The OrganOx replicates conditions inside the human body to keep livers viable during the journey from the donor to the recipient.
New technology is helping healthcare organizations improve transplants by preserving the organ during its journey from the donor to the recipient.
One such innovation is the OrganOx, a portable “pump” now being used by Intermountain Health for liver transplants. Officials say the technology, which has been used in more than 35 liver transplants since December 2023, could save hundreds of lives and improve the quality of life for thousands of people.
“This is potentially life-changing for the thousands of patients on the national waiting list for a liver transplant, and the more than a thousand patients a year who die waiting for a liver to become available,” Richard Gilroy, MD, a transplant hepatologist and Intermountain Health’s liver transplant medical director, said in a recent press release from the Utah-based health system. “Because of this technology we are able to use livers from donors that would previously not even have been considered for donation.”
The OrganOx includes a pump that functions as the heart and an oxygenator that functions as the lungs. When a human liver is placed inside the device, they combine to function as a human body would, keeping the liver oxygenated and maintained at normal body temperature until it can be transplanted.
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“This technology allows the donor liver to remain viable for longer periods of time, extending the time from organ removal to transplant from just hours to more than one day, and potentially travel longer distances between donor and recipient sites,” Jean Botha, MD, the medical director of Intermountain Health’s abdominal transplant program as well as Intermountain Primary Children’s Hospital’s pediatric transplant program, said in the press release. “The device also enables real-time assessment of liver function and quality, which may help to increase the pool of suitable organs for transplantation.”
The OrganOx is one of several devices and platforms developed over the past few years to improve transplants. Some aim to preserve organs longer outside the body, while others are using data analysis tech technology, including AI, to match donors faster and more efficiently with those in need of new organs.
The technology aims to improve clinical outcomes for the estimated 10,000 organ transplants performed each year and improve chances for the estimated 10,000 people on the waiting list for a new organ. According to experts, 17 people die each day on a waiting list, and a new name is added to a waiting list every 10 minutes. With livers in particular, it’s estimated that more than 2,000 are discarded each year because they don’t survive the typical process of cold preservation or are damaged by oxygen deprivation.
The strategy does come with some controversy. The process of keeping organs alive outside the donor’s body is called a normothermic regional perfusion, or an NRP transplant. When a device like the OrganOx is used, the process is called normothermic machine perfusion, or NMP. A recent NPR story shed light on the debate, highlighted by the American Journal of Bioethics, over whether the process keeps the body technically alive and blurs the definition of death.
In an e-mail to HealthLeaders, Botha said both NRP and NMP are saving lives.
“Actually, the two modalities are not in competition with each other but rather complimentary,” he wrote. “NRP is our preferred modality for all DCD (Donation after Circulatory Death) donors, in addition to increasing the utilization of DCD organs (livers and kidneys), it improves the outcomes of both.”
According to Botha, recent research comparing NMP to the traditional method of cold storage on a hypothetical cohort of 432 patients found that NMP allowed 54 additional successful transplants and saved hundreds of additional lives through the availability of more liver grafts and a reduction in waitlist mortality. This also improved the quality of life for liver transplant recipients.
Intermountain has done more than 1,000 liver transplants--including living-related, deceased donor, and split implantation--since launching its liver transplant program in 1986. Officials say the program has grown threefold since its launch, making it the third fastest-growing liver transplant program in the country.
Botha says the OrganOx is currently kept at Intermountain Medical Center in Murray, Utah, though it’s portable enough to be deployed from the donor’s operating room table to nearby transplant centers. The company is now putting a similar device through trials for kidney perfusion.
Eric Wicklund is the associate content manager and senior editor for Innovation at HealthLeaders.
KEY TAKEAWAYS
Tens of thousands of people are on waiting lists for new organs each year, and an estimated 17 people on those lists die each day.
Since December 2023, Intermountain Health has been using the OrganOx to preserve livers during the time they’ve been removed from a donor and before they’re transplanted.
The technology aims to replace traditional cold storage processes and replicate conditions inside the human body.