In yet another first, Apollo Hospitals, Chennai successfully performed liver transplantation using OrganOx Metra, a new organ preservation device; the first in Tamil Nadu and across the Apollo Hospitals Group in India to do so . In the conventional method, liver preservation requires storage in a cold solution or ice, during surgery whereas OrganOx Metra device maintains livers for transplant at optimal body temperature and helps in improving tissue quality, further reducing the discard rate of organs that are suitable for transplantation.
The traditional method of organ preservation requires cooling and storage in an ice box or cold solution, hence the liver lasts up to 8-10 hours only, outside the body. Normothermic machine perfusion with the OrganOx Metra device maintains the liver at normal body temperature before transplantation surgery and delivers oxygenated blood, medications and nutrients. OrganOx Metra can retain a liver healthy outside the body for upto 24-hours. This significantly reduces the tissue injury associated with transplantation and enables quality assessment by functional testing of the organ.
Cirrhosis caused by chronic hepatitis, fatty liver or long-term alcohol abuse are the most common reasons required for a liver transplant. Nearly one-fifth of the patients die on the waiting list for liver transplantation, due to the lack of suitable organs. Only 70% of the deceased donor livers, leads to liver transplantation with a high discard rate for marginal donors. The ever increasing demand for organs for liver transplantation coupled with the scarcity of suitable cadaver livers has led to variable use of marginal livers. The sub-optimal livers do not tolerate the conventional cold storage, thus increasing the potential risk of organ dysfunction leading to liver failure and death in the patient.
The transplant using OrganOx was successfully performed at Apollo Hospitals, Chennai on a 66-year-old patient. Mr. S. Rajendran who had liver cirrhosis due to non-alcoholic fatty liver disease needed a transplant to save his life. The cadaver marginal liver was obtained from an elderly donor aged 65 years. The liver was put on the machine and real time monitoring of the performance of the liver was done by checking continuous data on parameters such as bile production, lactates and sugar levels. Bile production, the single most important factor in deciding the functionality of the organ was produced in copious amounts.
Speaking during the press conference, Dr. Mohammed Nayeem, Senior Consultant, Apollo Liver Transplant Institute said, “The use of this machine enabled us to discharge the patient on the sixth post-operative day without any complications, thus markedly reducing overall hospital cost. The minimal ischemia-reperfusion injury because of the liver placed on the machine was reflected in the lower peak liver enzyme levels in the post-operative period.”
“The machine also enables the logistics of transportation of the organ to a far off place, as the organ can be preserved on the machine for up to 24-hours before use in the patient as opposed to less than 8-10 hours on the cold storage”, said Dr Anil Vaidya, the Multivisceral transplant surgeon.
