In 2018, the UMCG carried out 73 liver transplants. On average around 60 liver transplants were done in the past few years, and in 2017 there were 56. This increase of around 20 percent is almost completely due to the use of normothermic machine preservation of donor livers that were rejected for transplantation in the first instance. With this innovative technique developed at the UMCG, more donor livers can be made suitable for transplantation. The results of the transplants made possible by this technique have been very good so far. So far, there is a 100 percent transplant and patient survival rate.
In this technique developed at the UMCG, donor livers of an initially insufficient quality are ‘refurbished’ in a perfusion machine. The donor livers are rinsed with a special, cold oxygen-enriched liquid before being gradually heated to a temperature of 37 degrees, to bring them ‘back to life’. It can then be tested whether the acidity of the donor livers has returned to normal and whether the livers have begun producing bile again. Once they have been thoroughly tested outside the body, the livers can be successfully transplanted into the patients.
The UMCG has developed this special perfusion solution with a synthetic oxygen carrier that enables donor livers to be heated on the perfusion machine before being tested. In the development phase, the UMCG collaborated with HbO2 Therapeutics from the US. Thanks to the solution, donor blood is no longer needed to perfuse the donor organ. In addition to nutrients, the solution contains a special protein (Hemopure) that can transport oxygen both at low temperatures and at body temperature.
The results of the first transplants using initially rejected livers that were ‘refurbished’ by machine perfusion were published in the leading journal American Journal of Transplantation at the end of December 2018.