In practical terms, normothermic perfusion means placing the liver in a dedicated machine which allows blood flow to be reproduced in the organ and observing how it functions outside the human body. This method helps to ensure that the liver works correctly and that it is definitely suitable for transplantation prior to transplantation.
And how did the entire procedure progress? The organ was explanted from a deceased donor. After explanation, the liver was transported to the transplant centre in a state of so-called cold ischaemia, i.e. at 4 degrees Celsius. When she arrived at our Clinic, she was placed in a perfusion machine. The machine’s blood delivery system was filled with specially enriched blood at 36 degrees Celsius. The liver was “connected” to the machine through the arterial system and portal vein – thus restoring the vasculature in the harvested organ. Thus, conditions have been created that allow liver function to be assessed outside the recipient’s body and a decision to use it (or not) for transplantation to be made.
Until now, it was only possible to find out whether the liver would take up its function only after an organ transplant has already been carried out. And it must be stressed that failure to gain function is one of the most serious complications after transplantation and poses a direct threat to the patient’s life. The introduction of the normothermic perfusion method significantly reduces the risk of this complication, and the ability to observe a living, functioning organ in an extracorporeal machine is one of the most important developments in modern transplantology.
During the procedure performed at our Clinic, the liver perfused under normothermia functioned outside the body for 8 hours, producing bile and showing all the characteristics of normal function. Therefore, our specialists decided to move ahead with implanting it in the recipient. The team from the Department of General, Transplant and Liver Surgery has thus joined the small group of the most specialised liver transplant centres in the world. That was quite the special occurrence for the “Polish Liver Transplantation Programme.”
The procedure of organ harvesting and perfusion under normothermia was performed by a team consisting of: lek. Marcin Morawski, lek. Jan Stypułkowski, lek. Mateusz Bartowiak, lek. Andrey Zhylko i mgr Marzena Kaczmarska, all supervised by prof. Michał Grąt.
Liver transplantation performed: prof. Michał Grąt, dr Maciej Krasnodębski i lek. Adam Bołtuć and hepatectomy performed dr Ireneusz Grzelak, dr Łukasz Masior i dr Marcin Rychter assisted by instrumental five nurses mgr Anny Wąsik i lic. Joanny Stasiak. The anaesthesia was carried out dr Paula Dudek in the company of anaesthesiologist nurse mgr Joanna Kosińskia and mgr Piotr Wesołowski. The entire procedure was coordinated by mgr Krzysztof Zając.