NanOX Recovery Box – a new era of organ storage outside the body

In our country, every person, according to the law in force, is a presumed organ donor. Usually, the procurement of an organ takes place with their consent, and in the case of a serious accident and the patient's death – with the consent of the immediate family. In the case of brain death, with a continuously working heart and maintained respiration, the organ procurement and transplant operation is a very complex procedure, but we are not dealing with serious logistical problems here. The recipient is usually in the next room. The organ is only temporarily deprived of blood flow, which determines its quality and suitability for transplant. Only sometimes do we decide to transport an organ, such as a kidney, over a longer distance. Then it is appropriately prepared, the organ is cooled and transported in a special container under conditions of strongly slowed metabolism – a kind of hibernation. The situation is decidedly more difficult in the case of circulatory death – then at the moment of organ procurement, we are dealing with tissues deprived of blood supply, and therefore primarily oxygen, which means such organs are in much worse condition and can be seriously damaged. Such an organ should first undergo treatment and diagnostics. Therefore, technology is needed that allows for the storage, treatment, and diagnosis of organs outside the donor's body. Such technology would also allow for the deliberate procurement of poor-quality organs to treat/repair and continuously monitor them outside the donor's body.

The fundamental problem that must be solved in such a case is providing the stored organs with a source of oxygen and nutrients resembling human blood and the appropriate technological "care" of the organ storage apparatus. Work on such technology began at the Faculty of Chemical and Process Engineering of WUT over ten years ago; the technology is currently being developed by the company NanoSanguis, part of the NanoGroup listed on the Warsaw Stock Exchange.

The NanOX Recovery Box is a system for ex vivo perfusion of kidneys intended for transplantation, developed by the company NanoGroup, whose founder is Prof. Tomasz Ciach from the Faculty of Chemical and Process Engineering of WUT. The device is intended to enable the storage, transport, and continuous monitoring of a kidney, operating in hypothermic, subnormothermic, and normothermic modes.

How does the device work?

Ex vivo perfusion involves maintaining the flow of perfusion fluid through the organ's vascular bed outside the donor's body – the circulating fluid delivers oxygen and nutrients, removes metabolic waste products, and allows doctors to assess the organ's function before transplantation. The use of such procedures can extend the viability time of organs for transplantation, increase the donor pool, and create space to conduct repair processes in the organ before transplantation.

The NanOX Recovery Box is a device designed for ex vivo kidney perfusion, allowing for their safe storage, real-time monitoring, and the process of organ reconditioning. Technically, the system is flexible: it works both in the hypothermic mode, commonly used (for example with Belzer's solution), and in the normothermic mode, i.e., under conditions close to physiological. This makes the device compatible with existing procedures and simultaneously ready for implementing more advanced protocols. The construction contains an extensive system of sensors and automation: it monitors flow, pressure, temperature, pH, and oxygenation parameters in real-time and automatically regulates key perfusion conditions. In practice, this means the medical team receives constant insight into the organ's condition and can make decisions about its suitability for transplantation or about medical interventions. Although the main goal of current tests is kidneys, the device's architecture anticipates future expansion of applications to other organs – liver or heart – regardless of the perfusion mode or type of fluid used.

The project is being developed at NanoGroup with the participation of experts and technological partners, including the company A4BEE, which supports translating the prototype into production conditions and work on control systems.

Development stage and timeline

The NanOX Recovery Box has passed the conceptual phase and is currently undergoing advanced operational testing, including trials on isolated porcine kidneys, during which key perfusion parameters are maintained and regulated for many hours. Cooperation with an industrial partner has enabled the construction of prototype models under production conditions, and the team is currently completing the documentation required for certification. A patent related to the device has been filed, representing an important step in securing intellectual property ahead of commercialisation. According to the project plan, the certification procedure with a notified body is scheduled to begin in January 2026.

“The development of technology for long-term storage, treatment, and diagnosis of human organs or tissue fragments has the potential to save or significantly extend the lives of many people,” says Prof. Tomasz Ciach and Wojciech Frąckowiak. “With sufficient technological maturity, it could eventually enable the creation of something akin to libraries of human organs awaiting recipients. The NanOX Recovery Box has the potential to change the paradigm of organ preservation – from hypothermic methods to precisely controlled perfusion across the full temperature range. The application of such technology could significantly increase the supply of organs available for transplantation, improve patients’ quality of life, and save or substantially extend many lives. We believe that the NanOX Recovery Box will make organ preservation a precise and safe process, leading to better clinical outcomes.”

The university perspective

The NanOX Recovery Box remains a commercial project run by the independent company NanoGroup; however, the fact that one of its founders is Prof. Tomasz Ciach – an employee of the Warsaw University of Technology – creates a natural field of contact between the academic environment and industry. From the university perspective, this is an opportunity: to observe the technology transfer process, to build scientific-technical cooperation, and to engage students and doctoral candidates in research and validation work at the interface of engineering and medicine. The real start of the certification procedure in 2026 means that the solution developed by the NanoGroup team may reach clinics in the coming years – as a technology whose creation was possible thanks to the cooperation of science, engineering, and business, while simultaneously maintaining a clear distinction between the company's activities and the university's structures.