Boon for transplant patients: New machine can preserve liver for 24-hr

New Delhi: In a revolutionary medical development, a machine that keeps a liver "alive" outside the body for up to 24 hours before a transplant could have a "transformative effect" on organ waiting lists will be operational at Medanta Institute of Liver Transplantation, and many other hospitals in Delhi NCR.

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 enables doctors to test how well they function while on the machine prior to transplant, boosting the chances of successful transplantation. "We hope that with NMP (Normothermic Machine Perfusion) now available in India, 30 per cent more transplants would be possible, with improved results," said Dr AS Soin, Medanta Institute of Liver Transplantation.

With the NMP technology, oxygenated blood and nutrients pumps into the liver helps in overcoming the risk of graft injuries associated with preservation in ice.

He also added that 20-30 per cent transplants are turned down by surgeons due to damaged cells of liver – either prior to harvest or at the time of retrieval operation. Moreover, 5- 10 per cent liver do not function after the transplant. "15-20 per cent sustain damage during standard static cold preservation, take some time to function after transplant – delaying patient recovery, prolonging ICU stay, hospital stay and increasing costs to the patient," he added.

He further added that around 1,700 liver transplants are conducted in a year in India whereas nearly 2,50,000 die annually from liver failure and around 50,000 from liver cancer. "With the use of this technology, around 30-35,000 of these can be saved by liver transplant, Dr Soin added. According to NOTTO, nearly 4,300 patients were in the waiting list in 2017 out of which 640 patients got liver transplants.

Dr AS Soin, Chief Surgeon, Medanta Institute of Liver Transplantation and Scientific Advisor to OrganOx (Oxford, UK), said, "The machine is one of the advances in organ transplantation in the last 20 years. 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 that we turned down for transplant purposes due to mild damage, can now be revived using this technology."

Experts believe that with the new technology, the overall liver transplant cost will be reduced. The cost of liver transplant at present is around Rs 15 to 20 lakh, in which most of the expenses go when patients undergo in ICUs after transplant surgery. With this technology, the post-operation care days will also reduced.