The Pulsion device successfully measured liver function in potential donors
A portable finger-probe device that has successfully measured liver function in brain-dead adult organ donors could change the way organs are assessed and save thousands of dollars per transplant, a UCLA study has found. Working with OneLegacy, the non-profit organ- and tissue-recovery organization serving the Greater Los Angeles area, UCLA researchers measured liver function in 53 potential organ donors in a blind study of the device. Eleven livers were declined because of poor quality; the function of the 42 that were transplanted was tested later to compare to the results obtained using the device.
“This Pulsion device is the best single predictor of organ survival in our patients,” says Ali Zarrinpar, MD (RES ’10, FEL ’12), PhD, assistant professor of surgery in the Division of Liver and Pancreas Transplantation. “It gives us a quantitative measure of how good a liver is without having to visually inspect the organ.”
Although there are accurate and reliable function tests for other donor organs, this is not the case for livers, Dr. Zarrinpar says. Currently, depending on a thorough assessment of a potential donor’s medical history, multiple blood tests and any hospital treatments, a surgical team from the recipient’s medical center is dispatched to the donor’s location to visually inspect and potentially procure the organ. That team costs thousands of dollars per procedure, Dr. Zarrinpar says, and about 10-to-15 percent of the time the organ is deemed unusable.
On the flip side, an organ from a patient with a questionable history or borderline laboratory results may be considered a waste of the surgical team’s time and the retrieval effort abandoned. However, this device could easily be used to test organ function in such marginal donors, so its use could increase the number of organs used for transplant.
The device operates much like a pulse oximeter; it measures the rate at which a dye injected into the potential donor’s bloodstream is cleared by the liver. This novel, noninvasive and rapid test successfully predicted which livers would function properly in transplant patients, Dr. Zarrinpar says. “These data warrant further exploration in a larger trial in a variety of settings to evaluate acceptable values for donated livers,” the study states. “At a time of increasing regional sharing and calls for national organ sharing, this method would assist in the standardization of graft evaluation. It could also lead to increasing liver graft utilization while decreasing travel risk and expenses.”
"A Rapid, Reproducible, Noninvasive Predictor of Liver Graft Survival,” Journal of Surgical Research, July 2015