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‘Warming’ Of Liver Similar To Body Temperature Improves Organ Quality For Transplant

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Preserving livers in a warm storage similar to body temperature, instead of in iced-cold solutions, improves its quality and viability for organ transplantation.

A randomized clinical trial, the first of its kind, tested the quality of organs for transplant when kept in warmer temperature versus a cold storage. Researchers said this approach improves the quality of the tissues, which can prolong the survival of liver transplant recipients.

Experts said that the perfusion machine called metra (a Greek word for womb) can increase the supply of livers viable for transplant by 20 percent. It has been a longstanding practice that donor livers are preserved in ice until it is ready for transplantation.

"There's a huge issue in terms of the [high] number of patients compared to donor organs, and yet we're not using all of the donor organs that are available. If we can go some way towards utilizing the livers that are not transplanted it would have a major impact," study co-author Professor Peter Friend told BBC.

Injuries To Donor Organs

A total of 220 transplant recipients who had liver failure were enrolled in the clinical trial. The participants were randomly selected to receive a liver that was warmed up on the metra device or preserved on ice.

Researchers noted that the livers that were hooked up on the metra machine had 50 percent decrease in enzymes that cause tissue injuries.

The rate of allograft dysfunction, a fatal complication in liver transplants, was 10 percent compared to 30 percent for organs preserved on ice.

The authors reported that "the study means that the donor-livers were equally viable at the point of organ retrieval, regardless of preservation technique. However, transplant surgeons in the study had to discard twice as many of the livers kept on ice as organs on the metra."

Dr. David Nasralla, a transplant surgeon at the University of Oxford, noted that there is evidence on the functionality of the livers after it was kept on the metra machine.

He said that "a lot of surgeons" felt that the livers from the metra machine were safe for transplant when they could have felt otherwise if it was preserved the traditional way.

Nasralla said there are more benefits in using the metra because clinicians are able to continuously monitor vitals such as blood flow, bile production, and lactate clearance.

Jedediah Lewis, chief executive of the ‎Organ Preservation Alliance, explained that warm preservation allows for other procedures to take place like stem-cell treatments and gene therapy to further improve the organs.

The study was published April 18 in Nature.

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