Organ Transplantation
Preserving, repairing and regenerating donor organs
The demand for donor organs continues to grow, while the availability of suitable organs remains limited. Ageing populations, chronic disease and lifestyle-related health problems increasingly affect organ quality, creating major challenges for transplantation medicine. Many patients remain dependent on deceased organ donation, while the shortage of suitable organs leads to long waiting times and significant health risks for patients awaiting transplantation.
At the same time, many potentially usable donor organs are currently not used because of concerns about organ quality and the risk of poor function after transplantation. Existing preservation methods are often not sufficient to fully assess, maintain or recover organ viability outside the body.
Within the Convergence Health & Technology Flagship Organ Transplantation, researchers and clinicians from Erasmus MC, TU Delft and Erasmus University Rotterdam combine expertise in medicine, engineering, imaging, regenerative medicine, ethics and health economics to explore new ways to preserve, assess and potentially repair donor organs before transplantation. By combining technology development with clinical insight and societal evaluation, the program aims to contribute to more sustainable and future-proof transplantation care.
What the Organ Transplantation Flagship works on
At the centre of the program is the development of advanced ex vivo machine perfusion technologies: systems that keep donor organs functioning outside the body under controlled conditions. These technologies aim not only to preserve organs longer, but also to assess organ quality, support organ recovery and potentially repair damaged organs before transplantation.
Researchers work on technologies and approaches related to organ perfusion, organ assessment, regenerative medicine, organ-on-chip systems, biomarker development, AI-supported prediction models and personalized post-transplant care. The program combines medical, technological and societal perspectives. Alongside technology development, researchers also study implementation, reimbursement, ethical considerations, healthcare organization and patient perspectives surrounding transplantation innovation.
Current research and implementation activities focus on areas including liver, lung, kidney and heart transplantation, as well as long-term monitoring and personalized transplant aftercare.
Featured story
Preserving, repairing and regenerating donor organs
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How can technology help increase the number of donor organs suitable for transplantation? And what is needed to move transplantation care beyond organ preservation towards organ repair and regeneration? In this featured story, Jan IJzermans, Paddy French and Esther de Bekker-Grob discuss how the Organ Transplantation Flagship combines machine perfusion, regenerative medicine, imaging technologies, ethics and health economics to explore new approaches for transplantation care. The story highlights both the technological innovations and the broader societal questions surrounding future transplantation medicine Read the interview/story. |
Innovation highlights
Multi-organoid-on-a-chip platform
Researchers are developing advanced organoid-on-a-chip systems that combine organoids, cell cultures and perfusion technologies to study organ damage, recovery and therapeutic interventions outside the body. These models support more predictive preclinical testing and may help reduce dependence on animal experiments.
Advanced ex vivo organ perfusion
The Flagship develops advanced ex vivo perfusion platforms that keep donor organs viable outside the body for extended periods. Longer perfusion times create opportunities for organ assessment, repair and recovery before transplantation, while also supporting better organ selection and improved transplant outcomes.
Liver viability testing during perfusion
A clinical liver viability test developed within the Flagship helps assess organ function during ex vivo perfusion prior to transplantation. The approach supports safer use of extended-criteria donor livers and contributes to increasing organ availability for transplantation.
Dried blood spot monitoring
Researchers developed a dried blood spot (DBS) assay that allows transplant patients to monitor immunosuppressive medication levels and kidney function markers using small blood samples collected at home. The approach supports more personalized follow-up care and reduces the need for frequent hospital visits.
Personalized medication dosing
The Flagship is developing decision-support software for personalized tacrolimus dosing based on biomarker and DBS data. These approaches aim to improve medication safety and support more individualized post-transplant care.
Remote monitoring and self-care
The Flagship explores home monitoring approaches in which medication monitoring, blood pressure measurements and digital follow-up are combined into integrated post-transplant self-care pathways. These approaches aim to improve quality of life while supporting more sustainable long-term care.
AI-supported organ assessment
Researchers are developing biomarker-driven AI models to support organ assessment and predict transplant outcomes. By integrating clinical, biomarker and perfusion data, these models aim to improve organ selection and support more efficient use of available donor organs.
Artificial heart technologies
Together with the Holland Hybrid Heart initiative, the Flagship contributes to the development of artificial heart technologies and perfusion-based cardiac support systems. This collaboration combines expertise in perfusion, transplantation and regenerative technologies to explore future alternatives for patients with end-stage heart failure.
Flagship News: Organ Transplantation
Policy & societal impact
The Organ Transplantation Flagship contributes to healthcare innovation by developing technologies and care pathways aimed at increasing donor organ availability, improving transplant outcomes and supporting more sustainable transplant care. Research and pilot studies within the Flagship have contributed to the integration of machine perfusion technologies into national transplantation guidelines and reimbursement structures in the Netherlands. This includes ex vivo perfusion approaches for donor livers, lungs and hearts, which are now part of reimbursed clinical care.
Beyond technology development, the Flagship also addresses ethical, societal and economic questions surrounding organ repair, transplantation and regenerative medicine. Researchers collaborate with clinicians, policymakers, patient representatives and health economists to support responsible implementation and broader healthcare adoption.
Partners & ecosystem
The Flagship collaborates with healthcare organizations, transplantation centres, patient representatives, policymakers, industry partners and national transplantation networks.
Collaborations include partnerships with organizations such as the Nederlandse Transplantatie Stichting (NTS), Ministry of Health, Welfare and Sport (VWS), university medical centres, technology partners and public-private initiatives focused on transplantation innovation and regenerative medicine.
Education & talent development
Education and interdisciplinary talent development are integrated throughout the Flagship. Researchers, clinicians, engineers and students collaborate across Erasmus MC, TU Delft and Erasmus University Rotterdam through PhD projects, interdisciplinary supervision, training activities and educational initiatives related to transplantation, perfusion technology and healthcare innovation. The Flagship also contributes to professional training initiatives focused on organ perfusion and transplantation technologies.
Looking ahead
In the coming years, the Organ Transplantation Flagship aims to further strengthen the clinical implementation and evaluation of organ perfusion technologies, personalized transplant care and regenerative medicine approaches.
The Flagship continues to explore longer-term organ preservation, organ repair strategies, AI-supported assessment methods and broader implementation of home monitoring and personalized aftercare pathways. Researchers also continue to work on ecosystem building and collaborations around transplantation innovation, responsible implementation and future healthcare sustainability.
