New Delhi: A new machine OrganOx metra is all set to revolutionize cadaver liver transplant in India. It will not only keep livers from the brain dead alive up to 24 hours outside the body before transplantation, it will revive them too, if they get damaged in course of retrieval and transportation.
The upshot: more organs would be available for transplant; there would be whale of a time to transport donated liver from one place to another. The liver preserved through this machine is making the transplant almost a sure success all over the world.
Dr. A.S Soin, Chairman and Chief Surgeon, Medanta Institute of Liver Transplantation, and Scientific Advisor to OrganOx (Oxford, UK), today (May 10) launched this machine for the first time in India. The new technology completely changes the way cadaver donor livers are preserved to prior to transplant. Talking to Medicare News, Dr Soin said, ‘Ideally, this new way of preserving donated liver should be the rule rather than exception. I hope soon it will be so in India. It will not only increase the transplant rate, it will substantially ensure very high success rate as well.’
Dr. Soin further said, ‘The machine is one of the most important advances in organ transplantation in the last 20 years. Livers maintained on NMP (Normothermic Machine Perfusion- Organox metra) prior to transplant will work better, making the transplants safer. This technology will also help in transporting the liver easily from one place to the other as the machine can keep the organ alive for up to 24 hours. Another advantage is that many of the organs (20-30% of the livers retrieved) that we turned down for transplant purposes due to mild damage, can now be revived using this technology. We hope that with NMP now available in India, 30% more transplants would be possible, with improved results. The real advantage would accrue to them (5-10%) whose liver do not work after transplant.’
OrganOx and its exclusive partner in India, Duraent Lifesciences, have come up with this new state-of-the-art liver transplant technology. The groundbreaking procedure called Normothermic Machine Perfusion (NMP) developed by OrganOx, a company spun out of the University of Oxford, will replace the cold preservation technique and keep the organ alive up to 24 hours after it has been removed from the donor.
Offering a totally new approach, NMP technology pumps oxygenated blood and nutrients into the liver and helps in overcoming the risk of graft injuries associated with preservation in ice. Being deployed for the first time in India and Asia, the machine will help newly donated livers by brain dead donors to survive longer and, crucially, enable doctors to test how well they function while on the machine prior to transplant, boosting the chances of successful transplantation.
The first transplant in India took place on last month at Aster CMI Hospital in Bengaluru on a 56-year-old patient. The patient made a quick recovery and was discharged in a couple of weeks.
Speaking at the launch, Mr. Subith Kumar, CEO, Duraent Lifesciences, Hyderabad, said, ‘Earlier, the harvested livers were flushed with preservation fluid and then stored on ice, at times resulting in damage of the cells, especially when preserved for more than 10-12 hours. With the introduction of this new technology, we believe that doctors will get livers for transplantation without such damage. The machine helps to improve tissue quality and reduces the discard rate of organs that are suitable for transplantation. We hope this will enable many more life-saving liver transplants for patients suffering from liver failure.
There are 5 key advantages of this new technology.
– By providing the organ with oxygenated blood and nutrients the donor organ does not degrade over time, unlike the current standard of care of storing the organ in ice.
– The transplanting team can assess the function of the donor liver before the transplant; this allows some organs to be safely transplanted which may otherwise have been not transplanted.
– The transplant can happen in the daytime, this is because with the OrganOx metra® the preservation time can be doubled to 24 hrs.
– The additional preservation time provides the transplanting team with more time to deal with any complications; this may allow some patients to be transplanted who would otherwise not be offered a transplant.
– Finally, the new approach is CE marked and been deployed in more than 300 transplants in Europe, the US and Canada. Furthermore, results from the world’s first randomized clinical trial* of NMP with the OrganOx metra® were published on-line by the science journal Nature1 on 18th April 2018. These results show NMP to be superior to the current standard of care of preserving the donor organ on ice. Further details of the European clinical trial are provided below.