For the first time in the Netherlands doctors have refurbished a rejected donor liver in a perfusion machine and transplanted the liver. The patient is doing very well.
"This is great because now we can expand the donor offer by making more donor livers suitable for transplantation," says Robert Porte, liver transplant surgeon at the UMCG. "Increasingly, donors have diabetes and overweight conditions, which make their organs of lesser quality. Nevertheless, it is important that these organs are used for transplantation as there is still a large deficiency of donor organs. "
The transplantation is part of a trial, in which a donor liver, which has poor quality at the hospital, is first refurbished in a perfusion machine. This perfusion machine is from OrganAssist, a spinoff from the UMCG. How does this donor liver work? The donor liver was first rinsed with a special, cold oxygen-rich liquid and then gradually warmed to 37 degrees. This caused the liver to function again: the color and acidity of the donor liver became normal again. The liver was tested outside the body for a number of hours and was then successfully transplanted into the patient. According to the UMCG, the patient is doing well.
Global scoop with new perfusion fluid
The normal protocol is that donor organs are refrigerated on ice and transported to the transplant center. You can not test vitality and function. For this reason, the donor body must be warmed to 37 degrees again, so that the metabolism will return and it will function as in the body. In a cold donation the metabolism is almost silent. In order to warm up and test a donor liver on the perfusion machine, a special fluid has been developed in the UMCG. The nice thing is that no donor blood is needed to flush the organ. In addition to nutrients, the liquid contains a special protein that can transport oxygen at both low temperatures and body temperature. With this new perfusion fluid, the UMCG has a world premiere.
From unusable to usable!
In 2016 159 liver transplantations took place in the Netherlands. There are more donors, but a large number of donors are already considered unsuitable for transplantation. The UMCG expects that with this new technique some of those initially rejected livers may prove to be suitable for transplantation.