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Improving outcomes for people with inflammatory diseases

The National Institute for Health and Care Research Birmingham Biomedical Research Centre (NIHR Birmingham BRC) translates new scientific discoveries into treatments and diagnostics for patients in the UK and across the globe. We focus on inflammation and the diagnosis, prevention and treatment of its associated long-term diseases.

We are part of the NIHR and hosted by University Hospitals Birmingham NHS Foundation Trust in partnership with the University of Birmingham. We are joined by our new partners in Keele , Aston and Oxford Universities and additional NHS Trusts;  Birmingham Women’s and Children’s (BWCFT), Birmingham Community Healthcare  (BCHC) and  Sandwell and West Birmingham  (SWBH) – giving us greater reach, diversity and opportunities for co-creation and impact across our regional population.

Cutting-edge inflammation research

Our vision is to be a world-leading centre for translational research into inflammatory diseases. Inflammation causes or worsens many common long-term illnesses including arthritis, liver disease and cancer. More than 50% of the UKʼs population have at least one inflammatory disease, and over 50% of deaths worldwide are attributable to long-term diseases related to inflammation. This makes tackling inflammatory conditions a major NHS and global priority.

At the Birmingham BRC, we test and deliver new treatments for these diseases, most of which have no cure or treatments to improve quality of life. Thanks to our ability to work with the West Midlands’ uniquely diverse population, our research is relevant not only on a local and national level, but also on a global scale.

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NIHR announces nearly £800m to turn research into new treatments

Published: 14 October 2022

The NIHR has awarded nearly £800 million to 20 Biomedical Research Centres across England, to translate scientific discoveries into new treatments, diagnostic tests and medical technologies to improve patients' lives.

Biomedical research in the North and Midlands gets a significant funding boost, with nearly £250 million of the funding invested outside of London, Oxford and Cambridge. A new Biomedical Research Centre has been funded in the South West, increasing the coverage of early stage research across the nation and ensuring everyone has access to cutting edge clinical trials. 

NIHR Biomedical Research Centres are partnerships between healthcare professionals and academics in the country’s leading NHS trusts and universities. The centres, part of NIHR’s research infrastructure, receive substantial levels of sustained funding to attract the best scientists and create an environment where experimental medicine can thrive. 

This fourth round of NIHR Biomedical Research Centre funding, awarded following an open and competitive process judged by international experts and members of the public, will support research over the next five years in areas such as cancer, mental health, dementia and infectious diseases. The new funding will also provide opportunities for a diverse range of professionals to undertake research, expanding research expertise in allied health professionals - such as physiotherapists, radiologists and dietitians - as well as in doctors and nurses.   

The NIHR currently funds 20 BRCs , 12 of which have received additional investment in this new funding round. Over the past nine years, the BRCs have supported almost 60,000 studies and published 55,000 research papers, as well as supported the career development of more than 14,000 junior doctors and research scientists. 

Health and Social Care Secretary and Deputy Prime Minister Thérèse Coffey said:

“The pandemic has highlighted the importance of our booming research sector and the potential it has to not only strengthen health and care services, but lead to lifesaving developments.

“This additional funding will harness the UK's world leading innovation and allow research centres up and down the country to attract experts in their field and conduct research that saves lives.

“From helping develop the Covid vaccine to discovering world-first treatments, these centres have already delivered ground-breaking research and will continue to help us tackle some of the biggest health challenges we face, including cancer, to ensure the NHS continues to deliver world-class care.”

Professor Lucy Chappell, Chief Executive of the NIHR, said: 

“Research by NIHR Biomedical Research Centres has led to a number of ground-breaking new treatments, such as new gene therapies for haemophilia and motor neurone disease, the world-first treatment for Creutzfeldt–Jakob disease, a nose-drop vaccine for whooping cough, and the first UK-wide study into the long-term impact of COVID-19.

“This latest round of funding recognises the strength of expertise underpinning health and care research across the country and gives our nation’s best researchers more opportunities to develop innovative new treatments for patients.”

A major component of the nation’s knowledge economy

The NIHR invests significantly in people, centres of excellence, collaborations, services and facilities to support health and care research in England. Collectively these form the NIHR infrastructure.

