Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

Preserving livers at body temperature may improve transplant outcomes and increase viable donor liver numbers, thereby lowering waiting list mortality rates, reports a paper published online this week in Nature.

The current supply of viable donor livers isn’t enough to meet the demand caused by rising liver disease rates. The way we store donor livers today – in cold storage – means many livers must be discarded. The Consortium for Organ Preservation in Europe (COPE) clinical trial team at the Nuffield Department of Surgical Sciences, supported by CSM statistician Susan Dutton, tested whether maintaining livers at body temperature would mean fewer livers are discarded - so that more transplants can be carried out - and whether patients do better after transplant. The results were published online this week in Nature.

 

This research has the potential to profoundly improve liver transplants globally. - Dr David Nasralla

Many potential donor livers are deemed too high risk, because they are more susceptible to damage during the refrigeration used to preserve organs during transport between where the liver is donated and where the potential recipient is. Once a liver is in cold storage, normal cellular activity is suppressed, so we can’t test the liver’s viability until it has been transplanted and warmed up again. Instead, we could keep donor livers at body temperature and give them oxygenated blood, medication, and nutrients, as if they were on life support, using a process called normothermic machine perfusion. Livers can be kept like this for up to 24 hours. The process could one day allow us to monitor viability and even treat and repair the livers if needed.

David Nasralla and colleagues conducted the first randomized trial comparing conventional cold storage with normothermic machine perfusion in 220 liver transplant patients. They measured biomarkers of liver damage and found a 50% drop in graft injury and a 50% lower rate of organ discard when normothermic preservation was used instead of cold storage, even though the livers were preserved for 54% longer before transplant. In the year after transplant, the team found no significant differences in rates of bile duct complication, or graft and patient survival rates (as predicted by a clinically accepted biomarkers) between the different preservation approaches. "This research has the potential to profoundly improve liver transplants globally," says Dr Nasralla.

The device used for normothermic machine preservation was developed by OrganOx Ltd, a MedTech business spun-out from the University of Oxford as a result of a collaboration between Peter Friend (Nuffield Department of Surgical Sciences) and Constantin Coussios (Institute of Biomedical Engineering).

“It has been a while since proper innovation boosted organ transplantation,” writes Stefan Schneeberger in an accompanying Nature News & Views article. He explains that normothermic machine perfusion may substantially increase viable donor organ numbers and allow more time for transplants to occur.

Read more news coverage about this study on BBC Health News and University of Oxford News.

COPE is funded by a European Commission FP7 Award and is the official organ preservation task force of the European Society for Organ Transplantation (ESOT).

Similar stories

Immunology preprint reviews launched in Nature Reviews Immunology

Kennedy Main Research

The Oxford-Mount Sinai (OxMS) Preprint Journal Club has partnered with Nature Reviews Immunology to launch a monthly Preprint Watch column.

A more tailored approach to treating psoriatic arthritis

Arthritis Botnar Funding Main

Dr Laura Coates has been awarded £1.8M from the National Institute for Health Research (NIHR) to explore the potential for precision medicine in the choice of biologics to reduce inflammation and pain in psoriatic arthritis.

Motion-capture to help children walk: Oxford team support new gait laboratory in Ethiopia

Main Orthopaedics and trauma

The Research at Oxford on Analysis of Motion (ROAM) team at the University of Oxford have supported CURE Ethiopia Children’s Hospital to develop and open a brand new gait laboratory, the first of its kind in the country and the only other active gait lab on the African continent outside of South Africa.

Professor Eleanor Stride recognised in New Year’s Honours list 2021

Awards Main

Statutory Professor of Biomaterials is awarded Officer of the Order of the British Empire (OBE) for services to Engineering

Drug may boost vaccine responses in older adults

Kennedy Main

A preliminary study shows that a drug which helps immune cells self-clean may improve vaccine protection in older adults

Living reviews launched by Oxford and Cardiff in the wake of COVID-19 research

Kennedy Main Research

In a combined effort to help COVID-19 researchers the University of Oxford and Cardiff University have launched a series of “living reviews” in Oxford University Press’s new open access journal “Oxford Open Immunology”.