Transplantation of discarded livers following viability testing with normothermic machine perfusion

Hynek Mergental, Richard W Laing, Amanda J Kirkham, M Thamara P R Perera, Yuri L Boteon, Joseph Attard, Darren Barton, Stuart Curbishley, Manpreet Wilkhu, Desley A H Neil, Stefan G Hübscher, Paolo Muiesan, John R Isaac, Keith J Roberts, Manuel Abradelo, Andrea Schlegel, James Ferguson, Hentie Cilliers, Julian Bion, David H AdamsChris Morris, Peter J Friend, Christina Yap, Simon C Afford, Darius F Mirza

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28 Citations (Scopus)
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There is a limited access to liver transplantation, however, many organs are discarded based on subjective assessment only. Here we report the VITTAL clinical trial ( number NCT02740608) outcomes, using normothermic machine perfusion (NMP) to objectively assess livers discarded by all UK centres meeting specific high-risk criteria. Thirty-one livers were enroled and assessed by viability criteria based on the lactate clearance to levels ≤2.5 mmol/L within 4 h. The viability was achieved by 22 (71%) organs, that were transplanted after a median preservation time of 18 h, with 100% 90-day survival. During the median follow up of 542 days, 4 (18%) patients developed biliary strictures requiring re-transplantation. This trial demonstrates that viability testing with NMP is feasible and in this study enabled successful transplantation of 71% of discarded livers, with 100% 90-day patient and graft survival; it does not seem to prevent non-anastomotic biliary strictures in livers donated after circulatory death with prolonged warm ischaemia.

Original languageEnglish
Article number2939
JournalNature Communications
Issue number1
Publication statusPublished - 16 Jun 2020

ASJC Scopus subject areas

  • Chemistry(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Physics and Astronomy(all)


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