Some people who need organs have high levels of antibodies, such as from blood transfusions. In these highly sensitized individuals, being matched to an organ from a deceased donor or finding a living donor may be almost impossible. Mayo Clinic researchers are working to develop a bioartificial liver that allows people with liver disease to receive the improved liver function that comes with liver transplant without undergoing the procedure.
In this approach, live cells from pig livers filter the patient's blood in a process similar to that of kidney dialysis. This bioartificial liver offers several advantages:
- The live cells perform all the metabolic functions that a human liver does, besides filtering wastes from the body.
- Patients can avoid the risks of surgery and minimize disruption to their lives.
- The donor liver that the artificial liver recipient would have received is available for another person needing an organ.
Several other steps are involved, as well, to increase the safety and likelihood of success. The drug eculizumab (Soliris) is taken to prevent organ damage caused by antibody attacks on the new organ. Multiple rounds of plasma exchange filter out antibodies, and treatment with bortezomib (Velcade) prevents the production of new antibodies. Mayo Clinic was one of the first centers to use eculizumab.
If the individual needs to have more than one organ transplanted, as in heart-liver and kidney-liver transplantation, Mayo Clinic physicians plan the sequence of the procedures to reduce antibody production. Transplanting the liver first, when possible, may reduce the chance of rejection of the other organ.
In addition, Mayo doctors carefully individualize organ recipients' care plans to reduce the likelihood of organ rejection. With planning, the likelihood of rejection has been reduced from 40 percent to less than 10 percent.
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Sept. 22, 2018