Beta
×

Welcome to the Slashdot Beta site -- learn more here. Use the link in the footer or click here to return to the Classic version of Slashdot.

Thank you!

Before you choose to head back to the Classic look of the site, we'd appreciate it if you share your thoughts on the Beta; your feedback is what drives our ongoing development.

Beta is different and we value you taking the time to try it out. Please take a look at the changes we've made in Beta and  learn more about it. Thanks for reading, and for making the site better!

Device Keeps Liver Alive Outside Body For 24 Hours

timothy posted about a year ago | from the pure-whiskey dept.

Medicine 62

kkleiner writes "A new device will keep a liver alive outside of the human body for up to 24 hours. Developed at Oxford, the OrganOx circulates oxygenated red bloods cells and nutrients through the liver while maintaining the proper temperature. Doctors estimate that this new technique could double the number of livers available, saving the lives of thousands who die every year awaiting transplant."

cancel ×

62 comments

Sorry! There are no comments related to the filter you selected.

Wait a minute (4, Funny)

WOOFYGOOFY (1334993) | about a year ago | (#43545285)

If the subject is a liver then in what sense is it remarkable that they're kept alive?

Re:Wait a minute (0)

Anonymous Coward | about a year ago | (#43545371)

Because it takes two to tango.

Re:Wait a minute (1)

martin-boundary (547041) | about a year ago | (#43545379)

Meh, you're right. Let's see if they can kill dice next!

Re:Wait a minute (0)

Anonymous Coward | about a year ago | (#43545429)

Took me a second but...Well played, sir! (Posting AC cuz i just modded you up)

Re:Wait a minute (1)

140Mandak262Jamuna (970587) | about a year ago | (#43546069)

You are too subtle for your own good. You might have at least hinted something like, "come on, it is a liver, not a deader, its no big deal keeping it alive".

Re:Wait a minute (2)

necro81 (917438) | about a year ago | (#43546077)

It is good if you can keep it alive, because it keeps it viable for transplant to a dying patient for longer. So keeping the liver alive longer means more people receive transplants, so more people live longer, fuller lives.

Re:Wait a minute (1)

K. S. Kyosuke (729550) | about a year ago | (#43550065)

If the subject is a liver then in what sense is it remarkable that they're kept alive?

You need to keep it fresh for the delivery. Although, from POV of the transplant recipient, I guess that would be a relivery, wouldn't it?

Re:Wait a minute (0)

Anonymous Coward | about a year ago | (#43550519)

Oh man, I catch most things, but I almost didn't catch that. Very well played.

cool, but the Ex Vivo Lung is just breathtaking (5, Interesting)

knopf (894888) | about a year ago | (#43545291)

At the Toronto General Hospital they have a full lung living outside the body. They talked about it in this short TED segment. Ex Vivo Lung: http://www.youtube.com/watch?v=T2EmuyHoMAI [youtube.com]

Re:cool, but the Ex Vivo Lung is just breathtaking (1)

Tarlus (1000874) | about a year ago | (#43546299)

just breathtaking

I see what you did there.

Re:cool, but the Ex Vivo Lung is just breathtaking (0)

Anonymous Coward | about a year ago | (#43546801)

It's inspiring, is what it is.

Try the brain next (3, Funny)

Anonymous Coward | about a year ago | (#43545303)

Head in a jar, here we come!

Re:Try the brain next (1)

OhSoLaMeow (2536022) | about a year ago | (#43549289)

Head in a jar, here we come!

Ladies and gentlemen, I can envision a day when the brains of brilliant men can be kept alive in the bodies of dumb people.

What? (1, Funny)

Anonymous Coward | about a year ago | (#43545311)

No onions?

Re:What? (0)

Anonymous Coward | about a year ago | (#43545623)

Yes, thank you. This is why I clicked through to the comments. Where are my mod points when I need them?

Figures they'd do the liver first (-1)

Anonymous Coward | about a year ago | (#43545315)

Not hearts or kidneys, livers. Because you know, all those people who drink/drug their liver into oblivion really needed the second chance :P I'm sure they won't drink their way through the transplanted one, either.

Re:Figures they'd do the liver first (5, Insightful)

Sarten-X (1102295) | about a year ago | (#43545401)

Because you know, all those people with defective, cancerous, or physically-damaged livers don't really need the second chance, either.

