Bri­tish in­ven­tion set to save hun­dreds of liver pa­tients a year

MA­CHINE CAN EX­TEND TRANS­PLANT OR­GAN LIFE

Sunday Mirror (Northern Ireland) - - News - BY MAR­TYN HALLE and NICOLA SMALL

We can trans­plant liv­ers that would not have been used be­fore SUR­GEON NASRALLA ON OR­GANOX BREAK­THROUGH

A BRI­TISH in­ven­tion that can keep hu­man liv­ers “alive” out­side the body ready for trans­plant could save 200 more lives a year.

The Or­ganOx has al­ready come to the res­cue of 500 pa­tients fac­ing death while wait­ing for a suit­able donor.

Cre­ated by trans­plant ex­perts Prof Peter Friend and Prof Con­stantin Cous­sios, the ma­chine dou­bles the “shelf life” of a donor liver and re­duces the risk of tis­sue dam­age.

It can even test whether the or­gan is suit­able for trans­plant.

CHANCE

And it’s now in use across the coun­try af­ter be­ing given the NHS green light in Jan­uary. One trans­plant sur­geon said: “We are look­ing at a game changer in or­gan stor­age and trans­plan­ta­tion.”

Tra­di­tion­ally, donor liv­ers are stored in an ice box to be trans­ported to the patient – but they can only sur­vive a max­i­mum of 12 hours in ice with high tis­sue dam­age risk.

The Or­ganOx main­tains liv­ers at nor­mal body tem­per­a­ture and de­liv­ers oxy­genated blood, med­i­ca­tions and nu­tri­ents, keep­ing them in good con­di­tion for 24 hours.

In that time it can ac­cu­rately test the func­tion of a liver to as­sess its vi­a­bil­ity for trans­plant rather than re­ly­ing on a sur­geon’s vis­ual ex­am­i­na­tion.

And if the donor had a fatty liver, the ma­chine could even po­ten­tially re-con­di­tion it with drugs through the blood sup­ply – mak­ing pre­vi­ously non­vi­able liv­ers suit­able.

It is hoped the in­ven­tion will in­crease the num­ber of UK liver trans­plants by 20 per cent – about 200 pa­tients a year.

That means it could have saved some of the 45 pa­tients who died last year while on the wait­ing list.

And it also means pa­tients pre­vi­ously deemed not ill enough to be on the list, will now get a chance at life.

David Nasralla, a trans­plant sur­geon at the Royal Free Hos­pi­tal in Lon­don who helped in the tri­als of Or­ganOx, said: “We know that for some pa­tients where bowel can­cer has spread to the liver and it can­not be sur­gi­cally re­moved, a liver trans­plant would be the best treat­ment.

“But th­ese pa­tients don’t get a chance as we have to pri­ori­tise. That is why hav­ing this tech­nol­ogy is im­por­tant.

“If we can add 20 per cent to trans­plants we carry out at present that will be an im­por­tant ad­vance. It’s an ex­cit­ing tech­nol­ogy that has al­ready en­abled us to trans­plant many liv­ers that would not have been used.”

Or­ganOx was of­fi­cially ap­proved by the Na­tional In­sti­tute for Health and Clinical Ex­cel­lence (NICE) for NHS use in Jan­uary.

And it is now in use at six trans­plant cen­tres – two in Lon­don and in Cam­bridge, Birm­ing­ham, New­cas­tle and Ed­in­burgh.

Prof Friend, a trans­plant sur­geon and di­rec­tor of the Ox­ford Trans­plant Cen­tre, said: “It’s taken a decade since the very be­gin­ning for the box to be­come of­fi­cial on the NHS.

“In ad­di­tion to 250 trans­plants us­ing it in the UK, we have saved an­other 250 lives abroad. Our tech­nol­ogy is slowly gain­ing ac­cep­tance across the world.”

Sur­geons at the Royal Free have al­ready achieved a first with the ma­chine just months af­ter be­gin­ning to use it. They trans­planted the small­est liver ever, weigh­ing just 750g, into an adult us­ing the box. It had been re­jected by other cen­tres with­out the Or­ganOx.

The hos­pi­tal’s head trans­plant sur­geon Prof Jo­erg-Matthias Pol­lok said: “Hav­ing the ma­chine buys us time to test the liver and make sure it is func­tion­ing well, which means there isn’t the rush to trans­plant of­ten late at night or in the early hours. It takes the pres­sure off.”

STOR­AGE

Birm­ing­ham’s Uni­ver­sity Hos­pi­tal trans­plant sur­geon Prof Dar­ius Mirza said: “I’m cer­tain it will change the way we prac­tise or­gan stor­age and trans­plan­ta­tion. It is al­ready chang­ing prac­tice at cen­tres that have been able to use it.” End-stage liver dis­ease kills 11,000 peo­ple a year in Eng­land – with deaths up 25 per cent in a decade.

Prof Kevin Har­ris of NICE said: “By us­ing this pro­ce­dure, more pa­tients on the wait­ing list could be of­fered a chance of a trans­plant.

“It of­fers an­other way of pre­serv­ing and as­sess­ing the liver, so those who might have pre­vi­ously been con­sid­ered un­suit­able can be used safely.”

And peo­ple on the wait­ing list for a kid­ney trans­plant could be next to ben­e­fit, with the team be­hind Or­ganOx now look­ing at de­vel­op­ing a sim­i­lar ma­chine for them.

[email protected]­daymir­ror.co.uk

OLD WAY Liver had to be packed in ice

TRAGIC Elena NEW WAY The Or­ganOx has rev­o­lu­tionised liver trans­plants

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