From Haphazard to a Sustainable Normothermic Regional Perfusion Service: A Blueprint for the Introduction of Novel Perfusion Technologies

Normothermic Regional Perfusion (NRP) has shown encouraging clinical results. However, translation from an experimental to routine procedure poses several challenges. Herein we describe a model that led to the implementation of NRP into standard clinical practice in our centre following an iterative...

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Bibliographic Details
Published in:	Transplant international Vol. 35; p. 10493
Main Authors:	Hunt, Fiona, Johnston, Chris J C, Coutts, Lesley, Sherif, Ahmed E, Farwell, Lynsey, Stutchfield, Ben M, Sewpaul, Avi, Sutherland, Andrew, Babu, Benoy I, Currie, Ian S, Oniscu, Gabriel C
Format:	Journal Article
Language:	English
Published:	Switzerland Frontiers Media S.A 03-06-2022
Subjects:	Death Health Archive Humans Liver Transplantation - methods Organ Preservation - methods Perfusion - methods Tissue and Organ Procurement Tissue Donors Transplants normothermic machine perfusion education training model simulation donation after circulatory death normothermic regional perfusion training
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Summary:	Normothermic Regional Perfusion (NRP) has shown encouraging clinical results. However, translation from an experimental to routine procedure poses several challenges. Herein we describe a model that led to the implementation of NRP into standard clinical practice in our centre following an iterative process of refinement incorporating training, staffing and operative techniques. Using this approach we achieved a four-fold increase in trained surgical staff and a 6-fold increase in competent senior organ preservation practitioners in 12 months, covering 93% of the retrieval calls. We now routinely provide NRP throughout the UK and attended 186 NRP retrievals from which 225 kidneys, 26 pancreases and 61 livers have been transplanted, including 5 that were initially declined by all UK transplant centres. The 61 DCD(NRP) liver transplants undertaken exhibited no primary non-function or ischaemic cholangiopathy with up to 8 years of follow-up. This approach also enabled successful implementation of ex situ normothermic liver perfusion which together with NRP contributed 37.5% of liver transplant activity in 2021. Perfusion technologies ( and ) are now supported by a team of Advanced Perfusion and Organ Preservation Specialists. The introduction of novel perfusion technologies into routine clinical practice presents significant challenges but can be greatly facilitated by developing a specific role of Advanced Perfusion and Organ Preservation Specialist supported by a robust education, training and recruitment programme.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1432-2277 0934-0874 1432-2277
DOI:	10.3389/ti.2022.10493