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    Has all of the relevant evidence been taken into account?

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    Are the summaries of clinical and cost effectiveness reasonable interpretations of the evidence?

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Guidance assessment consultation document for In-situ abdominal normothermic regional perfusion to preserve donor livers during retrieval for transplantation after controlled circulatory death

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1 Recommendation

1.1

In-situ abdominal normothermic regional perfusion can be used as an option to preserve donor livers during retrieval for transplantation after controlled circulatory death.

What this means in practice

There is enough evidence on the safety and efficacy of this procedure for healthcare professionals to consider in-situ abdominal normothermic regional perfusion as an option to preserve donor livers during retrieval for transplantation after controlled circulatory death.

Healthcare professionals and centres doing this procedure should follow the relevant Human Tissue Authority's regulatory and legal requirements and the NHS Blood and Transplant Organ Donation and Transplantation's national protocols and guidance for consent.

NHS England may have policies on funding of procedures.

Auditing of outcomes

Healthcare professionals doing this procedure should collect data on safety and outcomes of the procedure. Details about everyone having this procedure should be entered into the NHS Blood and Transplant Organ Donation and Transplantation registry. Healthcare professionals should regularly review the data on outcomes and safety.

Who should be involved in the procedure

Healthcare professionals and centres should have specific training and expertise in this procedure. The procedure should be done in line with NHS Blood and Transplant Organ Donation and Transplantation policies and protocols.

Why the committee made this recommendation

Comparative observational studies show that this procedure works as well as, or better than, other methods used to preserve donor livers during retrieval for transplantation after controlled circulatory death. There is no data from randomised controlled trials. But the observational studies use methods that reduce potential bias and the results are consistent between them. Evidence also shows that the procedure could increase how many donated livers are accepted for transplantation. There are no concerns about the procedure's safety. So, it can be used.