TRANSPLANT REVOLUTION
NHS approves machine that triples life of donor livers – and will boost the number of operations
HEALTH officials have approved the NHS using a revolutionary machine that keeps livers alive before they are transplanted.
Watchdog NicE today publishes guidance recommending perfusion devices that act as ‘life-support machines’ for the organs after they are removed from a donor, pumping them with blood so the tissue does not deteriorate.
This can triple the length of time a liver remains viable outside the body – from as little as eight hours if stored on ice to roughly 24 hours.
Experts hope this could significantly increase the number of organs viable for transplant, because it extends the window in which each liver can be used.
The guidance will be implemented across the UK. With almost 2,000 Scots dying every year from liver disease, transplants are in huge demand.
At the moment just over 1,000 liver transplants are conducted every year in Britain – but between 300 and 600 people are still left waiting for a procedure.
Deaths from liver disease have risen by 25 per cent in a decade. Surgeons described access to perfusion machines, which add about £8,000 to the cost of a
‘We are looking at a game-changer’
£75,000 liver transplant, as a ‘gamechanger’.
As well as extending the time available to use each organ, the machines also allow doctors to carry out tests to check their viability. This should allow surgeons to use organs that they would not have risked transplanting in the past.
Roughly 40 patients have already undergone transplants as part of trials of the machines, but the new guidance should mean they become used far more routinely.
Transplant surgeon Professor Darius Mirza of the University of Birmingham said: ‘in the 30 years i’ve been involved with transplantation there have been three or four events which have been game-changers and i’m absolutely certain we are looking at a game-changer that will change the way we practise organ storage and transplantation.
‘it is already changing practice at the centres that have been able to use this technology.’
Professor Kevin Harris, a clinical adviser at NicE, said: ‘This procedure offers hope for patients needing a liver transplant.
‘it offers another way of preserving the liver, and assessing whether livers which might have previously been considered unsuitable, can be used safely.
‘The latest evidence reviewed by a NicE committee concluded that the procedure worked well and was safe to be offered to patients who had been fully informed of the risks and benefits. By using this procedure, more patients on the organ transplant waiting list could be offered a chance of a transplant and thereby potentially extending their lives.’
Vanessa Hebditch of the British Liver Trust said: ‘Every year hundreds of people with advanced liver disease die while waiting for a transplant. This device offers real hope as it may improve transplant outcomes and allow livers previously thought to be unsuitable to be used and increases the time livers are able to be kept.
‘it is an exciting development that has the potential to shorten waiting list times and reduce mortality rates from advanced liver disease.
‘After transplant, the vast majority of people go on to lead full and healthy lives and it is truly amazing to see the transformation.’ The final decision as to whether the machines are funded rests with individual NHS clinical commissioning groups around the country, but the NicE guidance will be hugely influential.
John Forsythe, associate medical director at NHS Blood and Transplant, said: ‘There has been a huge amount of research in the area of preservation and perfusion methods that allow us to both assess precious donor organs and to enhance their function.
‘This could potentially mean the organ works better and improve transplant outcomes.
‘Many of the lead researchers in the area of transplant preservation and perfusion techniques are in the UK and it is good to see that UK researchers continue to be at the forefront in this field.’