Book: The Culture of Organs

Overview
Published in 1938 at the Rockefeller Institute, The Culture of Organs is Alexis Carrel’s comprehensive account of maintaining whole, vascularized organs alive outside the body by sterile perfusion. Developed in close collaboration with Charles A. Lindbergh, the book consolidates nearly a decade of experiments that sought to bridge the gap between classical tissue culture and intact physiology. It sets out the conceptual basis, apparatus, procedures, and results that turned organ culture from a speculative idea into a reproducible laboratory practice, with an emphasis on surgical precision, engineering control, and rigorous asepsis.

Scientific Aim and Conceptual Frame
Carrel defines organ culture as the maintenance of an organ’s structure and function by recreating an internal environment that nourishes cells through their own vascular bed. The project asks what conditions are necessary for integrated tissues to preserve architecture, metabolism, and specialized activity when separated from the organism. Viability is judged not only by survival of cells but by retention of organ-specific features such as secretion, histological organization, and responsiveness to physiological cues.

Apparatus and Technique
At the center is the Lindbergh perfusion pump, an all-glass, closed, pulsatile system designed to deliver sterile nutrient media without mechanical trauma or contamination. The book details the geometry of organ chambers, the prevention of air bubbles and stagnant zones, the use of filtered gases to regulate oxygen and carbon dioxide tension, and precise control of temperature and pressure. Every component can be assembled, sterilized, and operated as a single unit to maintain asepsis over long runs. Media formulations combine balanced salt solutions, carbohydrates, protein sources such as serum or plasma, and buffers to sustain pH, with variations tailored to organ demands. Methods for sterilization, instrument handling, and surgical excision emphasize atraumatic techniques to protect endothelium and parenchyma.

Experimental Program
Carrel reports perfusion of endocrine and parenchymal organs, most prominently thyroid, ovary, and adrenal, chosen because their function can be judged morphologically and physiologically. Thyroid lobes preserve follicular architecture and colloid under suitable flow and composition; ovaries display maintenance of follicles and stromal integrity; adrenals retain cortical organization. Spleen and liver present greater difficulties due to complex microcirculation and metabolic load, illustrating the limits of uniform perfusion and waste removal. Across experiments, the book correlates survival and function with flow patterns, medium composition, gas tensions, and the stringency of asepsis. Photographic plates and histological sections document changes over time, distinguishing degeneration from adaptive remodeling.

Findings and Limits
The work demonstrates that intact organs can remain viable and functionally recognizable ex vivo when their vascular environment is precisely controlled. It identifies key determinants of success: absolute sterility; gentle, rhythmic perfusion; adequate oxygenation without bubble injury; appropriate osmotic and acid-base balance; and media tailored to organ metabolism. Failures cluster around contamination, endothelial damage, edema from inappropriate pressures, maldistribution of flow, and accumulation of toxic metabolites. Even under optimal conditions, longevity and full physiological output are limited, underscoring the gap between sustaining structure and replicating the systemic milieu of a living organism.

Significance and Legacy
The Culture of Organs marks an early convergence of surgery, physiology, and engineering, showing that organ-level homeostasis can be partly reconstructed outside the body. It provides a methodological foundation for later advances in organ preservation, machine perfusion, extracorporeal circulation, and bioartificial organs. Beyond its immediate technical contributions, the book offers a disciplined approach to experimental control, treating the internal environment as an engineered variable, which influenced subsequent biomedical instrumentation and perfusion science. While the broader historical context of Carrel’s career is complex, the volume stands as a landmark in twentieth-century biomedicine, capturing both the promise and constraints of keeping organs alive beyond the organism.