Newly-acquired Organ Assist started their revolution from TopDutch

Sometimes taking a fresh look at an old idea can have life-changing consequences. Organ Assist, which started as a spin-off from the University Medical Center Groningen (UMCG), is helping to alleviate a global challenge: The shortage of donor organs. Thanks to the Groningen-born equipment, substantially more donor livers and kidneys become available for transplant. In fact, there’s not simply more organs, but the organs are also in better condition going into the transplant.

Up until about five years ago, the organ transplantation process resembled a race against time. The quality of the donated liver or kidney was visually assessed and checked according to criteria. The organ was then cooled and transported to the recipient as quickly as possible. In the meantime the patient was prepped for surgery. During every second of this process the quality of the organ declined due to lack of oxygen.

Together with doctors and researchers, Organ Assist developed a perfusion machine that improves the process for all involved. Known in doctor’s jargon as ‘putting it on the pump’, perfusion is the process of connecting the kidney or liver to a device that pumps preservative infused with oxygen through the organ before transplantation. The result: no more loss of oxygen and deterioration of the organ.

“This method enables us to recharge, as it were, the battery of the liver, which has been slowly drained during transit,” says Vincent de Meijer. As a liver transplant surgeon at the UMCG he has been seeing the benefits of the process for years. “It enables us to optimize particularly vulnerable donor livers prior to transplant. We expect to soon be able to publish the results of a major international randomized clinical trial led by Prof. Robert Porte of the UMCG in which this method was tested.”

Porte’s study looks at cold perfusion. Organ Assist’s liver pump, developed together with the same researchers at the UMCG, involves the use of hot coils and is expected to have at least similar implications.

De Meijer expands: “This enables us to test the quality of donor livers before transplanting them. This is not necessary for all organs, but it is necessary for the donor livers that have been rejected on paper and by the eye. Such organs have been delivered to Groningen for testing since 2017. We have developed a protocol to optimize donor livers of questionable quality with cold perfusion, in order to be able to test them at a normal body temperature. After this ‘test drive’ some sixty percent of the previously rejected donor livers nationwide were able to be used for transplants. That’s huge.”

And as of yet, we’ve still not even mentioned all of the remarkable benefits. Another particularly important benefit is the potentially longer preservation time that is created by the perfusion method. De Meijer is currently investigating how further innovation can keep donor livers in good condition for a longer period of time. “What we want is to extend the preservation time to allow organs to recover but also, for example, to administer therapy. If we also succeed in repairing damaged donor livers, then we can use even more organs and make an even bigger dent in the worldwide shortage. But that’s still to come.”

The time of the transplant is still determined by the moment a donor organ becomes available and consequently more than half of the transplants take place at night. De Meijer is also currently investigating whether the perfusion machine can be used to extend the preservation time of donor livers. De Meijer explains, “we have just started a clinical study in which donor livers that would otherwise have been transplanted at night are temporarily connected to the perfusion machine, with the aim of making transplants more plannable. So that for example, we wouldn’t have to operate in the middle of the night simply because the clock is ticking, instead we would be able to postpone the operation until the next morning. This is better for the patient and for the entire medical team.”

All three liver transplant centers in the Netherlands (Rotterdam, Leiden and Groningen) have been using Organ Assist’s perfusion machines for some time now. In fact, they have adapted their process and infrastructure to the perfusion machines. Therefore, it isn’t surprising that there is also now a great deal of interest from the business community which resulted in a takeover bid by Swedish company XVIVO Perfusion, which was accepted.

This deal was reason for celebration both in Sweden and Groningen. And certainly not simply for the economic benefits. “Money is nice, but this means we are one step closer to our ultimate goal. That’s more important,” says Organ Assist’s CEO Wilfred den Hartog. This is an ambitious goal: to provide an organ to all patients in need.

Den Hartog continues; “From the outset we have focused mainly on the liver and kidneys, although we do also work with other organs. XVIVO Perfusion provide a similar service, but with hearts and lungs in particular. So together we can do a lot more. Our techniques do not differ very much and we can achieve great synergy benefits in other areas. An example? XVIVO Perfusion’s expertise lies in making perfusion fluids, whereas we have always had to buy them. On the other hand, we have invested a lot in protocols and treatment plans, which XVIVO Perfusion can now take advantage of. And then, of course, there is the scale-up. Together we have more distributors and agents all over the world. With this takeover, we can take the big steps we had in mind.”

Dina Boonstra, Director of the NOM, shares their vision. The Investment and Development Agency 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 on investment. With this takeover, that will be even greater than it already was. This is a truly perfect example of how we want to work. Helping a promising company grow, together. In my opinion, Organ Assist’s story is also a wonderful example of the flourishing life sciences sector in the Northern Netherlands. We can be very proud of that.”

Because it started in Groningen, it will stay in Groningen. Wilfred den Hartog is clear about that. “Our close ties with the University Medical Center Groningen speak for themselves. Added to the fact that our local suppliers are important, our people like to live here and we have a great network, means we see no reason to leave. Groningen will remain home to the Competence Center.”

NOM invested in Organ Assist in 2015, with a specific goal. Investment Manager Annemieke Wouterse says, “during the first five years, the founders were engaged in very important clinical trials and the development of their product. We helped them obtain funding for the next phase: Commercialization. The professionalization that they achieved is impressive. The fact that a listed company such as XVIVO Perfusion is now taking over the company shows how well Organ Assist is positioned.”

Organ Assist’s story began in 1999. Biomedical mechanical engineering Arjan van der Plaats started by building and testing organ perfusion devices at the UMCG under the supervision of Professor Gerard Rakhorst. Six years and countless hopeful results later, the two Organ Assists were created. They continued to pioneer, innovate and improve, resulting in numerous scientific publications, awards and distinctions. All Dutch transplant hospitals decided to work according to the ‘Organ Assist method’. In 2015, Wilfred den Hartog was recruited to boost the commercialization process. Co-founder Arjan van der Plaats is now CTO.