Yes, you've been told through all thirteen years of your life that drinking and abusing drugs can damage your liver. That doesn't mean it's the only way a liver can be damaged.

Re:Figures they'd do the liver first (1)

durrr (1316311) | about a year ago | (#43545675)

Cancers would generally disqualify you, as any cancer outside the liver would throw a massive house-wrecking party when you start the patient on immunosupressants after the transplant.

Re:Figures they'd do the liver first (1)

interkin3tic (1469267) | about a year ago | (#43546741)

That seems like a huge generalization, as there are thousands of types of cancers. Also seems like you're thinking very narrowly in an attempt to criticize the researchers. Perhaps there is a chemotheraputic that is really effective at killing a type of cancer, but is also super effective at destroying your liver. Perhaps you could beat cancer by taking your liver out and keeping it going while taking the drug, then putting it back in. Or perhaps this technology advancing a little could allow you to take a liver biopsy, grow a new liver in culture, and then replacing it. No need for immunosupressants.

This is a big advance, even if there are still specific problems.

Re:Figures they'd do the liver first (1)

quantumghost (1052586) | about a year ago | (#43547161)

To address the AC who started this thread:

Active alcoholism is a contraindication to transplant, however, damage due to alcohol related diseases is not:

Except from UpToDate [uptodate.com] (requires subscription)UpToDate.com

INTRODUCTION — After initial reluctance to transplant patients with alcoholic liver disease, it is now clear that transplantation offers an excellent survival advantage in appropriately selected patients, equal to that for other disease indications. The original reluctance stemmed from the perception that the disease was self-inflicted and from the possible presence of alcohol-mediated damage to sites outside the liver [1,2]. There was also concern that compliance with postoperative recommendations would be suboptimal and that recidivism would lead to graft failure. Opposing opinions and accumulated data have addressed these reservations [3]. Liver transplantation appears to be cost-effective for alcoholic liver disease, albeit possibly less so than for transplantation for some other indications such as primary biliary cirrhosis and primary sclerosing cholangitis [2,4-6].

snip

Alcohol abstinence and psychosocial factors — Sobriety and adequate social support are essential. No absolute interval of sobriety is required because some patients who are otherwise suitable candidates will not survive a six-month period. However, a period of six months of sobriety is used widely for predicting recidivism and also allows for hepatic recovery from ongoing alcohol-related injury [31], but accurately determining which patients are abstinent can be difficult. One study that included 40 patients with alcoholic liver disease who were admitted for an assessment for liver transplant found that 38 percent of patients had urine tests that were positive for alcohol (20 percent) and/or illicit drugs (30 percent) [32]. However, only 3 percent of the patients admitted to using alcohol.

Cancers would generally disqualify you

Not entirely. You can have HCC (hepatocellular concinoma) and get a transplant:

Also from UpToDate [uptodate.com]

INTRODUCTION — Hepatocellular carcinoma (HCC) is an aggressive tumor that often occurs in the setting of chronic liver disease and cirrhosis. (See "Epidemiology and etiologic associations of hepatocellular carcinoma".)

The only potentially curative treatment options are resection and liver transplantation Among patients who are not candidates for liver resection, some who have cirrhosis and HCC are candidates for potentially curative liver transplantation. Unfortunately, the majority of patients are not eligible for either resection or transplantation because of tumor extent, underlying liver dysfunction, and lack of donor organs.

(extra link mine)

The liver makes a good candidate because it is a "nice" organ to transplant. It is very tolerant of ABO incompatibility. It also has a decent survival outside of the body, IIRC, it is exceeded only by the kidney for durability outside of the body.

My concern is that this "liver-in-a-box" makes bile. Bear with here.....

RBCs (red blood cells) are primarily broken down in the spleen, not the liver. The hemoglobin is then broken down in macrophages (which do exist in the liver, but typically aren't involved in this part) into bilirubin which is transported to the liver by binding with albumin. Once in the liver, it is conjugated (chemically linked) to a sugar to increase its solubility, it is then excreted into the bile (which gives the bile the golden brown coloring). If there is no spleen in this circuit, what's breaking down the RBCs(now granted the liver can assume some of this function in asplenic patients, but I'm not sure it can take over this quickly)? This sounds like a fundamental problem with their system....guess if they can solve that they can keep a liver on the shelf for a week or more.