NIHR infrastructure funding supports the country’s leading experts to develop and deliver research funded by the NIHR, other public funders, charities and the life sciences industry. In doing so, its investment plays a crucial role in underpinning research in England and supporting economic growth.  

Over the past 9 years, the BRCs have leveraged nearly £9 billion of funding from external organisations to undertake experimental medicine and early translational research. The centres have collaborated with almost 3,000 small and medium-sized companies, as well as 2,000 other partners in the life sciences industry. More than 11,800 patents have been generated by BRCs and 85 spin out companies, with intellectual property from the centres generating more than £800m in revenue.

Supporting innovative research for COVID-19 and beyond 

The 20 existing BRCs have had a key role in responding to the COVID-19 pandemic. The sustained, long term funding they have received meant that resources could be mobilised quickly to help diagnose and treat COVID-19 and support vaccine research.

For example, BRC researchers have helped to understand immune responses to COVID-19 and vaccines , developed a new bedside molecular test for COVID-19 , investigated how the virus affects ethnic minority healthcare workers, and worked with Formula 1 engineers to create and roll out life-saving breathing machine to prevent patients from needing intensive care .

The impressive BRC track record of research runs over more than 15 years, with study findings improving care for patients. Researchers at the NIHR The Royal Marsden BRC showed that a one-week course of radiotherapy administered through fewer but larger daily doses was as safe and effective as standard care in women with early stage breast cancer . International guidelines subsequently recommended immediate adoption of this new approach, with the proportion of women with breast cancer receiving this new radiotherapy regimen increasing from less than 1% to 60% in a year.

Ultrasound was shown to improve detection of muscle wasting in diseases such as rheumatoid arthritis and inflammatory bowel disease , in research by the NIHR Birmingham Biomedical Research Centre. This method is now being used to assess muscle loss in a national long COVID study funded by NIHR .

Over in Newcastle, BRC researchers have launched the UK arm of a global gene therapy study in Duchenne muscular dystrophy. The study is the first time gene therapy has been given in the UK to a patient with Duchenne muscular dystrophy, a disease for which there are currently no approved treatments that target the disease itself rather than ease symptoms.

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Birmingham Health Partners

Accelerating Access to Drugs, Devices and Diagnostics

NIHR Birmingham Biomedical Research Centre (BRC)

The NIHR Birmingham Biomedical Research Centre (BRC)  brings together multiple BHP members – including leading NHS providers led by the University Hospitals Birmingham NHS Foundation Trust and academic institutions led by the University of Birmingham – as well as other organisations working closely with charities and businesses.

Officially opened in April 2017, Birmingham’s BRC aims to use utting edge experimental medicine to accelerate access to, and adoption of, drugs, devices and diagnostics tests for patients living with chronic inflammatory diseases.

BRC funding supports researchers of the highest calibre to develop innovative research ideas that can attract investment from other funders, furthering the nation’s economic growth.

In 2022, the centre was renewed by NIHR and granted more than £30 million in funding which represents an almost threefold increase from the previous award. 

NIHR Birmingham Biomedical Research Centre is building on the outstanding clinical research infrastructure in Birmingham to carry out studies in well-defined groups of patients with inflammatory disease in which we are:

• Testing new treatments that switch off or re-calibrate the overactive immune system that underpins these diseases
• Developing new biomarkers that will allow us to select the best new treatment for each patient
• Exploring the disease processes that drive these conditions, focusing on mechanisms that are shared between different conditions

Research centres

University Hospitals Birmingham NHS Foundation Trust (UHB) hosts a number of research centres, many of which focus their work on specific areas of disease or injury.

National Institute for Health Research (NIHR) Wellcome Trust Clinical Research Facility

The NIHR/Wellcome Trust Birmingham Clinical Research Facility (CRF) is a purpose-built dedicated unit where study participants take part in research programmes safely according to robust, ethically approved trial protocols.

The CRF is a collaboration between UHB, the University of Birmingham and Birmingham Women’s and Children’s NHS Foundation Trust (BWC).

• NIHR Birmingham Biomedical Research Centre

The NIHR Birmingham Biomedical Research Centre is a partnership between UHB and the University of Birmingham. The centre's purpose is to shed light on the common and distinct mechanisms underpinning diseases of the immune system, including colitis, Crohn’s disease and arthritis.

