The Royal Free London liver transplant services are very active in translational research to improve the success of liver transplantation, to improve the number of donor organs which can be used for transplantation, and to find new options to treat liver disease.
Mr Imber is leading a new trial on perfusing organs at normal body temperatures and the Royal Free London is one of only a handful of UK liver transplant centres to be part of the trial. By using special pumps which can keep the donor livers supplied with oxygen and energy outside the body, more organs can be kept in better condition during the transplant process. The new pump has already been used to treat some patients over the past year.
Prof Davidson and Prof Fuller are looking into using a different liver pump, at the moment using organs which cannot be transplanted because of concerns over their quality, to see whether changing the temperature, cooling the liver, or adding more oxygen can be helpful.
The Royal Free London team of liver transplant surgeons and anaesthetists have also started a trial to see whether patients undergoing liver transplantation can be helped to a quicker recovery by a process called conditioning, which is like exercise training of leg muscles during the operation, and may speed up the ability of the new liver to work well.
Prof Pinzani’s team is looking to the future, using liver pumps for the exciting possibility of taking unusable livers and turning them into ‘liver skeletons’, which can be filled new cells, such as stem cells, to make new livers for transplantation – but it will take some years to perfect this approach and make it ready for patients. Along the way, small buttons of the liver skeletons, with their cells, can be used to identify new drugs to better treat liver diseases and speed up development of new therapies for liver patients.