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By Nancy Lapid, Health Science Editor

Hello Health Rounds readers! Today we feature a glimpse into the future of life-saving treatment for patients with liver failure. In an experiment on a brain-dead organ donor, scientists were able to use a pig’s liver to do the work of the donor’s liver. We also cover some important developments in Parkinson’s disease research and advances toward a better understanding of the genetics of glaucoma in people of African descent. 

In breaking news, see these stories from our Reuters journalists: Britain’s Labour aims to save billions of pounds with planned health reforms; U.S. FDA seeks ‘boxed warning’ for CAR-T cancer therapies; Cameroon begins routine malaria shots in global milestone; CDC says JN.1 variant accounts for about 86% of COVID cases in U.S.; Fate of most remaining Zantac lawsuits weighed by Delaware judge; World risks missing deadline for pandemic accord, says WHO chief; and Martin Shkreli’s lifetime drug industry ban is upheld.

The only cure for liver failure is a transplant, but many patients die before a donor liver becomes available. In a successful experiment announced last week, surgeons came a step closer to being able to use pig livers as temporary substitutes for failing human livers, until the human livers either recover or are replaced during a liver transplant. REUTERS/Fabian Bimmer

It may someday be possible to use pig livers as a temporary means of keeping patients alive when their own livers are failing, a recent experiment in a brain-dead organ donor suggests.

The only cure for liver failure is a transplant, but many patients die before a liver becomes available.

While dialysis machines, artificial hearts and  extracorporeal membrane oxygenation (ECMO) machines are available as temporary stand-ins for failing kidneys, hearts and lungs, there are presently no mechanical options available to perform the functions of diseased livers.

The new approach, called extracorporeal perfusion, would circulate the patient’s blood through a pig liver outside the body, researchers said.

In some cases, the brief reprieve would allow patients’ failing livers to rest and recover. In other cases, the pig liver would serve as a bridge to transplantation, keeping the patient alive until a human donor liver became available.

In the three-day experiment with the brain-dead donor, performed at the Hospital of the University of Pennsylvania in Philadelphia, the donor’s own liver was left intact. The pig liver performed all of the functions usually performed by a donor liver with no sign of problems, the surgeons announced on Thursday.

“Any time a patient dies while waiting for a transplant, it is a tragedy, and we are always working to develop new ways to extend their lives,” Dr. Abraham Shaked of the Penn Transplant Institute, who led the experiment, said in a statement.

Its success offers “a glimpse into a future where innovative solutions can bring hope to patients who might otherwise be destined to die while waiting for a transplant,” he said.

Read more about xenotransplantation on Reuters.com

• Two pig heart transplants succeed in brain-dead recipients
• U.S. surgeons successfully test pig kidney transplant in human patient

Recent discoveries of biological factors underlying Parkinson’s disease and the development of reliable tests for them have allowed researchers to propose new systems for defining the stages of the debilitating, incurable neurological disorder.

Presently, the disease is diagnosed based only on patients’ symptoms. On Monday in The Lancet Neurology, two separate research teams proposed new classification systems based on objective biomarkers that become evident before symptoms begin to appear.

In both of the proposed systems, early “prodromal” stages are defined by the presence of certain genetic mutations and cerebrospinal fluid levels of a key nerve-cell protein called alpha-synuclein, with or without imaging evidence of dysfunctional dopamine-producing nerve cells in the brain.

As the disease evolves, patients also develop progressively worsening motor and non-motor symptoms such as tremor, loss of smell, gait and balance problems, sleep problems, and cognitive impairment.

The new classification schemes – formally known as the neuronal alpha-synuclein disease integrated staging system (NSD-ISS) and the SynNeurGe research diagnostic criteria – are currently intended for use only by researchers.

“We recognize that there are knowledge gaps and that our understanding of… disease biology and staging will evolve,” the NSD-ISS researchers wrote in their paper. “The goal is eventually achieving a clinically useful staging system to aid in early, accurate diagnosis, and to guide treatment,” they said.

Despite higher rates of glaucoma and related blindness among Black patients, researchers have only begun to identify genetic risk factors specific to people of African descent, according to a new report.

Black patients are five times more likely than others to develop glaucoma and up to 15 times as likely to be blinded by the condition. But the vast majority of research into the genetics of the eye disease has used data from people of European ancestry, Philadelphia-based researchers reported in the journal Cell.

For their new study, the researchers worked with Black community leaders to organize glaucoma screenings in churches and senior centers. They also worked with a Black-owned radio station to promote free glaucoma screening. Respondents received screening regardless of whether they agreed to enroll in the study.

Ultimately, 6,003 people with glaucoma and 5,272 without volunteered to provide data and genetic samples.

When researchers compared their findings in these volunteers to earlier analyses, they found the three newly identified genetic risk factors were not common in people of European descent.

“This work highlights the essential role of diversity in genetic research,” study leader Shefali Verma of the University of Pennsylvania Perelman School of Medicine said in a statement.

“Without our focus on this specific ancestry group, these unique and critical insights might have remained lost, and we would not have been able to substantially enhance our understanding of the genetics behind (glaucoma) in this overaffected population.”

The researchers said they are currently focused on developing better methods for diagnosing glaucoma early, when it is most amenable to treatment.

Using identified variants, the team developed a genetic risk score that they said outperforms a similar risk score developed using information from individuals of European ancestry.

This newsletter was edited by Bill Berkrot.

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