The centre aims to establish a multidisciplinary team of clinicians, nurses, scientists and clinical trials experts that can deliver a trials acceleration programme (TAP) to reduce the time taken to translate scientific discoveries into clinical benefits for patients.

• NIHR Trauma Management MedTech Co-operative

Based at UHB, the NIHR Trauma Management MedTech Co-operative is one of eleven MedTech and in vitro diagnostic co-operatives (MICs) set up to build expertise and capacity in the NHS. The goal is to develop new medical technologies and provide evidence on commercially supplied in vitro diagnostic (IVD) tests.

The remit of the Trauma MIC is to develop and deliver a programme of work that could improve clinical outcomes and quality of life for patients who have suffered a traumatic injury.

NIHR Surgical Reconstruction and Microbiology Research Centre

The NIHR Surgical Reconstruction and Microbiology Research Centre (SRMRC) is a national hub for trauma research.

The main aim of the SRMRC is to transfer new emergency medicine practices developed in the military frontline to the NHS to improve outcomes for all patients. In addition, the SRMRC takes findings from the science lab to the patient’s bedside to improve emergency medicine practice in military and civilian settings.

Since the centre’s start in 2011, civilian and military scientists have worked alongside civilian and military clinicians in a variety of specialist areas to improve the care and treatment of trauma patients.

The centre is jointly funded by the NIHR and the Ministry of Defence, with additional "matched" funding provided by UHB and UoB.

Medical Devices Testing and Evaluation Centre

Based in the Institute for Translational Medicine on the Queen Elizabeth Hospital Birmingham site, the Medical Devices Testing and Evaluation Centre (MD-TEC) provides med–tech and life sciences businesses with access to state-of-the-art simulation and usability facilities alongside dedicated medical device expertise from the academic and clinical environment.

The centre supports the acceleration of products from bench to market, at less cost and with reduced risk. Companies can ensure their products match need and avoid the re-engineering and re-evaluation caused by an initial lack of user testing and the hurdles of regulatory blockages.

MD-TEC facilities include a near-replica operating theatre, and intensive care and ward bed areas, boosting Birmingham’s provision of test bed facilities suitable for manufacturers.

• Centre for Conflict Wound Research

The Scar Free Foundation Centre for Conflict Wound Research, based at Queen Elizabeth Hospital Birmingham, is a partnership between:

• University of Birmingham
• the Scar Free Foundation
• the Centre for Appearance Research (CAR, University of the West of England)
• CASEVAC injured veterans club

The centre aims to generate a national and international network of clinical and academic research with the common goals of:

• improving the lives of patients living with scarring
• developing approaches to prevent scarring

Midlands and Wales Advanced Therapy Treatment Centre

The Midlands and Wales Advanced Therapy Treatment Centre (MW-ATTC) is funded by Innovate UK and is part of the ATTC network. It consists of a large regional network with the commercial and NHS infrastructure required to facilitate the delivery of advanced therapy treatments to patients.

The centre includes a wide range of specialists in advanced therapy manufacturing, including academic and commercial partners, logistics companies, specialists in clinical trial delivery and teams focused on IT solutions and health economics.

The MW-ATTC has clinical sites based in Birmingham, Cardiff, Leicester, Nottingham and Swansea.

PIONEER, the Health Data Research Hub for Acute Care, is one of seven HDR UK hubs.

PIONEER aims to improve healthcare pathways and treatments by understanding:

• the symptoms and diseases people have when they become unwell
• whether those people had been to hospital or other healthcare providers with the same problems
• the time it took to make a diagnosis and the care they received

UHB is the data controller for PIONEER, with the overall project led by University of Birmingham. The West Midlands Ambulance Service, the University of Warwick and Insignia Medical Systems are also founding members of the hub.

• HDR UK PIONEER hub

INSIGHT is a Health Data Research Hub focusing on eye health and its connection to wider health issues, including diabetes and dementia. It's one of seven HDR UK hubs.

The hub uses anonymised, large-scale data and advanced analytics, including artificial intelligence (AI), to develop new insights in disease detection, diagnosis, treatments and personalised healthcare.

