dead pig. With their perfusion system OrganEx, the research group was able to almost completely restore the blood flow in the organs about one hour after a cardiac arrest, prevent further cell damage and possibly even trigger repair processes in the organs, as they report in the scientific journal "Nature".

Sestan and colleagues expanded a system called BrainEx for their work, which researchers have already used to partially maintain brain activity in pigs several hours after death. It is already possible to a certain extent to preserve individual organs, but previous methods failed when it came to whole bodies. OrganEx is trying to change that by mechanically pumping a special fluid through the body that is tailored to correct the electrolyte and metabolic imbalances caused by the lack of oxygen. In the experiment, the system thus proved to be significantly more effective than ECMO, a heart-lung machine often used in intensive care units that artificially oxygenates the body's own blood.

Possible applications especially in transplant medicine

. In practice, the new perfusion system could primarily be of interest for organ transplants. "In brain death donation, OrganEx could be used to significantly prolong the ischaemia time of explanted donor organs. For this, corresponding studies on the effectiveness would have to be made," explains Jan Gummert, Director of the Clinic for Thoracic and Cardiovascular Surgery at the Heart and Diabetes Center NRW. Countries in which organ donation is possible even after cardiac arrest, unlike in Germany, would benefit most. If such organs are transplanted, the chances of success are often lower than with organs that come from a brain-dead donor - precisely because of the damage caused by a lack of oxygen. > But it is also conceivable to use it for patients whose organs have had too little blood supply for a short time, for example after a heart attack, says Uta Dahmen, head of the Department of Experimental Transplantation Surgery at Jena University Hospital. "However, there is still a long way to go from a promising experimental study to the routine clinical use of a new medical device."

Spectrum of Science

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Cover image: © Noctiluxx / Getty Images / iStock (detail) / Illustration of a heart with veins and arteries.

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