In a first for San Diego County, physicians at Scripps Green Hospital have used a warm perfusion transportation system to bring a donated liver to La Jolla where they implanted the organ into a 36-year-old Las Vegas police officer who had been on the transplant waiting list for more than nine months.
The effort was part of a clinical trial evaluating the transportation system, known as OCS (Organ Care System) Liver, at major transplant medical centers across the United States.
“We are constantly challenged by a shortage of livers to meet the transplant needs of our patients,” said Christopher Marsh, MD, a Scripps Clinic organ transplant surgeon and division head of Scripps Center for Organ and Cell Transplantation. “Warm perfusion transportation has the potential to expand the supply of organs that are available to our patients and, as a result, improve the chances of a successful transplant and a positive long-term health outcome for more of our patients.”
While more than 8,200 people received a transplanted liver in the United States last year, according to United Network for Organ Sharing, that figure falls far short of the 13,318 people who currently are on the waiting list and 12,000 new patients who are added to the list every year.
Scripps Green is the first hospital in San Diego County to participate in the PROTECT clinical trial and one of only three participating sites on the West Coast. The randomized study, which aims to enroll a total of 300 transplant patients, is designed to evaluate the effectiveness of OCS Liver for preserving and accessing donor livers for transplantation.
Traditionally, donated livers are placed on ice inside an insulated container – quite literally a cooler – and transported over relatively short distances within regions to ensure their preservation.
The OCS transportation system changes that paradigm by moving the liver in a heated portable carrier where the organ is connected to a pumping system that maintains a steady flow of oxygen-rich blood from the donor along with stabilizing fluid (a complex mixture of nutrients, electrolytes and hormones), mimicking the liver’s natural function in the body. Theoretically, the system allows for transportation over much greater distances and for longer periods of time to a waiting patient without compromising the organ’s viability.
In addition to maintaining a normal body temperature, the new transportation system lets the liver continue to clear acid and produce bile, which is used in the body in the small intestines to help digest fats and fat-soluble vitamins. The system also allows doctors to continuously monitor the function and health of the organ while it is being moved.
The patient who received the liver, Jonathan Hovan, needed the organ as part of his treatment for liver cancer, which was diagnosed last July.
Early in the morning of June 26, Dr. Marsh traveled to Palomar Medical Center in Escondido where he recovered the donated liver, connected it to the transportation device’s pumping system and traveled with the entire system to La Jolla in an ambulance. Once at Scripps Green Hospital, Dr. Marsh removed the liver from the transportation device more than six hours after the organ was first attached, and he prepared it for implant.
Drs. Marsh, Schaffer and Scripps Clinic transplant surgeon Jonathan Fisher, MD, all received special training on the use of OCS Liver earlier this year in Boston. They expect to enroll nine more patients using the mechanical system in the clinical trial over the next year.
Learn more about Scripps Health, a nonprofit integrated health system in San Diego, Calif.