INSIGHT is a collaboration between six partners:

• UHB (lead institution)
• Moorfields Eye Hospital NHS Foundation Trust
• Action Against AMD (founded by Fight for Sight, Macular Society, Blind Veterans UK, Sight Scotland/Sight Scotland Veterans)
• INSIGHT website

NIHR Applied Research Collaboration West Midlands

The NIHR Applied Research Collaboration (ARC) West Midlands is a five-year initiative (2019 – 2024) with a mission to create lasting and effective partnerships across health and social care organisations, and universities (Birmingham, Keele and Warwick), in order to improve care services across the West Midlands.

The ARC is one of 15 across England aiming to improve the health and care of patients and the public. Its work builds on research conducted by its predecessors, the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for West Midlands, and the CLAHRC Birmingham and Black Country pilot.

• NIHR ARC West Midlands

Birmingham Experimental Cancer Medicine Centre

The Birmingham Experimental Cancer Medicine Centre (ECMC), jointly funded by Cancer Research UK and the National Institute for Health Research, is led by Professor Gary Middleton and has an international reputation for innovation in personalised medicine, with the development of novel, stratified studies driven in partnership with the CRUK Clinical Trials Unit.

Research is developed at UHB, with University of Birmingham providing academic leadership. Strengths of the ECMC include the National Lung Matrix Trial, the development of innovative immunotherapeutic strategies and experimental haematology studies. Most recently, the Bladder Cancer Centre has been launched, led by Birmingham’s Dr Rik Bryan working in collaboration with the universities of Oxford, Cardiff and Manchester.

• Birmingham ECMC

Centre for Clinical Haematology

The Birmingham Centre for Clinical Haematology (CCH), supported by Cure Leukaemia, oversees one of the most active academic and clinical haematology practices in the world.

The centre hosts an internationally competitive early phase clinical trials portfolio. Its mission is to develop and deliver novel drug and transplant therapies in patients with haematological malignancies. Many of these trials provide pioneering treatments for patients who have exhausted all other available treatments.

The trials, which have the potential to be practice changing, cover a range of haematological conditions, including leukaemia, lymphoma, myeloma and amyloidosis, as well as rarer conditions.

• Birmingham Health Partners: CCH

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Last reviewed: 26 April 2021

New £30M research injection to improve treatment of inflammatory diseases

Renewed National Institute for Health and Care Research Birmingham Biomedical Research Centre continue funds for developments around inflammatory diseases

Local people with cancer and heart disease are amongst those set to benefit from a major injection of research funding which will develop new diagnostic tools and treatments for those with cancer, liver and heart disease, and many more illnesses.

The NIHR Birmingham Biomedical Research Centre has today been granted more than £30 million of funding from the National Institute for Health and Care Research, a major funder of global health research and training, to support world-leading research into inflammation and the myriad of diseases and health issues that it can cause.

The centre unites leading NHS providers led by the University Hospitals Birmingham NHS Foundation Trust and academic institutions led by the University of Birmingham. The partnership sees eight organisations working closely with charities and businesses to support research into inflammation which causes or worsens many common long-term illnesses including arthritis, liver disease and cancer.

The announcement sees the NIHR Birmingham BRC increase its funding almost 3-fold and will enable researchers to focus on eight areas of illness including heart disease, women’s health, and common complications from inflammation. It will also enable researchers to consider new tests and biomarkers for disease, health technologies including stem cells and gene therapy, patient experiences and data science.

