Cold storage of human organs for transplant could be a thing of the past thanks to the work of biomedical engineer Professor Constantin Coussios, Director of the Institute of Biomedical Engineering, who is to receive the Royal Academy of Engineering’s prestigious Silver Medal later this month for work including a ground-breaking method of preserving functioning organs at body temperature. He will receive the medal at the Academy Awards Dinner in London today.
Working closely with transplant surgeon Professor Peter Friend, Professor Coussios co-founded spin-out company OrganOx in 2008, to develop the technique into a medical device that could be manufactured and translated into clinical practice. The OrganOx metra® was first demonstrated in 2013 with the world’s first transplant of a human liver preserved at body temperature. It has now completed trials with over 200 transplant patients in six countries across two continents, demonstrating better organ utilisation and improved transplant outcomes compared to conventional cold storage. The OrganOx metra® can store a functioning liver outside the body for up to 24 hours, greatly extending the time available to match a suitable donor with a patient who is waiting for a transplant. The system also monitors the organ while it preserves it, enabling surgeons to ensure it is functioning properly before transplanting it, essentially ‘test-driving’ the organ and reducing the risk of transplant failure.
OrganOx is already in use across the National Health Service, where it was used to perform over 10% of NHS liver transplants in 2016. It is now approved for use in Europe and is being used in hospitals in Germany, France, Spain and Belgium as well as the UK. The system is also in use in Canada and a major trial regulated by the Food and Drug Administration (FDA) is ongoing to enable introduction of the technology in the United States.
The next stage of the work is to extend the principle of normothermic preservation to other organs, such as kidneys, and the team are aiming for a first-in-man transplant next year of a kidney preserved at body temperature. Professor Coussios said: ‘Kidney dialysis is very expensive - £18 thousand a year per patient – and it is a tough and restricting regime. A transplant operation costs £20-30 thousand pounds – but will free the patient from dialysis for at least ten years. If OrganOx can enable more kidney transplants to happen successfully, then we can make a real contribution to improving the patients’ quality of life whilst reducing healthcare costs for the NHS.’
Professor Coussios’ drive to improve medical treatments does not stop at transplants – he and his research team are also pioneering a way of using tiny bubbles to help pump cancer drugs deeper into the tumours which they are designed to attack, maximising the drug’s effectiveness. Working closely with Professor Robert Carlisle and Dr Christian Coviello at the Institute of Biomedical Engineering, and CEO Dr Colin Story, he formed another company to develop this technique: OxSonics, one of the most valuable spin-outs to have emerged from the University of Oxford, which today employs 14 people at the Oxford Science Park.
OxSonics works by injecting thousands of miniature bubbles into a patient’s bloodstream together with the cancer drug. Each tiny bubble is stabilised by a polymer cup until the bubbles and the drug molecules reach the tumour. Once there, the team use an ultrasound probe to make the nanobubbles vibrate – this produces a pumping action or convection that propels the cancer drug right into the tumour.
Professor Coussios said: ‘Conventional cancer drug delivery requires a high dose to be effective, and typically less than 1% of it gets into the tumour itself, with most of it being deposited near blood vessels. Our technique enables up to hundred times more of the drug to enter the tumour and to reach those cells that are far away from blood vessels. We therefore hope that it will enable better therapeutic outcomes, potentially using lower doses of cancer drugs.’
OxSonics is planning to start clinical trials with its SonoTran device next year, and the team is also looking at how this platform technology could be used to deliver other types of non-cancer drugs such as vaccines, cardiovascular drugs and gene therapies.
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