Portable device measures donor liver function, predicts organ survival

In a new study conducted by researchers at University of California at Los Angeles, a portable, finger-probe device was successful in measuring liver function in brain dead adult organ donors, according to newly published data.

“This device is [the] best single predictor of organ survival in our patients,” Ali Zarrinpar, MD, PhD, department of surgery, David Geffen School of Medicine at UCLA, said in a press release. “Ultimately, what it does is gives us a quantitative measure of how good a liver is without having to visually inspect the organ. It gives us a measurement to talk about when we’re thinking about whether to transplant an organ into a recipient.”

Using the device (LiMON, PULSION Medical Systems), Zarrinpar and colleagues measured indocyanine green plasma disappearance rates (ICG-PDR) on 53 brain-dead donors for 51 recipients before organ procurement and compared them with graft function and outcomes. The ICG-PDRs and ICG clearance via noninvasive pulse-densitometry were automatically measured by the device.

Overall, 11 liver grafts were declined by all centers because of their quality and 42 grafts were transplanted. A primary surgeon assessed the grafts at the time of procurement and it was seen that the assessment of the graft was correlated with a 7-day survival (P < .001).

ICG-PDR was the only donor factor associated with a 7-day survival of a liver graft, according to a logistic regression analysis. The mean ICG-PDR for the grafts surviving 7 days was higher compared with non-surviving grafts (24.2% vs. 18.7% per minute).

Factors not associated with 7-day survival included donor risk index, donor age and transaminase levels at peak or procurement.

According to the press release, the device attaches to the patient’s finger to measure oxygen in the blood and measures the rate at which a dye injected into the potential donor’s bloodstream is cleared by the liver. The device could potentially offer an easy way to test organ function in donors, which could increase the number of organs used for transplant, researchers detailed in the study.

“Although the number of transplant candidates continues to grow, organ availability has plateaued, resulting in more patients dying while on transplant waiting lists,” Zarrinpar said. “This device, which can be used in any hospital, could help increase the number of donor livers and help save very sick patients waiting for transplant.”

The researchers concluded: “These data warrant further exploration in a larger trial in a variety of settings to evaluate acceptable values for donated livers. 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.” – by Melinda Stevens

Disclosure: Zarrinpar reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.