The funding will allow us to make a step-change in our work tackling different forms of cancer, trialling new drugs for liver disease, and dealing with antimicrobial resistance Professor Philip Newsome Professor Phil Newsome, Director of Research and Knowledge Transfer at the University of Birmingham’s College of Medical and Dental Sciences and Director of the NIHR Birmingham Biomedical Research Centre said: “Inflammation plays a central role in many health conditions, with millions of people in the UK alone experiencing inflammatory diseases such as arthritis and bronchitis.   “The significant increase in funding for the NIHR Birmingham Biomedical Research Centre will enable us to provide an outstanding environment for world-leading clinical research. The funding will allow us to make a step-change in our work tackling different forms of cancer, trialling new drugs for liver disease, and dealing with antimicrobial resistance.” Improving patient outcomes for illnesses including cancer and liver disease Patients will benefit from the increased funding for the NIHR Birmingham BRC through collaborative research that has seen nearly 1,000 clinical trials and informed UK clinical guidelines. Researchers will look at eight themes to continue to understand and help patients manage inflammation-based diseases including cancer, arthritis, and liver disease. The investment of the NIHR funding in biomedical research will enable clinicians, researchers, patients and supporters to find new treatments such as the development of new immunotherapies, which are types of cancer treatments to support the body to fight cancer. Prior to having a liver transplant, Joy was invited to join NIHR Birmingham BRC research to better understand sarcopenia Patient Story – Joy     When Joy needed a liver transplant, the team at University Hospitals Birmingham involved in her care made her aware about an opportunity to take part in a trial through the BRC to better understand sarcopenia.   In many chronic inflammatory diseases, including liver disease, loss of muscle mass and strength (sarcopenia) occurs. Importantly sarcopenia contributes to poor patient quality of life, reduced ability to cope with challenges such as surgery or infection and higher risk of death. The NIHR Birmingham BRC has been investigating inflammatory sarcopenia to find the best treatments and support for patients who experience inflammation-related muscle loss.   Joy said: “It was interesting to be made aware of muscle loss and to be encouraged to do tests [to assess sarcopenia]. Following the two-day assessment, I was encouraged to increase protein in my diet because of muscle loss and the trial reinforced how important that was. I think the trial made me feel like I was doing something positive at a time when some things in my life were dampening down.”   “After the transplant, one of the first people I saw in hospital was a member of the research team. She had heard I had had the op and made a point of dropping by. We had a lovely chat. As a beneficiary of liver transplant and the improving outcomes for liver transplant patients, I am heartily in favour of research in this as well as other medical fields.” Tim Jones, Chief Innovation Officer, at University Hospitals Birmingham NHS Foundation Trust said: “We are delighted with the award to the NIHR Birmingham BRC which builds on our successful track record of joint working in Inflammatory disease, the award will significantly support the acceleration of new discoveries for the benefit of our patients”. Full list of themes that are part of the NIHR Birmingham Biomedical Research Centre Arthritis Heart and circulatory inflammation Liver Disease Cancer-related inflammation Oral and intestinal health Infection & Acute Care Inflammatory diseases unique to, or most common, in women Muscle wastage (sarcopenia) Next Generation Therapies Data, Diagnostics and Decision Tools Patient Reported Outcomes Step change in data and digital healthcare Researchers based at the NIHR Birmingham BRC will also support a major improvement in how data and digital healthcare can improve patient outcomes. The  Data, Diagnostics and Decision Tools  theme will see the development of new infrastructure and innovation to tackle major challenges in the use and interpretation of data in biomedical research. Bringing together expertise across a range of disciplines including clinical trials, health informatics, and artificial intelligence, increased funding will see improvements in the way data is held and used to uphold the highest levels of research integrity.   The expanded funding will also enable the NIHR Birmingham BRC to invest in research excellence and create additional capacity, to collaboratively focus on key wider areas of clinical practice including the development of new tests and biomarkers, and next generation therapies such as stem cell and gene therapy.   Case study – infrastructure to support innovation:   Mark Maybury joined the Birmingham Rheumatology Research Group in 2018, supported by the NIHR-funded Birmingham Biomedical Research Centre. Coming from a clinical role as a physiotherapist and musculoskeletal sonographer, Mark has been working with academics to support research trials for rheumatoid arthritis drugs and has been involved in pioneering work in the use of ultrasound-guided synovial joint biopsies. Mark said: “One of the many reasons that attracted me to move into this research post at this institution was the opportunity to learn and during my time at the Birmingham BRC I have been given the opportunity for personal study and involvement in research. But as well as learning myself, I’ve also had the opportunity to pass on my knowledge – training research fellows in diagnostic ultrasound and to develop new instrumentation for ultrasound guided synovial biopsy. The results of the studies I have worked on will help influence the treatment of hundreds of thousands of patients, not only in the UK but worldwide, which is more patients than I ever could ever help as a clinician. I find that a very sobering thought.” The investment from NIHR is hugely important for researchers working across the BRC partner institutions, to continue to tackle some of the critical health themes that affect our region Professor David Adams

Professor David Adams, Pro-vice Chancellor and Head of the College of Medical and Dental Sciences at the University of Birmingham, and director of the previous NIHR Birmingham BRC said:

“The investment from NIHR is hugely important for researchers working across the BRC partner institutions, to continue to tackle some of the critical health themes that affect our region.

