The Telegraph
Since 1st March, 1999
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Organ transplant breakthrough in UK

London, June 6: British doctors have discovered an organ transplant technique that can preserve kidneys and livers for longer after death in a breakthrough that is expected to save hundreds of lives.

Medical advances in surgical and preservative methods have allowed doctors at King’s College Hospital in London to transplant livers from donors whose hearts have already stopped beating.

So far, 31 adults and children have received the life-saving transplants at the hospital. If, as expected, the technique is adopted across Britain, Europe and the US, tens of thousands more life-saving transplants could take place each year.

The practice of taking organs from people whose hearts have stopped beating was abandoned in the 1970s because the tissue from such donors was already beginning to decay. At present, organs are only used if they are removed immediately the heart stops, usually after a life-support machine has been switched off.

The King’s College doctors have adopted new methods, however, which allow organs to be removed from corpses five minutes or more after the heart has stopped beating.

Paolo Muiesan, one of the centre’s transplant surgeons, said that the technique was already providing an important source of new organs. “This could increase the availability of livers by 10 per cent and kidneys by 25 per cent. Even if it provided just one extra organ it would save another life and be worthwhile,” he said. “It will increase the donor pool and reduce pressure on an over-stretched, life-saving service.”

About 65 people in Britain die each year awaiting a liver transplant. Unlike patients needing kidneys, people with liver disease are not able to use dialysis to keep them alive.

Muiesan and his colleagues are using new types of tubing that allow better access to blood vessels. They also rely on improved techniques of cooling and preserving the organ once it has been removed from the donor. Other hospitals, including nearby Guy’s in London and some American centres, are using similar methods to transplant kidneys and pancreases from “non-heart-beating donors”. In addition, the transplantation of hearts from such patients is being investigated.

Muiesan said that as the technique became more widespread, it would allow families to agree to the donation of organs after the sudden death of a patient, when previously it would not have been possible. “The non-beating heart donor programme allows the wishes of those wanting to donate to be respected,” he said.

Among the beneficiaries are Haniyeh Shademan, seven, who had her failing liver removed last month by surgeons at King’s and replaced with the liver from a 10-year-old “non-heart beating” donor. Two weeks later she is running around smiling.

Haniyeh was placed on the transplantation list after doctors realised that a rare genetic disease was destroying both her liver and kidneys.

“The liver was producing substances that were toxic to her kidneys,” said Jill Wilson, the hospital’s paediatric transplant co-ordinator. “If we hadn’t used a non-heart beating donor, they would have had to wait at least twice as long.”

Her father Reza Shademan, 39 and mother, Nasreen, 33, from Roehampton, said that a year ago they had expected their daughter to die. “Everyone, from our GP to all the doctors and nurses and all the staff has been brilliant,” said Nasreen Shademan. “We have been through hell in the past year, but we now have hope.” At present, for a transplant to take place a patient has to be either brain dead or to have a heart that has stopped beating.

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