• The technology described in this briefing is OrganOx metra. It is a device for normothermic machine perfusion to preserve donor livers before transplant. Several alternative devices offering hypothermic and normothermic perfusion exist on the market.

  • The innovative aspects are that the device preserves organs for longer than standard care. It can also do additional functional testing of the organ that may help increase the use of available donor livers.

  • The intended place in therapy would be as an alternative or in addition to static cold storage for donor liver preservation for up to 24 hours before implantation for people needing liver transplant.

  • The main points from the evidence summarised in this briefing are from 6 studies, including 1 randomised trial and 5 non-randomised clinical trials, with a total of 483 livers. One economic evaluation was also found. They show that the OrganOx metra may help increase the number of donor livers that can be successfully transplanted compared with static cold storage.

  • Key uncertainties around the evidence are that sample sizes of the published studies are small and do not compare to alternative devices.

  • One field safety notice was reported on this device in May 2021. It related to a design flaw that has since been corrected.

  • The cost of the OrganOx metra is £30,000 per device per year on lease (excluding VAT). Additional costs include the use of disposable sets (£6,000 per set), staffing (£500) and associated medicines and solutions used during the procedure (£1,210). The company proposes that 9 metra devices would support current transplantation numbers nationally.