People identified as needing a liver transplant are placed on a waiting list for a donor liver. The waiting time for a suitable liver can vary quite a lot: the average waiting time for a liver transplant for adults in the UK is 4 months (NHS B&T). Previously static cold storage (SCS) was the gold standard preservation strategy. This involves the donor liver being flushed with cold organ preservation solution and placed in a sterile bag in a cold storage icebox for up to 4 hours, aiming to minimise liver degradation. This is done by a specially trained team before being transferred to the selected hospital for transplant as soon as possible, to minimise ischaemic damage to the organ. Whilst this approach is still used, increasingly preservation strategies are also being used to try and utilise donor organs and meet rising demand. As a result machine perfusion devices are currently in use across all 7 specialist liver transplant centres by special arrangement only, funded charitably in all cases. Arrangements of which devices, how and when they are used varies across centres with great disparity in access currently. Machine perfusion devices provide the opportunity to carry out functional viability testing of the liver for clinicians to determine if it is appropriate to transplant for positive outcomes for the recipient. Machine perfusion devices also support preservation for an extended period of time (up to 24 hours), enhancing donor organ sharing by removing geographical and transportation barriers with the potential to reduce discarded organs and inequity of access.
 
Status Awaiting development
Technology type Device
Decision Selected
Reason for decision Anticipate the topic will be of importance to patients, carers, professionals, commissioners and the health of the public to ensure clinical benefit is realised, inequalities in use addressed, and help them make the best use of NHS resources

Timeline

Key events during the development of the guidance:

Date Update
04 March 2025 Awaiting development. Status change linked to Topic Selection Decision being set to Selected