NICE has been notified about this procedure and it is part of its work programme. The Interventional Procedures Advisory Committee (IPAC) will consider this procedure and NICE will issue an interventional procedures consultation document about its safety and efficacy for 4 weeks’ public consultation. IPAC will then review the consultation document in the light of comments received and produce a final interventional procedures document, which will be considered by NICE before guidance is issued to the NHS in England, Wales, Scotland and Northern Ireland.
 
Status In progress
Process IP
ID number 1794
Description In this procedure a veno-venous circuit is usually used to perfuse the patient’s blood through an extracorporeal whole liver. The aim is to provide metabolic support and prolong survival, to allow time for the patient’s liver function to recover or to find a suitable donor liver for transplantation. Blood is pumped from a catheter inserted into the femoral vein through an oxygenator and the hepatic artery and portal vein of an extracorporeal whole liver. The liver may be a human liver not suitable for transplantation or a xenogeneic liver (typically a pig liver). Effluent blood from the extracorporeal liver, which is maintained at a normal temperature with a normal pH and electrolytes, is returned to the patient through a subclavian or jugular venous cannula. The literature describes modifications to the technique, such as isolating the patient’s immune system from the extracorporeal liver and using different sites for venous access. Extracorporeal perfusion is continued for up to 5 days until either the patient has a liver transplant or their liver function recovers.

Provisional Schedule

Expected publication 31 March 2021

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Timeline

Key events during the development of the guidance:

Date Update
24 September 2020 - 22 October 2020 Interventional procedure consultation

For further information on how we develop guidance, please see our page about NICE interventional procedures guidance