Could just imaging the Monty Python skit coming out of that!

Transplants & cancer (2)

coyote_oww (749758) | about a year ago | (#43548663)

I have had a liver/kidney transplant. The MELD scoring process determines who get the next liver available. Blood type is considered, transplants match blood type, even though this is not strictly technically necessary, because otherwise, type O (universal donor, anyone can use type O) patients would be on longer lists then other blood types - it's a fairness problem. MELD score considers various blood test score indicators for how sick you are. The sicker you are, the higher score you get, and thus higher on the "list". Other factors will be considered, to adjust for "sick" that doesn't show up in the blood tests. Early stage liver cancer will usually move someone up on the transplant list.

Caveats:
1) you have to be well enough to survive the operation, and well enough to have good prospects for reasonable survival beyond the surgery. You'll inactive until you recover sufficiently.

2) you have to have NOT demonstrated mental instability (not attributable to liver disease) that would cause you to be unable to maintain the post-transplant drug regimen - this will get you off the list until such issues are resolved. Attitude, doctor shopping, and any behavior that makes the transplant team unhappy can qualify. Follow your doctors instructions! Note that liver disease does commonly cause mental issues in it's end-stages, so the assumption is that your ok, till you demonstrate otherwise.

3) Cancer: you can have a limited amount of cancer of the liver (since they will replace the liver anyhow). There are specific criteria about how many lesions and how big they can be. Too little gives you a smaller MELD score (and you have to wait till they get bigger). Too much, and your off the list. Other cancers will generally put you off the list entirely, as the immuno-suppressant regimen will cause the cancers to take off like wildfire, resulting in a shorter overall lifespan. In support groups for transplant-list patients, announcing you have been diagnosed with liver cancer can lead to minor celebrations, which is a bit weird, but makes sense given how the system works.

4) Infections must be eliminated, again, because the immuno-suppressant regimen will cause them to take off. Off the list till eliminated.

5) Recreational drugs and alcohol. None. Top 2 causes of liver failure are cirrhosis and hepatitis - primarily brought on from drinking and intravenous drugs. They do blood tests for metabolites monthly, or more often, to ensure that you're behaving. No point in a new organ if you haven't eliminated the habit that destroyed the old organ. Plus, people generally look at that as unfair (see Mickey Mantle, one of the drivers for the MELD reform).

Re:Figures they'd do the liver first (1)

tibit (1762298) | about a year ago | (#43545417)

Protip: you don't get a liver transplant if you are a drinker.

Re:Figures they'd do the liver first (1)

durrr (1316311) | about a year ago | (#43545595)

If you stop drinking entirely for some months you qualify for a new one.

Re:Figures they'd do the liver first (0)

Anonymous Coward | about a year ago | (#43545629)

That's true, even though there's no medical justification for that. People who get a transplant tend to quit drinking if they haven't already quit. And requiring a period of abstinence just makes the surgery more likely to be a waste than if they just did the operation up front.

Re:Figures they'd do the liver first (1)

tibit (1762298) | about a year ago | (#43545991)

How can there be no justification? I have nothing against prolonging an alcoholic's agony, but this should be handled by putting them on a bottom of the list. People who don't intend to destroy their livers should be given precedence IMHO. Given that the shortage of organs of all kinds is going to stay with us for the foreseeable future, this pretty much means that in fact drinkers are not going to get transplants. Yes, I do realize that there are many things that must match in a liver and it may just happen that in spite of otherwise good recipients, there's simply no match to anyone on the list but a drinker. That's fair game, of course.

Re:Figures they'd do the liver first (1)

TheCarp (96830) | about a year ago | (#43545649)

Of course, how available do they have to get before you do? Given the study someone else posted showing that there is already a fair supply of livers, and increasing availability may not decrease mortaility.... perhaps a surplus of livers means that the availability of transplant can be opened to more people.

