Evidence on the safety of extracorporeal whole liver perfusion for acute liver failure shows serious, well-recognised complications. Evidence on efficacy is inadequate in quantity and quality. Therefore, this procedure should only be used in the context of research. Find out what only in research means on the NICE interventional procedures guidance page.
Clinicians and centres doing this procedure must follow the relevant regulatory and legal requirements of the Human Tissue Authority and the procedure should only be done in accordance with the policies of the NHS Blood and Transplant (NHSBT) Organ Donation and Transplantation Liver Advisory Group. Details of any patient who has a liver transplant after extracorporeal whole liver perfusion for acute liver failure should be entered into the NHSBT UK transplant registry, and clinical outcomes should be reviewed locally.
Further research should report details of patient selection, the exact protocol followed, the type of liver used, and long-term immunological and microbiological surveillance. Outcomes should be reported in a way that allows the procedure to be compared with other current treatments.
The procedure should only be done in centres specialising in treating acute liver failure and liver transplantation by a multidisciplinary team experienced in managing this condition.