Acquired Organ Assist started revolution from Groningen

How revisiting an old idea can have implications of global proportions. Organ Assist, which began as a spin-off from the University Medical Hospital Groningen (UMCG), is helping to alleviate a global problem: the shortage of donor organs. Thanks to the Groningen equipment, substantially more donor livers and kidneys have become available for transplantation. AND the organs are in better condition prior to transplantation.

Until about five years ago, an organ transplant was much like a race against time. A removed liver or kidney was assessed for quality on paper and by eye, then refrigerated and taken as quickly as possible to the recipient patient, who was meanwhile being prepared for transplantation. The lack of oxygen caused the organ to deteriorate slightly every minute along the way.

Good for patient, surgeon and humanity

Together with doctors and researchers, Organ Assist developed a perfusion machine that improves that process on all sides. Perfusion is what it's called, "putting on the pump" in everyday language among doctors. Before transplantation, the kidney or liver is connected to a device that pumps preservative fluid containing oxygen through the organ. The result: no more loss of oxygen, and an end to organ deterioration.

'This method allows us, as it were, to recharge the battery of the liver that has slowly drained during transport,' Vincent de Meijer says. As a liver transplant surgeon at UMCG, he has seen the benefits for years. 'With this, we are able to optimize especially vulnerable donor livers prior to transplantation. We soon expect to publish the results of a large international randomized clinical trial led by Prof. Robert Porte from the UMCG in which this method was investigated.'

That's cold flushing. At least as important are the hot flushing methods developed by the same researchers at the UMCG using Organ Assist's liver pump. De Meijer: "That enables us to test donor livers for quality before transplanting them. This is not necessary for all organs, but it is necessary for donor livers that are rejected on paper and on the face of it, which are therefore brought to Groningen in the Netherlands for this purpose since 2017. We developed a protocol to optimize these fragile donor livers of questionable quality with cold machine perfusion, in order to then test them at normal body temperature. After this 'test run,' some sixty percent of previously nationally rejected donor livers could ultimately still be used for transplants. That's huge.

All of the Netherlands has already been converted

And even then, the remarkable benefits have not all been mentioned. The potentially longer preservation time created by perfusion is another very important one. De Meijer is investigating how further innovation can preserve donor livers in good condition even longer. 'What we want is to use that longer time to allow organs to recover, but also to administer therapy, for example. If we succeed in repairing damaged donor livers, we can use even more organs and do even more about the worldwide shortage. But that is still in the future.

It is currently still the case that the availability of a donor organ determines the time of transplantation; more than half of it at night. De Meijer is also currently investigating whether the perfusion machine can be used to extend the storage life of donor livers. De Meijer: "We have just started a clinical study to temporarily connect donor livers that would otherwise be transplanted at night to the perfusion machine, with the goal of making transplants more plannable. So that, for example, we don't have to operate in the middle of the night because the clock is ticking, but can postpone the operation until the next morning. That's better for the patient and for the whole medical team.

By now, all three liver transplant centers in the Netherlands (Rotterdam, Leiden and Groningen) have been using Organ Assist's perfusion machines for some time. In fact, they have adapted their process and infrastructure to it. Not surprisingly, there is also great interest from the business community. The Swedish company XVIVO Perfusion converted this interest into a takeover offer, which was accepted.

All patients an organ

Both in Sweden and in Groningen, that deal caused a little celebration. And certainly not primarily because of the tokens paid. 'Money is nice, but we see our ultimate goal one step closer with it. That is more important," says Organ Assist CEO Wilfred den Hartog. That is an ambitious goal: to provide organs to all patients who need them.

Den Hartog: "From the beginning, we focus mainly on liver and kidneys, although we also work with other organs. XVIVO Perfusion does something similar mainly with hearts and lungs. So together we can mean a lot more. Our techniques are not very different, but we can achieve great synergy advantages in other areas. An example? XVIVO Perfusion is strong in making perfusion fluids.

We always bought those in. Instead, we invested a lot in protocols and treatment plans, which XVIVO Perfusion can now take advantage of. And then, of course, there is the economy of scale. Together we have more distributors and agents around the world. This acquisition allows us to take the big steps we envisioned.'

Together we have more distributors and agents around the world. This acquisition allows us to take the big steps we envisioned.
CEO of Organ Assist Wilfred den Hartog

Groningen pride

And big steps they are, NOM director Dina Boonstra also sees. The development company was actively involved in the growth of the Groningen company and is now happy to sell its shares. 'For us it was important that the expertise remains in Groningen. And as NOM we always look at the social return. This takeover makes that even greater than it already was. Really, this is a perfect example of how we want to be involved. Helping a promising company grow. Organ Assist's story is also, in my opinion, a wonderful example of the thriving life science sector in the Northern Netherlands. We should be proud of that.

Because in Groningen it began, in Groningen it remains. Wilfred den his Hartog is clear about that. 'Our close ties with the UMCG speak for themselves. Add to that the fact that our local suppliers are important, that our people like living here and that we have a very nice network, and you see no reason to leave. Groningen simply remains the Competence Center.'

NOM invested in Organ Assist in 2015 for a specific purpose. Investment Manager Annemieke Wouterse: "For the first five years, the founders were engaged in very important clinical trials and the development of their product. We helped them get funding for the next phase: commercialization. The professionalism that was achieved is impressive. That a listed company like XVIVO Perfusion is now taking over the company shows how well Organ Assist is put together.'

Since 1999

Organ Assists has its origins in 1999. Biomedical mechanical engineer Arjan van der Plaats then began building and testing organ perfusion devices under the guidance of Professor Gerard Rakhorst at the UMCG. Six years and numerous hopeful results later, the two founded Organ Assist. They continued to pioneer, innovate and improve, resulting in numerous scientific publications, prizes and awards. All Dutch transplant hospitals decided to work according to the "Organ Assist method. In 2015, Wilfred den Hartog was recruited to boost commercialization. Co-founder Arjan van der Plaats is now CTO.