A special machine that could keep donor livers viable for longer may lead to a rise in the number available for transplant, experts say.
New guidance from the National Institute for Health and Care Excellence (NICE) says the machines could help preserve livers and enable doctors to work out whether livers previously considered unsuitable could actually still be be used.
At the moment, donor livers are usually stored with cold fluid and ice until they are transplanted into a patient.
With the latest technique, a perfusion machine is used to deliver oxygenated blood, and sometimes nutrients or medicines, to the donor liver, with the aim of reducing damage to it.
The machine also allows the liver’s function to be assessed before it is transplanted, and can increase how long the liver can be stored.
Sue Bennett, 45, a mother of three from Ranton in Staffordshire, had a liver transplant using the new technique as part of a trial.
She said: “Before my transplant I was very ill. I was losing weight, I couldn’t sleep and my quality of life was quite low.”
Now, she said, her life was “unbelievably wonderful”.
She added: “I’m very healthy, I’m very happy and very active. I think I’ve been very lucky.”
End-stage liver disease currently kills 11,000 people a year in England, and deaths from it continue to rise.
Causes of liver disease are varied but include viral hepatitis, excessive drinking and obesity.
The new NICE guidance recommends the machine – known as ex-vivo machine perfusion for extracorporeal preservation of livers for transplantation — is used in some settings as more data is gathered on how effective it is.
Professor Kevin Harris, programme director and clinical advisor for the interventional procedures programme at NICE, said: “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.”
University of Birmingham professor Darius Mirza, transplant surgeon at University Hospital’s Birmingham NHS Foundation Trust, said: “In the 30 years I’ve been involved with transplantation there have been three or four events which have been game changers.
“I’m absolutely certain we are looking at a game changer that will change the way we practice organ storage and transplantation.”
Vanessa Hebditch, director of policy at the British Liver Trust, said: “This 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.”
Research on the technique is currently ongoing at University of Birmingham, Queen Elizabeth Hospital Birmingham and other transplant centres.
In the 12 months to March 2018, there were 1,043 liver transplants in the UK and 359 patients on the UK active transplant list.
John Forsythe, associate medical director at NHS Blood and Transplant, said: “Many of the lead researchers in the area of transplant preservation and perfusion techniques are in UK and it is good to see UK researchers continue to be at the forefront in this field.
“Transplantation wouldn’t be possible without the generosity of organ donors and their families.”