Re:Figures they'd do the liver first (1)

tibit (1762298) | about a year ago | (#43546025)

What's a fair supply in terms of the probability that a recipient finds a matching donor? Just having plenty of donor organs may simply mean that you'll have plenty of livers that none of your recipients are good matches for. It may well be that, for example, people with less likely combinations of some matching factors (as I shall call them) are more likely to get liver disease. So it's more likely for an unlikely liver to get sick -- then good luck finding a matching donor organ. It's a made up scenario, but I'd like to see some numbers that show it isn't so. I'm overly skeptical when it comes to transplants -- we're still long way away before a transplant could really be considered an everyday thing, in spite of them being done daily all over the world. Having to take drugs with serious side effects for the rest of your life doesn't strike me as something that should be mentioned merely in passing. Transplantology is really a very young discipline. Despite it seeming mainstream, it's anything but. Yeah, sure, it's often better to stay alive and take drugs than face sure death, but the anti-rejection cocktails are no fun. Well, a bit more fun than chemo, but still.

Re:Figures they'd do the liver first (1)

nojayuk (567177) | about a year ago | (#43546861)

Jim Baxter, the famous Rangers player and well-known alcoholic received two liver transplants before he died of pancreatic cancer several years later.

Perhaps they didn't have a choice? (3, Informative)

Junta (36770) | about a year ago | (#43545479)

The liver is one of the more resiliant organs (the only one that can regenerate). It's probably the easiest organ to start with.

Re:Perhaps they didn't have a choice? (1)

geekoid (135745) | about a year ago | (#43549551)

Give back you medical degree. It isn't then only organ that can regenerate.

Re:Perhaps they didn't have a choice? (1)

Junta (36770) | about a year ago | (#43569193)

"The liver is the only internal human organ capable of natural regeneration of lost tissue; as little as 25% of a liver can regenerate into a whole liver." Other organs can heal, the liver can actually grow back.

Re:Figures they'd do the liver first (0)

Anonymous Coward | about a year ago | (#43545743)

It isn't about second chances.

Now you can just out your liver before going on a 24-hour binge and spare it the exposure to the damaging effects of alcohol in the first place. Don't forget to put it back when you're done or leave it in a taxi while you're drunk.

Re:Figures they'd do the liver first (1)

necro81 (917438) | about a year ago | (#43546107)

The liver is used to living at the tail end of the circulatory supply, after all the other organs have gotten their share. Plus, one of its main jobs is detoxifying the blood, so it can put up with higher levels of contaminants in the blood. In other words, if you are testing out an organ-sustaining machine, and you can't guarantee that you can keep the blood pristine, the liver is a pretty good choice for trying things out.

Right tech/wrong place (4, Funny)

Anonymous Coward | about a year ago | (#43545355)

I need a device to keep my liver alive inside my body.

Re:Right tech/wrong place (0)

Anonymous Coward | about a year ago | (#43546627)

Such a device already exists. It's called a padlock. Put one on your liquor cabinet, throw away the key, and your liver will continue to operate for years and years.

Re:Right tech/wrong place (0)

Anonymous Coward | about a year ago | (#43547467)

*Woosh* Way to go douche-nozzle! That will show that AC who's boss.

Re:Right tech/wrong place (1)

Lehk228 (705449) | about a year ago | (#43550195)

12 step programs are not new technology

Re:Right tech/wrong place (0)

Anonymous Coward | about a year ago | (#43557657)

I was not aware that /. was so full of humorless assholes. In reponse: We get it! Thank you for trying to save the world. Now sod off! We don't need you to save us from mediocre jokes about drinking.

Alcohol consumption? (1)

acidradio (659704) | about a year ago | (#43545361)

So will this help me get more drunk? Less hungover? Will I dance better? I mean, what else do you really use your liver for?

Got a better idea (-1)

Anonymous Coward | about a year ago | (#43545447)

Don't drink and drug your liver to death in the first place.

Re:Got a better idea (1)

Anonymous Coward | about a year ago | (#43545515)

Don't ever eat out and contract hepatitis.

Re:Got a better idea (1)

durrr (1316311) | about a year ago | (#43545737)

Also, avoid accidentally poisoning your liver with meds or mushrooms, and stay off them bad genes. No sex, and no blood transfusions either.

While at it, we could simply stop all transport accidents by telling people to not crash their vehicles.

