'Life support' for transplant livers better than freezing: study

April 18, 2018 by Mariëtte Le Roux
A doctor carries a transplant kidney during surgery at Johns Hopkins Hospital in Baltimore, Maryland.

Keeping transplant livers on "life support" at body temperature preserves them better than the prevailing method of near-freezing, and could reduce the number of donor organs thrown away, a study said Wednesday.

Currently most livers are stored in an inert state at temperatures just above freezing until they can be transferred to a recipient.

But many end up damaged, meaning that only a portion of livers harvested for transplant get used despite an urgent, and growing, organ shortage.

"Approximately one in five patients died on the UK transplant waiting list last year, whilst, paradoxically, almost 500 livers from deceased organ donors were not... transplanted," study co-author Constantin Coussios of the University of Oxford told AFP.

"This was because the suboptimal condition of many is such that these are unlikely to work after being preserved in an ice box. Despite many advances in liver transplantation, the method of organ preservation has scarcely changed in 30 years."

A newer method called normothermic machine perfusion (NMP) uses a machine to pump blood through the liver at 37 degrees Celsius (98,6 degrees Fahrenheit)—the .

The technique keeps the liver functioning artificially while feeding it oxygenated blood, medicine, and nutrients.

But scientists did not know if it actually works better than the prevailing method, prompting the first-ever study to compare the warm and cold liver storage methods.

Coussios and a team studied what happened to two sets of —100 stored on ice, another 120 with NMP, and published their findings in the science journal Nature.

The NMP livers, the authors found, had 50 percent less "graft injury" than the near-frozen organs, and could be kept for considerably longer.

Liver is 'a patient'

More of the NMP livers them could be transplanted.

The number of livers retrieved from donors but rejected after storage "was reduced by 50 percent," said Coussios.

By keeping it functioning artificially, NMP allowed for easier assessment of liver quality than was possible with a near-frozen, hypothermic organ, he said—a sort of pre-surgery "test drive".

The team concluded that widespread use of NMP could cut the number of people who die waiting for a transplant while harvested organs are discarded.

The first NMP device, dubbed OrganOx, was trademarked in 2016, and has started to be used in Europe, India, and Canada, said Coussios

One of the study authors is a former chief executive of OrganOx Limited, and Coussios is its technical director.

In a comment also carried by Nature, Stefan Schneeberger of the Innsbruck Medical University in Austria said the team made a "convincing case" for the effectiveness of NMP, which he said treats the liver "like a patient.

"It is perfused, monitored, and fed by a machine. If it performs well, it is transplanted immediately; if not, it might undergo treatment, modification or repair before transplantation."

The long-term effects of NMP must be studied before it can be concluded to be a more effective and suitable for organ storage, Schneeberger added.

Coussios said further study is needed into the cost-effectiveness of the technology.

Explore further: Transplanted livers help body defend against organ rejection, study finds

More information: A randomized trial of normothermic preservation in liver transplantation, Nature (2018). nature.com/articles/doi:10.1038/s41586-018-0047-9

Related Stories

Transplanted livers help body defend against organ rejection, study finds

April 18, 2018
For decades, transplant experts have observed that liver transplant recipients often need less anti-rejection medication, known as immunosuppressive drugs, than recipients of other solid organs. Similarly, when patients receive ...

British team perform new 'warm' liver transplants

March 15, 2013
British surgeons said Friday they have performed successful liver transplants on two patients using a revolutionary technique which keeps the organ warm and functioning while outside the body.

US study reports dramatic reduction in likelihood of liver transplantation in patients with hepatoce

April 13, 2018
Patients with hepatocellular carcinoma (HCC) waiting for a liver transplant in the USA are now significantly less likely to receive a new liver than they were around a decade ago. A nationwide study presented today at The ...

UAB performs Alabama's first transplant where cadaver liver is 'kept alive' outside body

April 21, 2017
Physicians in the University of Alabama at Birmingham Department of Surgery have transplanted Alabama's first patient with a cadaver liver that was recovered from the donor and "kept alive" and preserved at body temperature ...

Potential liver recipients may have new option

June 5, 2015
(HealthDay)—Livers from donors who suffered cardiac death can be safely and effectively transplanted into patients dying of liver cancer, a new study suggests.

Recommended for you

Surprise finding—for very sick elderly, lighter sedation won't drop risk of postoperative delirium, study suggests

August 13, 2018
Johns Hopkins Medicine researchers say a study designed to see if reducing the amount of anesthesia reduces the risk of postoperative delirium in older patients surprisingly found that lighter sedation failed to do so in ...

Kidney transplant chains more effective in saving lives

August 9, 2018
New research from the UBC Sauder School of the Business has found that transplant societies which prioritize kidney transplant chains over kidney exchanges can increase the total number of transplants, thereby saving more ...

Surgical mesh implants may cause autoimmune disorders

July 31, 2018
Surgical mesh implants, often used for hernia or gynecological repair, may be the reason so many patients report symptoms of an autoimmune disorder, according to a University of Alberta rheumatologist.

Surgeons discuss options when the risks of surgery may be too high

July 27, 2018
In an essay published July 26 in the New England Journal of Medicine, Ira Leeds, M.D., research fellow, and David Efron, M.D., professor of surgery, both of the Johns Hopkins University School of Medicine, along with their ...

Blood plasma during emergency air transport saves lives

July 25, 2018
Two units of plasma given in a medical helicopter on the way to the hospital could increase the odds of survival by 10 percent for traumatically injured patients with severe bleeding, according to the results of a national ...

The dark side of antibiotic ciprofloxacin

July 25, 2018
The use of ciprofloxacin and other antibiotics of the class of fluoroquinolones may be associated with disruption of the normal functions of connective tissue, including tendon rupture, tendonitis and retinal detachment. ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.