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UK health agency issues draft guidance on in-situ liver perfusion procedure
Draft guidance from the National Institute for Health and Care Excellence recommends a new method to preserve donor livers inside the body after circulatory death. Officials estimate the approach could add about 150 transplants annually. Separate guidance also covers external preservation machines.
Jul 7, 7:02 PM·1m read1 source
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The National Institute for Health and Care Excellence released draft guidance on a procedure that keeps donor livers supplied with oxygen inside the body for roughly two hours after the donor's heart stops. The method, called in-situ abdominal normothermic regional perfusion, allows the organ time to recover from damage while still in place and gives medical teams additional time to assess viability.
Current practice flushes livers with cold fluid and packs them in ice immediately after removal, which can cause damage. In 2024/25, 727 livers were donated after circulatory death in the UK, but only 309 were transplanted.
External preservation option Separate draft guidance recommends specialist machines that store livers outside the body in a protective solution. NHS Blood and Transplant estimates wider use of the in-situ method could produce around 150 additional transplants each year.
Dr Anastasia Chalkidou, health tech programme director at Nice, said the evidence shows the procedure works as well as or better than existing methods and has a good safety record. Vanessa Hebditch of the British Liver Trust said the approach could increase the number of viable donor livers available for transplantation.
