Perfusion Device Revives Donor Eyeballs, Paving the Way for Full Eye Transplants

The field of organ transplantation may soon see progress in one of its most challenging areas: full eye transplants. A research team led by Pia Cosma at the Center for Genome Regulation, part of the Barcelona Institute of Science and Technology, has developed a perfusion device called “Eye-in-a-Care-Box” (ECaBox). The device supplies oxygen and nutrients to eyeballs extracted from deceased donors, successfully maintaining and restoring their functionality. This development was reported by the MIT Technology Review on July 3, 2026.

Technical Barriers to Full Eye Transplants

Two major reasons have long made full eye transplants difficult. First, the complexity of surgically disconnecting the eye from the brain and optic nerve and then connecting it to a new environment. Secondly, the biological issue of rapid deterioration of the eyeball as soon as it is removed from the body.

Previous attempts at full eye transplants showed that transplanted eyes were unable to detect light. Preserving visual functionality during the transplantation process requires minimizing the time between extraction and transplantation while maintaining tissue viability. However, traditional cooling preservation methods are known to cause degeneration in the eyeball within 24 hours.

How ECaBox Works

Cosma’s team developed ECaBox using organ perfusion technology. The device utilizes the arteries supplying blood to the eyeball, delivering a liquid rich in oxygen.

Inside the device, a “bed” is designed to hold the eyeball, with excess liquid drained. The sealed casing maintains constant temperature and pressure and features transparent windows on the sides for observing and photographing the eyeball.

Shannon Tessier from Massachusetts General Hospital, an expert in perfusion research for other organs, commented, “This is truly remarkable. It could be a new frontier in retinal preservation.”

Results from Pig Eyeballs

The research team initially experimented with pig eyeballs, which are anatomically similar to human eyeballs. These were obtained from a local slaughterhouse.

Pig eyeballs left at room temperature deteriorated rapidly, with cells contracting and tissue structures lost. Even when cooled to 4°C, degeneration progressed within 24 hours.

In contrast, eyeballs housed in the ECaBox maintained significantly better condition. After 24 hours, the perfused eyeballs demonstrated “markedly higher viability.” Most notably, they retained their ability to respond to light. This light responsiveness, which is lost immediately upon extraction in untreated eyeballs, was restored after approximately 15 minutes of perfusion in the ECaBox. In some cases, this functionality lasted for over 10 hours.

Testing on Human Donor Eyeballs

Following their success with pig eyeballs, the team conducted experiments on human donor eyeballs. They collected 12 eyeballs from six deceased individuals, placing one of each pair in the ECaBox while leaving the other untreated as a control.

The results mirrored those of the pig experiments: the perfused eyeballs showed better viability. The findings are currently published as a preprint (non-peer-reviewed research), and Cosma has refrained from commenting further at this stage.

Prospects for Full Eye Transplants

If full eye transplants become feasible, they could offer hope for restoring vision to patients who have lost their sight due to injury or disease. In cases where the retina and optic nerve remain intact, transplanting an eyeball may restore visual function.

However, several challenges remain. Even if the ECaBox can maintain eyeball viability, connecting the optic nerve and brain after transplantation is critical. Regenerating the optic nerve confronts fundamental issues with repairing the central nervous system, and further breakthroughs will be required before full eye transplants become practical.

Editorial Opinion

The short-term impact of this research lies in its implications for organ preservation technology. Demonstrating the efficacy of perfusion preservation for complex and delicate tissues like eyeballs suggests potential applications for other challenging organs (e.g., pancreas, small intestine). In the field of transplant medicine, maintaining donor organ quality and extending preservation times are constant challenges. Devices like the ECaBox could revolutionize organ banking practices.

In the long term, while the practical realization of full eye transplants remains uncertain, this technology strengthens the foundation for overall vision restoration research. The ability to observe and experiment on live eyeballs for extended periods offers new tools for studying retinal diseases and developing treatments. Utilizing donor eyeballs could also expand corneal transplantation without relying solely on living donors.

The editorial team poses a question: Could perfusion technology go beyond preservation and transform the research environment for nerve regeneration? Sustaining tissues in a living state opens the door to prolonged experiments on nerve regeneration, which were previously impossible. However, ethical issues surrounding this technology must also be addressed.

References

• MIT Technology Review: “A device that revives eyeballs from dead donors could make eye transplants possible” — Published on 2026-07-03