08-07-2025
‘Engineering magic' preserves organs for longer by mimicking body
It was the bile that convinced him. Professor Constantin Coussios still remembers standing with a liver and watching as the blood he had given it went in and bile came out.
He said: 'It was incredible. It was disconnected from the brain, the nervous system, the vascular system. It just knew what to do.'
That was when he realised that his idea, that there was a better way of preserving organs for transplant, could really work.
Professor Constantin Coussios, the inventor of the device
The conventional way to keep an organ fresh outside the body is to keep it cold. Then, like food in a refrigerator, there is a ticking clock until it goes off. However, there is an odd contradiction there. Inside you, organs stay alive extremely well at 37C. What if, instead of chilling them we kept them warm — and convinced them they had never left the body?
On Tuesday night, the device he co-invented, which has since been used in 6,000 liver transplants in 12 countries, won the Royal Academy of Engineering's MacRobert Award, which is given for engineering that benefits society and has proven commercial success.
Coussios, the director of the Oxford Institute of Biomedical Engineering, is far from the first to have recognised that mimicking the conditions in the body could be a way to keep organs alive. 'It is a pretty obvious idea: rather than taking an organ and storing it on ice, fool it into thinking it is still in the human body' But making the idea work — getting the blood flow and conditions right — has been extremely challenging.
Their device works by creating an environment 'as close to engineeringly possible' to the human body. Coussios said: 'It is placed in a cradle that is designed to mimic the method in which it rests in the abdomen …We then have a pump that replaces or mimics the function of the heart. We have an oxygenator that mimics the function of the lungs. We have a reservoir that mimics the capacitance of blood.'
They have now also branched out into kidneys, which are more complicated in part because you have to keep enough flow through them to compensate for the urine production.
It has resulted in many more organs being used as the device can better test their viability
The medical advantage is not only longer preservation times for organs. It is also that you can get an understanding of how good the organ actually is. With a conventional transplant, organs are often rejected because, for instance, they are from someone too old. 'People will typically not want to transplant an organ that's come out of an 86-year-old,' said Coussios.
Inevitably, this means throwing away viable organs. 'There are 86 year olds who actually have the livers of 20 year olds. And we just don't know because we don't have a way of making that assessment.'
• Meet the people changing the world of organ transplants
If that liver is making bile in front of you though? 'We were able to demonstrate that 70 per cent of livers that are presently discarded by every UK liver transplant center can be safely transplanted.'
Loubna Bouarfa, one of the judges, called the technology 'truly incredible'. She added: 'What's blown me away is how elegantly engineered the solution is. Fully portable, fully automated. Behind that simplicity is some serious science. Artificial intelligence, fluid dynamics and gas analysis, all designed to keep the organ healthy for longer. It's medical brilliance powered by engineering magic.'
