METRA AND FUNCTIONAL LIVER ASSESSMENT
Assess donor liver function with the ³Ô¹ÏºÚÁÏÍø metra®
³Ô¹ÏºÚÁÏÍø metra enhances current clinical understanding of donor liver function leading to more donor livers being available for transplantation1
Assessment of donor liver function is limited with static cold storage and over a third of deceased donors in the UK do not result in a transplanted liver.1–3 The ³Ô¹ÏºÚÁÏÍø metra enables the assessment of donor liver function by allowing surgeons to monitor markers such as perfusate lactate clearance, pH, transaminase levels, glucose metabolism and bile pH during preservation.2,3 Informed decisions on donor liver function may lead to fewer discarded organs and increased utilisation, as demonstrated in our randomised trial.1
Normothermic machine perfusion with the metra has been shown to reduce the risk and impact of ischaemic reperfusion injury and graft injury following transplant.1
The risks of graft injury during static cold storage are well established in marginal donor organs such as DCD (donation after circulatory death) or elderly donors.5–7
Compared to static cold storage, the metra has been associated with a 50% reduction in graft injury, as measured by a 50% reduction in peak AST during the 7 days after liver transplantation. This was despite a 54% increase in preservation time.1
Preservation times and Peak AST
| NMP | SCS | P value | |
|---|---|---|---|
| Mean peak AST (95% CI) | 488 (409–583) |
965 (795–1172) |
<0.001 |
| Total preservation time | 11h 54min | 7h 45min | <0.001 |
Adapted from Nasralla D et al. Nature 2018; 557(7703):50–56
49% reduction in peak AST between NMP and SCS despite a 54% longer mean preservation time
Longer preservation times with the metra facilitate complex and lengthy transplant surgeries
metra and complex surgeries
Want to know more about the metra?
If you would like to know more about the metra and how it may benefit your liver transplantation unit, click ‘Contact Us’ and a member of the ³Ô¹ÏºÚÁÏÍø team will be in touch.
References: 1. Nasralla D et al. Nature 2018; 557(7703):50–56. 2. Laing RW et al. BMJ Open 2017;7:e017733. 3. NHS Blood and Transplant. Organ Donation and Transplantation Activity Report 2017/18. 4. Jayant K et al. Exp Rev Gastroenterol Hepatol 2018;12:1045–1058. 5. Manara AM et al. BJA 2012;108 (suppl 1):i108–i121. 6. Zhai Y et al. Nat Rev Gastroenterol Hepatol. 2013;10(2):79–89. 7. Boteon YL et al. Current Transplantation Reports 2018;5:113–120.
UK/US MD-040-10-1 - September 2022