OnMedica – News – Infusion technique could increase the number of viable donor livers

NICE: slows the rate of tissue deterioration and extends shelf life

A technique that slows down the rate of tissue damage and lengthens storage time could increase the number of viable livers that can be safely used for a transplant, says the National Institute of Health and Wellness. excellence (NICE) in the latest guidelines published today.

An infusion apparatus not only reduces the rate of tissue damage occurring after removal of the liver from the donor, but variations of this technique can also allow the liver to be rinsed with blood at body temperature and fed with oxygen, in drugs and nutrients, enabling its viability and function must be badessed.

The hope is that the machine infusion saves more lives and reduces waiting times for a liver transplant.

End-stage liver disease kills 11,000 people each year in England. The number of deaths due to liver disease has risen by 25% in a decade and continues to increase, while the average age of deaths due to liver disease, currently 50 to 59 years old, continues to decline.

NICE recommends that the procedure be used as part of special arrangements while more data is collected on its effectiveness.

Surgeons who undertake the procedure should inform patients of pros and cons, comply with the regulatory and legal requirements of the Human Tissue Authority and enter the details of all patients subject to this procedure into the NHS Transplant Registry. Blood and Transplant (NHSBT) from the United Kingdom.

Professor Kevin Harris, program director and clinical advisor for the interventional procedures program at NICE, said, "This procedure offers hope to patients requiring a liver transplant. It offers another way to preserve the liver and badess if livers that may previously have been found to be unsuitable can be used safely.

"The latest evidence reviewed by a NICE committee concluded that the procedure was working well and that it was safe to be offered to patients who had been fully informed of the risks and benefits. Clinicians must seek the approval of the management of their trusted institution and record all procedure data in a database. "

He added: "By using this procedure, a larger number of patients on the waiting list for an organ transplant could be offered the option of a transplant and hence, A potential extension of their life. "

Darius Mirza, professor of Hepatobiliary Surgery and Transplantation at Birmingham University Hospital, said: "In the last 30 years, I have been involved in transplantation. Four events have been instrumental and we are absolutely convinced that we are looking for a game changer that will change the way we do organ storage and transplantation.

"It is already changing the practice in centers that have been able to use this technology as part of clinical trials or as part of an extension of the service badessment."

John Forsythe, Associate Medical Director of NHSBT, said, "There is a lot of research in the area of ​​preservation and perfusion methods that allows us to evaluate valuable donor organs and improve their function. This could potentially mean that the organ works better and improve the results of the transplant. "

Vanessa Hebditch, Policy Director at the British Liver Trust, commented: "This new device offers real hope as it can improve the results of the transplant and allow the livers that previously thought unsuitable to be used, any by increasing the life of the livers. retained.

"This could potentially shorten wait times and reduce mortality rates from advanced liver disease. After the transplant, the vast majority of people continue to live fully and in good health and it is truly amazing to see the transformation. "

The NHSBT figures show that in 2017-2018, 1043 liver transplants were performed in the UK and 359 patients were on the list of active transplants in the UK.