Perfused Liver Utilisation Study (PLUS) v1.0 13/08/2021

  • Research type

    Research Study

  • Full title

    Utilisation of normothermic machine preservation in extended criteria livers - a national threshold-crossing study

  • IRAS ID

    283200

  • Contact name

    Trials & Research Governance

  • Contact email

    ctrg@admin.ox.ac.uk

  • Sponsor organisation

    University of Oxford / Clinical Trials and Research Governance

  • ISRCTN Number

    ISRCTN11552402

  • Duration of Study in the UK

    4 years, 11 months, 30 days

  • Research summary

    The supply of suitable livers for transplantation is lower than the number of patients who could benefit. More than 10% of patients on the waiting list die before receiving a transplant. Less than 2/3 of deceased donors in the UK result in a liver transplant, because livers from many donors are less suitable, due to older age or medical conditions, and are more likely to cause complications. To use these organs, we need to find better ways to preserve and test livers so that more of the available livers can be transplanted safely.

    Normothermic machine perfusion (NMP) is a novel method of organ preservation which replaces the icebox, using a machine which restores the flow of blood at body temperature allowing the liver to function during storage. Previous studies have shown substantial reductions in injury and suggested that transplant surgeons could accept higher risk organs with confidence, mainly due to the ability to assess function prior to transplant. However, these studies were not primarily designed to test the effects of NMP on organ use, and there remains a need to assess fully whether this complex and expensive technology should become the standard of care.

    The NMP device in this study has already been used in small numbers of transplants in the UK’s seven liver transplant units. This mostly relies upon charitable funding, because this technology has not yet been funded by NHS commissioners.

    We will identify offers of donor livers less likely to be used and make the NMP machine available for storage and assessment. We will compare the proportion resulting in successful transplants with a group of offers where NMP was not used to see if a pre-defined threshold for increased use is met. We will also collect information about the cost-effectiveness of the new technology compared to the old.

  • REC name

    South Central - Oxford C Research Ethics Committee

  • REC reference

    21/SC/0297

  • Date of REC Opinion

    10 Nov 2021

  • REC opinion

    Further Information Favourable Opinion