Re:Got a better idea (1)

Chrisq (894406) | about a year ago | (#43546017)

Also, avoid accidentally poisoning your liver with meds or mushrooms, and stay off them bad genes. No sex, and no blood transfusions either.

While at it, we could simply stop all transport accidents by telling people to not crash their vehicles.

Or just tell them not to drive

The problem isn't just supply (3, Informative)

Albanach (527650) | about a year ago | (#43545521)

This is quite specific to liver transplants in the United States. Here most patients who die while awaiting a liver transplant have had an offer of a donor liver. 55% of patients who die have had the offer of a high-quality donor liver.

Increasing supply will always be a good thing, but there are huge issues to be addressed in making sure those on the US wait list for a liver transplant actually get a transplant from the available organ supply. It seems patients and doctors are turning down way too many good organs.

"Our data show that the current liver allocation system has provided one or more transplant opportunities to nearly all candidates before death/delisting. Therefore, simply increasing the availability of de-ceased donor livers or the number of offers may not substantially reduce wait-list mortality." http://www.ncbi.nlm.nih.gov/pubmed/22841780 [nih.gov]

Re:The problem isn't just supply (1)

TheCarp (96830) | about a year ago | (#43545597)

The most heartbreaking thing about that, I was just reading the story of someone who died after being delisted. Delisted because he was a cancer patient on medical marijuana, and testing positive for marijuana disqualified him for a liver.

The rationale? A positive on the drug test may indicate drug abuse and smoking increases exposure to aspergillius fungus, both of which are risk factors for the implanted organ.

seriously... and to think there is actually not a shortage of livers.... thats just terrible.

Re:The problem isn't just supply (2)

hedwards (940851) | about a year ago | (#43545689)

It gets worse when you realize that the shortages are the result of including people that couldn't be given a transplant even if there were a perfect match available right now. Either they're no longer healthy enough or they're otherwise not cleared for the transplant. In either case they're kept on the list to bolster efforts to get more organs.

Which is problematic because in the US the standards employed to ensure that the system doesn't turn people into organ donors when there's still a chance of saving them doesn't work very well. The doctors doing the transplant are sometimes representing both the dieing and the individual needing the transplant. What's more, in many places they're changing the standards so that it's opt out and good luck if you happen to be taken to a hospital that doesn't have a record of you not wanting to give up your organs, or where you have specific wishes you want respected.

I don't mind the idea of my organs being harvested, I just don't care for having somebody else making those sorts of decisions without proper consideration for me.

Re:The problem isn't just supply (1)

Beorytis (1014777) | about a year ago | (#43545941)

What's more, in many places they're changing the standards so that it's opt out and good luck if you happen to be taken to a hospital that doesn't have a record of you not wanting to give up your organs, or where you have specific wishes you want respected.

I'm going to go out on a short, cynical limb and guess that the hospitals still get paid (well) for removing and preserving the organs from such "donors" whether or not they have a chance of finding a recipient, and that these same hospitals lobby for the revised standards in the name of "saving more people."

Re:The problem isn't just supply (1)

Albanach (527650) | about a year ago | (#43546015)

I'm going to go out on a short, cynical limb and guess...

I think you may have guessed wrong. This page [lutheranhospital.com] states that the costs of harvesting the organ is borne by the recipient/the recipient's insurance. If correct, it is very much in the interests of the hospital harvesting the donor organs for them to be used rather than discarded. There would be no economic motivation to harvest an organ that they know will not be used.

Re:The problem isn't just supply (1)

Beorytis (1014777) | about a year ago | (#43547639)

For the hospital you linked, it does sound like the organ is not harvested until they know there's a recipient. But there still have to be some cases where the transplant doesn't happen. It's hard to imagine the hospital simply writing off their costs in those cases.

Good for heavy nights out too (1)

hughbar (579555) | about a year ago | (#43545955)

Just take liver out, go out drinking and put it back in when finished. What could wrong with that?

Good news for mine (1)

charlesbakerharris (623282) | about a year ago | (#43546013)

This is good - my liver sure doesn't stand much of a chance as long as it's still inside me.

Satan at work with the surgical knife. (-1)

Anonymous Coward | about a year ago | (#43546087)

> could double the number of livers available, saving the lives of thousands who die every year awaiting transplant

It is the other way. Every year thousands of people are killed to make organs available for transplant. Methods vary. Kosovo albanians ritually culled 300 serb people in the basement of the "Yellow House" to harvest organs. Sooner or later the serbs are going to avenge that on kosovans, down to the 7th off-spring!

