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OCTOBER 2014
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‘World first’ for liver transplant team Surgeons at Queen Elizabeth Hospital Birmingham (QEHB) achieved a world first when they transplanted a resuscitated liver that would have previously been considered unviable. The transplant team successfully revived the liver by pumping oxygenated blood through it after a journey of more than 200 miles inside an ice box. The organ had taken seven hours to arrive in Birmingham, a delay which would have significantly increased the risk of graft failure if the transplant was carried out in the conventional way. However, after being resuscitated using the ‘warm blood’ machine, the surgical team at QEHB, which carries out nearly 200 liver transplants a year, was able to transplant the revived liver into a patient who had been on the waiting list for a new organ. Although other transplant centres around the world have carried out the same resuscitation technique on discarded livers, or tested similar procedures on animal models, the team at QEHB became the first in the world to successfully transplant a revived liver graft from a cardiac death donor into a patient. Satpal Mahal, aged 46, from Walsall in the West Midlands, who had liver cirrhosis, was discharged from QEHB just 11 days after receiving his new liver. The entire process took around eighteen hours from the organ first being retrieved to completion of the transplant operation. It involved a team of around a dozen staff from University Hospitals Birmingham NHS Foundation Trust (UHB) led by consultant liver transplant surgeons Mr Thamara Perera, Mr Paolo Muiesan and Mr Hynek Mergental, consultant anaesthetist Dr Hentie Cilliers and theatre staff. Mr Perera, who performed the operation, said: “There has been recent interest within the liver transplant community about the use of various machine devices to ‘pump blood’ at body temperature into organs retrieved from donors because it has been shown to minimise the damage which is inevitable when organs are preserved in cold storage. “Many options and different combinations of techniques are proposed and currently under
I knew that I was in the best place with the right physicians and staff. Satpal Mahal
Satpal Mahal who underwent a ‘world breaking’ liver transplant
investigation in various clinical studies and trials. “Several centres in the world are currently investigating the possibility of this type of warm resuscitation at the end of cold storage. However, this was the first successful transplant. “There are other centres that have been testing this technique on animals and discarded livers that are deemed unsuitable for transplantation. “Our centre initially carried out tests on discarded livers before we got to this stage. The Liver Unit at QEHB is now performing three different approaches to revive organs from deceased donors which is a unique achievement.” Mr Perera said they carried out the resuscitation procedure on the liver using a machine called Organ Assist, which was funded by the QEHB Charity. Mr Mergental, who assisted in the procedure, has set up this facility of testing livers over the last few months: “In this particular case the
organ was transported to QEHB in an ice box so it was seven hours before it arrived at the hospital for transplanting. This was considered too long for the transplant operation to be carried out in the conventional way – from the cold storage directly in to the recipient – so it was decided to resuscitate this organ on the machine using ‘warm blood’. If we had used the liver in the normal way then the chance of failure would have been high.” He said that UHB had previously given approval for the new procedure in April this year but this was the first time they were able to test it. Mr Mahal, who was managing director of his own import and export business prior to his illness, said he was enjoying life as a “world breaker”: “I was very confident even though this was a new procedure. “I knew that I was in the best place with the right physicians and staff. And I have been told that it has been very successful, so it’s a world breaker.”
Page 15 Runners step out to support our charity Friends and Family
Share your views about our services This month sees the launch of the NHS Friends and Family Test across all outpatient services run by the Trust, including Therapy Services and the Imaging Department. This means patients who come to the hospital, or to a clinic off-site, will be asked whether they would recommend the service to friends and family if they need care. The Friends and Family Test is the biggest ever collection of patient views and in 2013 it was rolled out to inpatient wards and the Emergency Department. It was also introduced as a staff survey earlier this year. The Friends and Family Test asks patients, “How likely are you to recommend our service to friends and family if they needed similar care or treatment?” Patients answer on a scale of extremely likely to extremely unlikely. Patients can pick up a postcard in clinic, fill it in and drop it in the box provided. The Friends and Family Test will also be available on the Trust website and on the self check-in kiosks in some outpatient areas at QEHB. The survey should be completed after an appointment has taken place. Since April 2013, over 30,108 UHB inpatients and 7,024 visitors to the Emergency Department have answered the Friends and Family Test. With QEHB outpatient clinics alone treating 2,000 patients a day, the Trust hopes for a high response rate so that it can find out what patients think and improve services where necessary. The Friends and Family Test score is published each month on NHS Choices website and on the Trust’s own website. Nationally, the NHS Friends and Family Test has already generated well over a million responses. We listen and act on feedback The Friends and Family Test is just one of the ways the Trust gathers feedback from patients, carers, visitors, staff and volunteers. Each month the ‘You Said, We Did’ column features a different improvement as a result of comments and suggestions. The Trust values feedback and makes changes so that the experience of hospitals is as positive as possible. Please take every opportunity to tell the hospital what you think – it can really make a difference.
Puzzle page: brainteasers, mind benders and more P19 Find your way around: hospital maps P20 news@QEHB 2014_10_Oct.indd 1
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