Liver transplantation

2024: No biopsy. Ultrasound technology for detecting rejection of transplanted liver developed

In mid-October 2024, American researchers presented an ultrasound method that allows you to detect and determine the stage of acute cellular rejection of a liver transplant. The shear wave ultrasonic elastography with attenuation measurement (AMUSE) method was compared with biopsy data, yielding "excellent" results. Read more here

2023

Developed magnetic device for liver transplantation

In November 2023, it became known about the development of magnetic devices for liver transplantation. They are based on magnetic anastomosis technology (Magnetic Anastomosis Technology, MAT)

Published in the journal Scientific Reports, the results of a study of vascular anastomoses performed with MAT showed positive results. A new design mat using magnetic rings made of composite Ti-NdFeB material, suitable for permanent implantation, demonstrated high biocompatibility and significantly reduced the duration of extrahepatic surgery to 13 minutes.

It is noted that the magnetic devices used to apply the anastomosis were perfectly aligned, without signs of stenosis or curvature, and the surface of the anastomotic stoma was smooth. Histological analysis confirmed these findings by showing neat intimal alignment and regular placement of endothelial cells and collagen fibers at the site of anastomosis application. The results demonstrate the potential of MAT in liver transplantation to effectively reduce critical surgery time while ensuring vascular anastomosis integrity and functionality.

As part of the study, MAT technology was tested on pigs. All the liver transplants he performed were successful, each procedure took about 2250 minutes.

According to News Medical, citing the conclusions of experts, MAT technology has been successfully used to quickly implant donor liver in pig liver transplantation without any postoperative complications. At the same time, traditional methods of applying vascular anastomoses manually in liver transplantation are complex and time-consuming, which often leads to longer hepatic-free phases.^[1]

World's first robot liver transplant performed

On July 12, 2023, American researchers at Washington University School of Medicine in St. Louis reported performing the first successful liver transplant operation through. robot

Liver transplantation is one of the most complex abdominal surgeries, the results of which depend heavily on the professionalism of the team of surgeons. Traditionally, a vertical incision of 7.6 to 10 cm is made and a horizontal incision of 30 to 41 cm below the chest to remove the diseased liver and replace it with a healthy donor organ. Due to the nature of the procedure, which can involve severe bleeding and requires stitching together small blood vessels, it was thought to be extremely difficult to perform in a less invasive way. Robotic surgery allows you to change the current approach.

Successful robotic liver transplant was performed

When using a robot, the surgeon controls the manipulators in the form of joysticks. With high-resolution 3D rendering, you can perform more accurate and complex manipulations than is available with traditional methods. In particular, when transplanting the liver in this way, several cuts were made with a size of about 1.3 cm and one vertical cut with a length of 15 cm.

The first patient was a 60-year-old man who needed an emergency liver transplant due to cancer and cirrhosis. The robotic operation lasted approximately 8 hours, but surgeons believe that in the future this time will be reduced - as the technology spreads and the necessary experience is gained. It is noted that the operation took place without complications: a month after the liver transplant, the recipient was able to walk comfortably.

The transplant was successful: the new liver immediately began to work, and the patient recovered without any surgical complications, said Dr. Adeel Khan, who led the team of surgeons.[2]

2022: Announcement of a human body mimicking machine to repair donor liver before transplant

On June 7, 2022, clinical researchers from the University of Zurich in Switzerland announced the creation of a perfusion machine for storing donor liver before transplantation.

In organ transplantation, time is crucial because the viability of the organ is rapidly reduced after it is removed from the donor body, which usually involves performing an emergency organ transplant operation on the recipient. This problem was the impetus for the development of this technology, and in 2020, the researchers who created it reported that their perfusion machine can keep the liver working for a week, which will allow transplantation for a long time after organ extraction.

Human body mimicking machine released to repair donor liver before transplant

Another issue affecting those on the transplant waiting list is the lack of donor organs. Organs whose condition does not meet a certain level are rejected as unsuitable for transplantation. However, if organs with minor problems can be restored, then the number of available organs can increase significantly. This principle is also the basis of this development, in which the researchers used a perfusion machine to "repair" the damaged liver.

The perfusion machine is designed to mimic the human body. It includes a pump for liver perfusion that mimics the human heart. The oxygenator mimics the lungs and the dialysis machine mimics the kidneys. The machine also performs numerous infusions of hormones and nutrients, mimicking the gut and pancreas. In addition, the device gently moves the liver, which happens in the body when the diaphragm presses on it during breathing.

The device also allows doctors to treat the liver, which can have some problems. For example, they can administer antibiotics or hormonal drugs, and conditions inside the apparatus allow optimizing liver metabolism.

Шаблон:Quote 'Our therapy shows that by treating the liver in a perfusion machine, it is possible to alleviate the lack of functioning human organs and save lives, said Pierre-Alain Clavien, a researcher involved in the study. In 2021, the Swiss team took the damaged liver, which is usually not suitable for transplantation, restored it in the car within three days, and then successfully transplanted it to a patient who, after 1 year, survived and feels good.^[3]

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