When your blood is drawn for medical tests, your genome is sequenced and if there is a match for a politician or rich/influential person, you are placed on the list of slaughter-people, who are tracked 7x24x366. If the big boss suffers an accident, illness or assasination attempt, needing a replacement organ, the secret agencies will quickly arrange to have you accidented brain-dead and you will be cut up for parts.

The most heinous case happened in Hungary. A 4 year old child was placed in temporary state customdy as his parents lost the rent of a home due to loss of job. A bookshelf allegedly toppled over the boy while in state custody and he allegedly became brain-dead. Yet, the parents were not allowed to visit the child in the hospital, not even see him throught the window, on various bureaucratic grounds. The boy allegedly died spontaneously, after being pulled from respirator, pulled much sooner than usual and his little body was cut up for organ transplant. Hungarian populace suspects there was much foul play there and the organs went to people who hate Jesus Christ.

The dumb Vatican meanwhile continues to teach donating organs is similar to the self-sacrifice of the well-known ancient christian symbol of the pelican bird. No, it isn't, it is just Satan at work, as usual.

Re:Satan at work with the surgical knife. (1)

Anonymous Coward | about a year ago | (#43547889)

Whoops....looks like your tin foil hat fell off, better get it back on quick!

Had a liver transplant (0)

Anonymous Coward | about a year ago | (#43546279)

I had a liver transplant almoust 5 years ago.
This is a big for the liver transplant world because right now a liver can only survive for 12 to 16 hours outside the body. Given the amount of time to call a patient in and prep them for surgery as well as harvest and transport an organ. Furthermore a lot of work has to be done crossmatching the organ on several levels (not just blood type). All of this results in surgeries that are often under huge time pressures. Having more time to do all of the above will result in much better outcomes and survival rates

More information (1)

maroberts (15852) | about a year ago | (#43546847)

The lead researcher on the project was a Dr H. Lecter, who is also researching methods of Fava Bean propagation, and assisting Italian wine growers in enhancing the quality of Chianti.

When asked for a comment, Dr Lecter said: I do wish we could chat longer, but... I'm having an old friend for dinner. Bye

94% (1)

olip85 (1770514) | about a year ago | (#43546895)

I don't know how to keep a liver alive outside a body for 24 hours, but I know how to destroy a liver inside a body in under 24 hours.

TransMedics (0)

Anonymous Coward | about a year ago | (#43547157)

Check out TransMedics.com - their device keeps hearts and lungs alive outside of the body.

Why only 24 hours? (1)

erroneus (253617) | about a year ago | (#43547321)

What requirement for liver survival is not being met? I recall quite some time ago when it was considered to be some sort of breakthrough when they realized "you know that pump we use when we do heart surgery? The body needs pulsing circulation to survive, so let's do that instead of just streaming fluid." I have to wonder if they are trying something similar here.

use it as a treatment? (0)

Anonymous Coward | about a year ago | (#43547469)

Why not plumb this liver up to someones blood supply system, and use it to clean the blood etc of unhealthy people. if its temporary, then immuno response shouldn't be that big a deal. if they can get it to live even longer, so much the better. if they can use cows liver instead, even better still. Those things are huge, and could be even better that teh real thing...... just plug your self in over night after a session, and wake up all cleansed...

Why bother? (0)

Anonymous Coward | about a year ago | (#43547513)

There seems to be an adequate supply of Chinese felons waiting to donate their organs.

Tried it once... (1)

Ossifer (703813) | about a year ago | (#43547537)

... didn't like, no, didn't like it one bit...

Check for New Comments
Slashdot Login

Need an Account?

Forgot your password?

Submission Text Formatting Tips

We support a small subset of HTML, namely these tags:

  • b
  • i
  • p
  • br
  • a
  • ol
  • ul
  • li
  • dl
  • dt
  • dd
  • em
  • strong
  • tt
  • blockquote
  • div
  • quote
  • ecode

"ecode" can be used for code snippets, for example:

<ecode>    while(1) { do_something(); } </ecode>