Organ saved for transplant by pumping it with oxygenated blood and nutrients in pioneering approach set to save hundreds of lives
The first of hundreds more lifesaving transplants has been made possible thanks to a new technique being pioneered on the NHS.
More usable organs will be retrieved by pumping them with oxygenated blood and nutrients. The first of such organs has been saved as part of the NHS pilot which is forecast to eventually increase the number of organ transplants by nearly 20% a year. It comes with the NHS transplant waiting list at a record high after a post-pandemic drop in donors.
A liver was retrieved from a deceased donor and transported to the new Assessment and Recovery Centres (ARC) at the Royal Free Hospital where it underwent the organ-boosting process using a machine called an OrganOx Metra.
This “machine perfusion” enabled surgeons to perform extra testing which gave them the reassurance the liver would be suitable to transplant safely. It was then transported to Kings College Hospital and transplanted into a patient on the waiting list. ARCs are now being set up with organ boosting machines at 15 hospitals across England.
Derek Manas, medical director at NHS Blood and Transplant (NHSBT), said: “This transplant is a seminal moment and a breakthrough in the UK’s organ donation and transplantation network.
“The ARCs could unlock a step change in organ transplantation at a time when the transplant waiting list is at an all-time high of more than 8,000 people.
“If the pilot is successful and a full national ARC model is introduced, it would be the first nationwide network of its kind in the world, with more than 700 more transplants a year.”
Medics have to make quick decisions on organ retrieval in the moments after someone dies. Some organs are not transplanted because in the short time when decisions have to be made, it is not clear they are of good enough quality to be safely transplanted.
By circulating oxygenated blood, medications, and nutrient-rich fluids through the organ at a specialist centre, surgical teams have more time to test and assess the organs. That can reassure clinicians that some of these organs are healthy enough for transplant after all.
Time is critical because transplants usually need to take place within a few hours of retrieval from the donor. Machine perfusion enables up to 24 hours of extra testing and decision making which can make all the difference. Until now many organs which could probably be transplanted go unused because there is so little time for testing and assessment.
Consultant David Nasralla, a liver transplant surgeon at the Royal Free, said: “This is a milestone moment which will hopefully lead to many more successful transplants and lives saved. For the UK and NHSBT to pioneer the approach is ground-breaking and it has galvanised the entire transplant community.”
It comes as the NHS transplant waiting list is at a record high with thousands of people waiting and dying before they get an organ. The rate of bereaved families supporting donation has dropped to 59%, down from 68% before the Covid-19 pandemic
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The law change which came into force in 2020 and was credited with helping keep organ donation going during the Covid crisis. It meant there would be a presumption in favour of donation but bereaved next of kin would always retain their right to veto transplants. More families have vetoed transplants since the pandemic and the reason for this is unclear.
The NHS states that it is vital that people sign the Organ Donor Register to make their wishes clear, in case the worst happens. Wasting fewer organs is seen as one answer to tackling the record transplant waiting list. In the past decade nearly 5,000 people have died waiting for a life-saving transplant.
ARCs are being set up at 15 hospitals specialising in different organs such as kidneys, livers and hearts. If the pilot is successful the ARC system will become the standard of care nationwide.
NHSBT estimates it will enable 750 extra liver, lung, and kidney transplants each year by 2030. In future organs will receive not just extra assessment but have their function boosted with surgical repairs, blood type changes and cell therapies.
Miriam Cortes-Cerisuelo, clinical lead for transplant surgery at King’s College Hospital, said the organ-saving procedure was “groundbreaking”. She said: “Over recent years there have been huge strides in organ donation and transplantation and this has the potential to be the next step in saving patients’ lives.
“We are excited to see how being part of this pilot could help transform the way we care for liver patients in the future, bringing hope to the thousands of people who are waiting for an organ donation.”
To find out more and to register an organ donation decision call 0300 123 23, visit organdonation.nhs.uk or use the NHS app.
