Centre for Organ Assessment, Repair, and Optimisation (COARO)

Thanks to the generosity of RPATI patients and supporters, the RPA Translational Centre for Organ Assessment, Repair, and Optimisation (COARO) was established in 2018.

Many deceased-donor organs that are available for transplantation are of poor quality and are either discarded or used with high risk to recipient outcomes. In order to increase the number of usable organs, new approaches to organ viability assessment, preservation, repair, and improvement are necessary.

Associate Professor Carlo Pulitano is leading a team of dedicated scientists who are developing new technologies to assess, repair and modify organs before transplantation. One of our main projects is the development of a perfusion system that can preserve a liver for up to 2 weeks under normothermic conditions. The Extended Organ Perfusion System (EOPS) detoxifies and sustains the liver through autoregulation of multiple physiological functions.

This project was the successful and very proud recipient of the 2023 NSW Health Research Award which has demonstrated the outstanding achievements in providing evidence to assist in the safe and reliable care with the improved outcomes to our patients with a better quality of life.

This system provides a unique model for facilitating recovery of critically injured donor livers unsuitable for transplantation, but also enables the introduction of new therapeutic agents such as gene therapy, stem-cell therapy, pharmacotherapy, and organ/tissue engineering.

Recently our team has demonstrated for the first time the feasibility of splitting whole livers into left and right lobes during normothermic ex-vivo perfusion and the two partial livers perfused concurrently. In this concept, a liver can be divided into two lobes, and, after reaching a sufficient size, it can be transplanted into two recipients.

It is estimated that EOPS can enable resuscitation of initially declined high-risk donor livers. Therefore, increasing the number of liver transplant recipients of more than 35%.

With these developments, the possibility of success and better health outcomes for adults and children with end-stage liver disease and liver tumours is increasing.