
Machine keeps human livers alive for one week outside of the body - sschueller
https://www.media.uzh.ch/en/Press-Releases/2020/Liver.html
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blensor
I am not a medical expert or even remotely tied to that field but don't livers
regrow to some extent? If this process could be extended even further wouldn't
that mean we could regrow complete livers from partial donations pretty soon,
making the whole "waiting for a donor" gamble obsolete?

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Karlozkiller
No expert either, but afaik you can divide livers into thirds and they will
regrow. So when you transplant a liver you take two thirds from the donor, I
assume to give the recipient more liver to work with, but I don't know why.
(spelling edit)

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social_quotient
Yeah seems 25% is needed for regrow. That number seems interesting, almost
like the body’s parity raid bit.

[https://en.m.wikipedia.org/wiki/Liver_regeneration](https://en.m.wikipedia.org/wiki/Liver_regeneration)

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samstave
Funny to use “parity raid bit” on an SPOF organ such as is the liver.

Though, i have always been curious as to why the body only has one liver while
having pairs of many other organs...

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ASalazarMX
Adding to your question, why did the liver evolve to regenerate while other
organs evolved to have spares? What makes it special?

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riversflow
I’m guessing it has something to do with the size of a liver. Organs that have
spares are relatively small.

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abakker
Lungs? They’re pretty big. My grandfather lived 60 years with only 1, and it
stretched to fill most of his chest cavity.

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coder1001
One great use of this could taking good parts of a cancer's patient's liver,
regrowing the parts independently and then putting back the part that does not
show any sign of cancer.

Not sure if one week will do it, but could be very viable when this tech is
extended to more than a week.

Major advantage of reusing one's liver is the body would be less likely to
reject it, hence relying less on immune suppression medications.

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GGfpc
Can a person survive without a liver for 1 week?

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toss1
Based on the experiences of a friend & close family member & what the doctors
said: when your liver stops functioning, you will have about six weeks to
live. The prognosis schedule was pretty much spot-on in both cases,and the
last week has much less useful consciousness. Since the first few weeks are
not really debilitating, I'd wager that one week without a liver to re-implant
a repaired organ should be a good plan.

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golem14
Out of curiosity: Amanita poison I thought mostly attacked the liver and leads
to death in much less than 6 weeks (more like a few days, maybe a week). So I
assume the 6 weeks means massive effort in the ER to stabilize the patient
without liver, maybe some advanced blood filtering?

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toss1
Interesting discrepancy.

Both the ones I knew were in hospice and not a huge intervention for the six
weeks, so not a tone of continuing intervention.

I'd _guess_ that liver failure is maybe defined not as 100% failure, but
failure to keep up with daily demand due to an external impairment such as
cancer, and that this is just a typical curve of declining function until the
body becomes too poisoned to survive.

Anybody with more detailed real bio/medical information?

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husarcik
My medical education is congruent with your thoughts. Liver failure is defined
as partial or complete loss of function. You're also right about the "too
poisoned to survive" aka end-stage liver disease. People in this stage often
die from too much toxin build up, infection, or bleeding. Your explanation is
great.

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toss1
Thanks! very helpful.

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greatpatton
I'm wondering how do they control pathogens, as from my understanding the
perfusate is lacking white blood cell. This is not described in the Nature
article.

However this kind of technologies open really a lot of new possibilities
regarding organ transplantation, and even auto transplantation as describe at
the end of the article.

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epmaybe
The liver has reticuloendothelial tissues (along with spleen, lymph nodes)
that do technically produce white blood cells. I'm not sure how much of this
production is still active in adults.

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pharke
I'm wondering if this will be a good test bed for keeping other organs alive
outside the body. As far as I know, the liver is the most robust organ and so
makes a natural starting point for this kind of work.

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baxtr
The first question that popped into my mind is: does this work for brains too?

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awinter-py
or as jim jarmusch would say, only livers left alive

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piterdevries
What about a head?

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mschuster91
This one will probably take decades to get in a useful state.

For head (or other organ) artificial alive-keeping we still don't know enough
about how they work - and in case of especially the head we don't have the
adequate technology yet to properly reconnect the neurons.

It might be that we can do this sooner than keeping the full head alive
though, given that there is way more investment in such research to help
people with spinal injuries regain motor control.

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BurningFrog
It seems like the inputs the head requires are pretty well defined.

Oxygenated, nutrition loaded blood mainly. But I'm sure that misses 8
unsolvable essentials...

Preserving sanity for the severed head is a whole other story.

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mschuster91
It's more complicated than "only" blood. The hormones and other signalling
chemicals involved in the brain-body communication are not really figured out
- we don't even know what hormonal balance is "normal" and treat mental
illnesses such as depression and schizophrenia with a "shotgun" approach -
shoot a lot of loads and see which one has an effect.

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BurningFrog
There are also nerve "cables" to interface with.

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aledalgrande
I've never heard about reconnecting severed nerves and have them function. Is
that currently possible?

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BurningFrog
Not that I know.

But it's at least an understandable and defined problem.

