British invention set to save hundreds of liver patients a year
MACHINE CAN EXTEND TRANSPLANT ORGAN LIFE
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.
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.”
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.
OLD WAY Liver had to be packed in ice
TRAGIC Elena NEW WAY The OrganOx has revolutionised liver transplants