Organersatz

Organersatz, or organ replacement, refers to strategies, devices, and therapies that restore or substitute the function of a failing organ when transplantation is not possible or as a temporary measure. The term covers mechanical devices, artificial tissues, extracorporeal support systems, and certain regenerative approaches that perform the organ’s physiological role in whole or in part. It is distinct from organ transplantation, although some organ ersatz therapies serve as a bridge to transplant or may complement transplant results.

In cardiovascular medicine, artificial hearts and ventricular assist devices (VADs) replace or support the pumping function of a diseased heart; a total artificial heart may replace both ventricles in selected cases. For kidney failure, dialysis (hemodialysis or peritoneal dialysis) removes waste products and excess fluid, providing essential kidney function. Liver support systems, such as extracorporeal liver assist devices (MARS, Prometheus), detoxify blood and aid metabolism, typically as bridge therapy rather than durable replacement. Pancreatic function is aided by artificial pancreas systems that automate insulin delivery based on glucose monitoring; whole-organ transplantation is a separate option. For lung support, extracorporeal membrane oxygenation (ECMO) oxygenates blood and removes carbon dioxide, used in critical illness or as a bridge to recovery or transplantation.

Research in organ ersatz includes bioartificial organs and regenerative approaches aimed at longer-term solutions. Safety, device reliability, infection risk, thrombosis, and cost are important considerations, and regulatory approval governs clinical use.