Thousands of donated livers could be saved by warming them

Keeping donated livers at body temperature may be preferable to the traditional technique of putting them on ice, new research has found.  

After being harvested, donated livers are typically stored in ice boxes while they wait to be transplanted. 

With this method, a large percentage of the organs don’t last until it’s time to transplant and thousands of donor recipients die while waiting.

A British study has found that a machine that keeps livers functioning by pumping them full of blood and nutrients while they’re waiting to be transplanted could lead to 20 percent more donations.

While the results are promising, skeptics say they won’t be ditching their ice boxes for the far more expensive approach any time soon.

Liver donations kept at body temperature with a new machine are 20 percent more likely to be transplanted, according to a new study from Britain (stock image)

‘This research has the potential to profoundly improve liver transplants globally,’ said lead researcher Dr David Nasralla of the University of Oxford.

‘Simply by changing the way donor livers are preserved prior to transplantation improved the survival of livers compared with cold storage, which improved both the transplant success rate as well as the number of livers available for transplant. 

Nearly 115,000 people are on the waiting list for an organ transplant in the US.

Last year there were just 34,770 transplants performed in part because there are too few donations. 

Also, donated organs can’t be stored for long — about four to six hours for a heart or lung, and about 12 hours for a liver.   

When in an ice chest organs essentially hibernate, not frozen but cold enough to slow cellular activity and thus their deterioration.

Liver donations that were put on new machine that acts as life support were much more likely to be transplanted, Dr Nasralla said.

Similar technology is also being explored for heart and lung transplants.  

‘The normothermic machine perfusion technique maintains donor livers at body temperature for up to 24 hours, supplying the organs with oxygenated blood, medications and nutrients — much like a patient on life support,’ Nasralla said. 

‘The benefit was most pronounced in donor livers that were more marginal to begin with.’ 

The new study published this week involved 220 liver transplants performed in Britain, Belgium, Germany and Spain. 

Participating hospitals randomly assigned newly donated livers to be put into coolers as usual — or to be stored for up to 24 hours in a machine made by Britain’s OrganOx Ltd. that keeps the organs functioning with warm fluids.

The researchers said the study wasn’t big enough to detect any potential differences in patient survival, but that the warmed livers were found to be healthier when transplanted.

They had less cellular damage during storage, a risk for transplant failure, than the livers kept on ice.

Surgeons were able to preserved the warmed livers several hours longer and discarded fewer of them, ultimately transplanting 20 percent more of those organs than the cooled ones, the study found. 

The results are promising but surgeons are watching for more evidence that such a big, and expensive, change in organ storage is worthwhile — and if so, when best to use it, Dr Devin Eckhoff, transplant division director at the University of Alabama at Birmingham, told AP.

OrganOx’s liver machine is approved abroad but experimental in the US, where a similar study is underway at 14 transplant centers including Eckhoff’s. 

A competing company, Massachusetts-based TransMedics Inc., recently gained Food and Drug Administration approval for warm preservation of donated lungs.

‘It’s clearly a lot more expensive than an ice box,’ OrganOx co-inventor Peter Friend told AP. 

Friend couldn’t provide exact costs and said more research is needed to tell whether spending thousands more up-front on high-tech organ preservation might prove cost-effective if it lets doctors save organs that otherwise would be wasted or postpone middle-of-the-night transplants until morning.

UNOS’ Klassen says the bigger question is if scientists might use such machines to ‘recondition’ organs, by adding medications or other therapies to make them healthier before transplant.