New technology gives fresh hope to liver transplant patients

Organ transplants have saved thousands of lives over the years but the length of time that an organ can be kept alive outside the body has placed constraints on the number of transplants that can be performed. Livers, for example, are currently cooled to 4°C to preserve them. However, they continue to deteriorate and must be used within about 12 hours, severely limiting the window of opportunity for surgeons to operate. In fact, currently only about 650 liver transplants are carried out annually in the UK and demand far outstrips supply. This could be about to change.

In a world first, a team of scientists at Oxford University has developed a machine that can warm the liver to body temperature while maintaining a circulation of blood, oxygen and nutrients. This allows it to function as it would inside the body, meaning that it is not only preserved but can also repair itself, give doctors the opportunity to examine it for defects and, crucially, allow doctors more time before they have to operate.

Researchers believe that the machine will keep livers alive for at least 24 hours and tests indicate that 72 hours or more is not beyond the realms of possibility. Also, the machine is portable (about the size of a supermarket trolley) and could be modified to help preserve other organs and to test the toxicity of new medicines.

To date, in a pilot trial at King’s College Hospital in London, two patients have been given livers kept alive by the new machine. In neither case have there been any complications. The first, 62-year-old Torbay man Ian Christie, was diagnosed with cirrhosis of the liver last May and told that, without a transplant, he could die within 18 months. He is delighted with the results.

Oxford’s Professor Constantin Coussios, who helped develop the device, is amazed at the success of the trials, while Professor Nigel Heaton, Director of Surgery at King’s, has described the new development as a potential “bona fide game changer.” He says that the extra time it affords gives patients extra options. Echoing these sentiments, Wayel Jassem, the surgeon who performed the transplants, says that the new technology represents a major breakthrough that could herald exciting changes in liver transplant practice.