Transplantation: More people will be able to receive a new liver in 2025

36 per cent of all donated livers are currently discarded. This is due to uncertainty about their quality and whether they will function as they should in the recipient. 

A new machine – called perfusion machine – makes sure that a donated liver maintains its viability outside the donor’s body for many hours. This enables the quality of the liver to be checked before transplantation.

It is highly probable that it will be in use by 2025. It could save more people in need of a new liver. 

Research on small crucian carp fish may be able to save even more lives in the long term.

Interesting differences between crucian carp and mice

A new study has compared crucian carp and mice. While crucian carp can survive without oxygen, mice cannot.

“Even though the mitochondria, the power-generating components of cells, behaved remarkably similarly, there were some distinct and interesting differences,” says Professor Kåre-Olav Stensløkken from the University of Oslo.

The fish's defense against antioxidants was higher. Much fewer harmful reactive oxygen species were also produced.

These factors pose challenges for transplantation. 

Stensløkken's research team is now intensely studying the processes occuring in the fish. The researcher believes that part of the key lies in the mitochondria.

Crucian carp avoid oxygen damage

“Crucian carp have solved the problem of how to avoid harm when there's a lack of oxygen and when the oxygen returns. This species of fish can survive without oxygen for nearly three months under ice and also escape harm when oxygen returns to the water in the spring,” the researcher explains.

Stensløkken has been doing research on crucian carp since he was a research fellow. He and his team are responsible for the basic research. Professor Søren Pischke and his team are responsible for the clinical research. Stensløkken and Pischke are part of a collaboration across several fields.

Fewer organs will have to be discarded

Pischke is glad that the new liver perfusion machine will soon be in use.

“It will ensure that fewer organs go to waste. At present, many donated livers have to be thrown away because they cannot be tested before a transplant takes place," he says.

Soon, livers will be able to be tested outside the recipient's body. He hopes they can increase the number of viable livers by 20-30 per cent.

The machine undergoing tests is already in use in the Netherlands and a similar one is being used in England. The researchers at the University of Oslo are collaborating with Dutch researchers in their study.

“We hope to be able to transplant tested livers in 2025. We are well underway and training is currently in progress. It's important that we don’t expose vulnerable patients to danger and we must therefore take our time. But we must soon get started,” says an impatient Pischke.

While livers today are only tested for functionality, even more livers, and therefore patients, may be saved thanks to the research on crucian carp. 

The researchers are mostly collaborating on testing the function of mitochondria.

“I hope Stensløkken and his team find mechanisms that can make livers more resilient and ideally lead to an improvement in mitochondrial function," says Pischke.

Reference:

Gerber et al. Differential production of mitochondrial reactive oxygen species between mouse (Mus musculus) and crucian carp (Carassius carassius), Acta Physiologica, vol. 240, 2024. DOI: 10.1111/apha.14244

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