Organ transplantation is a race against time. An organ must be transplanted within 24 hours. It must be removed from the donor, transported, checked and placed with the recipient. Marlon de Haan is researching how you can extend this period for kidneys. “An organ is, as it were, an organism, with individual cells that all have their own energy needs,” he explains. “Until now, we reduce the energy requirement of a donor organ by storing it on ice. Cooling slows down the metabolism.”
For his PhD, De Haan is researching an alternative way of storing kidneys. Instead of being cooled, the kidney is kept in a perfusion system. “That is a kind of pump that can supply the organ with nutrients. By adding oxygen, sugar and protein to the kidney, we try to keep the organ alive longer – and ultimately have more time for a transplant. It is already succeeded in extending the lifespan of a pig kidney in the lab, but also of a human kidney that had been rejected for transplantation. This took up to four days. The first important step has therefore been taken.”
More time is not the only benefit. “If there is any doubt about the quality of a donor organ, it will not be used,” explains De Haan. “But in a perfusion system, the functioning of an organ can be monitored for a longer period of time. If the initial doubts have been removed and the organ appears to be functioning properly, it can still be transplanted. In addition, it is possible to condition an organ in the perfusion system. By making adjustments, the organ can be made more suitable for a specific recipient, thus reducing the chance of rejection.”
Pork kidney
Storage and conditioning are already very successful in some organs, such as the liver. For the kidney, however, it is still music in the future. “The kidney is one of the most complex organs in the body,” explains De Haan. “That’s because a kidney consists of almost thirty types of cells. By way of comparison, a heart has about ten. Not only do all those cells have their specific energy requirements, it is also important how they work together. By experimenting with pig kidneys, we are trying to to find out.”
Pig kidneys are often used for medical research because they are very similar in size, structure and appearance to human organs; also on a cellular level. De Haan and his colleagues will collect the kidneys from the slaughterhouse themselves. “The situation should resemble the reality of a transplant,” he says. “That’s why the organs are quickly removed after slaughter and transported on ice. We go straight to the lab and get to work.”
By: National Care Guide
