Donor livers can only be stored outside the body for a short time, up to 6 to 10 hours. The organ must therefore get to the recipient as quickly as possible. As a result, transplants have always been under great time pressure. The UMCG has had an ‘Organ Preservation & Resuscitation’ unit since 2015. This is a room where donor organs such as livers, lungs and kidneys can be treated with oxygen-rich fluid in perfusion machines before transplantation. With the new perfusion techniques, organs can not only be better preserved but also tested just before transplantation. As a result, more organs can be made suitable for transplantation.
The protocol of this perfusion technique for testing donor livers has now been published in Nature Protocols. Head of the UMCG Comprehensive Transplantation Center Vincent de Meijer and surgical resident Otto van Leeuwen, wrote it together with Robert Porte, formerhead of the Transplantation Center and who now works in Rotterdam. De Meijer: ‘With this publication, the protocol is now accessible to every center in the world that performs liver transplants. We hope that as many centers as possible will start using this technique. It is safe for the recipients and ensures that we can give more patients a new liver and thus a new life.'
After UMCG started using this technique in 2015, other centers in the Netherlands (Rotterdam and Leiden) followed a few years later. De Meijer: ‘That led to us being able to do a record number of 253 liver transplants in the Netherlands by 2024. In Groningen we did 95, which is also a record. We can now make much better use of the available donor livers. Almost 70% of our transplants were done with livers that we first had ‘on the pump’. And almost all of these transplants take place during the day and have become schedulable, also as a result of our perfusion technique.'
Staff from transplant centers from Norway, Germany, Israel, Belgium and Australia have already visited the UMCG to take a look in the perfusion kitchen. De Meijer: ‘Don't run too fast’ we say to all centers, do it step-by-step. We always advise them to first gain experience with cold perfusion, where the livers are kept cool and flushed with perfusion fluid. That is a prerequisite before proceeding to hot perfusion, though.'
Apart from needing the right equipment to perform the perfusion technique, well-trained staff are also essential. Otto van Leeuwen was involved in the education program for organ perfusionists from the beginning. 'Worldwide, we are the only ones to organize the international organ perfusionist training program in the UMCG since 2022. A course for which students from all over the world apply every year. Every perfusion procedure requires the presence of 1 or 2 perfusionists. Without these professionals, you cannot perform the perfusion technique properly. '
