A PROCEDURE assessed by NICE (National Institute for Health and Care Excellence) and used in research led by the University of Birmingham has been hailed as an exciting development in increasing the number of livers which can be safely used for transplantation.
Liver transplantation is a highly successful treatment for end-stage liver disease, which kills 11,000 people a year in England. Deaths from liver disease have soared by 25 per cent in a decade and continue to rise, while the average age of death from liver disease (currently 50-59 years) continues to decrease.
Today NICE has issued final guidance which recommends the procedure — ex-vivo machine perfusion for extracorporeal preservation of livers for transplantation — is used under special arrangements as more data is gathered into its efficacy.
NICE’s independent advisory committee did not identify any major safety concerns.
NHS England and commissioners will decide whether they fund the procedure. However research is already taking place at centres around the UK including studies by experts from the University of Birmingham’s Centre for Liver and Gastrointestinal Research in the Institute of Immunology and Immunotherapy, University Hospitals Birmingham NHS Foundation Trust’s Queen Elizabeth Hospital Birmingham, and the National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre.
University of Birmingham Honorary Professor Darius Mirza, Consultant Transplant Surgeon at University Hospitals Birmingham NHS Foundation Trust, said: “In the 30 years I’ve been involved with transplantation there have been three or four events which have been game changers and I’m absolutely certain we are looking at a game changer that will change the way we practice organ storage and transplantation.
Sue Bennett, 45, a mother of three from Ranton in Staffordshire, had a liver transplant using this new technique in 2015.
She said: “I signed up for the trial not knowing I would be one of the first to have this procedure in the country. Before my transplant I was very ill. I was losing weight, I couldn’t sleep and my quality of life was quite low.
“Having a transplant has changed my life. I‘ve joined the gym, got fit and gone back to work and did some voluntary work for the Staffordshire Search and Rescue team and I also compete nationally and internationally in the Transplant Games as a member of the Team GB transplant team.
John Forsythe, associate medical director at NHS Blood and Transplant, said: “There has been a huge amount of research in the area of preservation and perfusion methods that allow us to both assess precious donor organs and to enhance their function. This could potentially mean the organ works better and improve transplant outcomes.
“Many of the lead researchers in the area of transplant preservation and perfusion techniques are in UK and it is good to see UK researchers continue to be at the forefront in this field.
Vanessa Hebditch, director of policy at the British Liver Trust said, “Every year hundreds of people with advanced liver disease die whilst waiting for a transplant.
“This new device offers real hope as it may improve transplant outcomes and allow livers that were previously thought to be unsuitable to be used and also increase the time that livers are able to be kept.
For the financial year ending 31 March 2018, there were 1,043 liver transplants in the UK and 359 patients on the UK active transplant list, according to NHS Blood and Transplant.
The number of patients on the active transplant list reached a ten year high in 2015 when 611 patients were on the waiting list. However the large drop attributed to the 2018 figure may be due to the introduction of the National Liver Offering Scheme (NLOS) in March 2018.