“The funding will allow us to bring together teams that can use an in depth understanding of disease processes to deliver new therapies and diagnostic tests for a range of chronic inflammatory diseases for which we currently have few effective treatments.”

BRC funding nationally

The NIHR Birmingham BRC is among 20 centres across England that have been awarded a combined £790 million by the National Institute for Health and Care Research, to translate scientific discoveries into new treatments, diagnostic tests and medical technologies for patients.

NIHR Biomedical Research Centres are partnerships between healthcare professionals and academics in the country’s leading NHS trusts and universities. The centres, part of NIHR’s research infrastructure, receive substantial levels of sustained funding to attract the best scientists and create an environment where experimental medicine can thrive.

The Birmingham Biomedical Research Centre is made up of the following partners:

• University Hospitals Birmingham NHS Foundation Trust
• University of Birmingham
• Sandwell and West Birmingham NHS Trust
• Birmingham Women’s and Children’s NHS Foundation Trust
• Birmingham Community Healthcare NHS Foundation Trust
• Keele University
• Aston University
• University of Oxford

Professor Lucy Chappell, Chief Executive of the NIHR, said:

“Research by NIHR Biomedical Research Centres has led to a number of ground-breaking new treatments, such as new gene therapies for haemophilia and motor neurone disease, the world-first treatment for Creutzfeldt–Jakob disease, a nose-drop vaccine for whooping cough, and the first UK-wide study into the long-term impact of COVID-19.

“This latest round of funding recognises the strength of expertise underpinning health and care research across the country and gives our nation’s best researchers more opportunities to develop innovative new treatments for patients.”

NIHR Birmingham Biomedical Research Centre Institute of Translational Medicine Birmingham B15 2TH

[email protected]

The NIHR Birmingham Biomedical Research Centre (BRC) is part of the NIHR and hosted by  University Hospitals Birmingham NHS Foundation Trust (UHBFT) in partnership with the University of  Birmingham (UoB).

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Transplantation of discarded livers following viability testing with normothermic machine perfusion

Affiliations.

• 1 Liver Unit, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust (UHBFT), Birmingham, UK. [email protected].
• 2 National Institute for Health Research (NIHR), Birmingham Biomedical Research Centre, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. [email protected].
• 3 Centre for Liver and Gastrointestinal Research, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK. [email protected].
• 4 Liver Unit, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust (UHBFT), Birmingham, UK.
• 5 National Institute for Health Research (NIHR), Birmingham Biomedical Research Centre, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
• 6 Centre for Liver and Gastrointestinal Research, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.
• 7 Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK.
• 8 D3B team, Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK.
• 9 Department of Cellular Pathology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust (UHBFT), Birmingham, UK.
• 10 Department of Intensive Care Medicine, University of Birmingham, Birmingham, UK.
• 11 OrganOx Limited, Oxford, UK.
• 12 Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
• 13 Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK.
• 14 National Institute for Health Research (NIHR), Birmingham Biomedical Research Centre, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. [email protected].
• 15 Centre for Liver and Gastrointestinal Research, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK. [email protected].
• 16 Liver Unit, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust (UHBFT), Birmingham, UK. [email protected].
• 17 National Institute for Health Research (NIHR), Birmingham Biomedical Research Centre, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. [email protected].
• 18 Centre for Liver and Gastrointestinal Research, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK. [email protected].
• PMID: 32546694
• PMCID: PMC7298000
• DOI: 10.1038/s41467-020-16251-3

There is a limited access to liver transplantation, however, many organs are discarded based on subjective assessment only. Here we report the VITTAL clinical trial (ClinicalTrials.gov number NCT02740608 ) outcomes, using normothermic machine perfusion (NMP) to objectively assess livers discarded by all UK centres meeting specific high-risk criteria. Thirty-one livers were enroled and assessed by viability criteria based on the lactate clearance to levels ≤2.5 mmol/L within 4 h. The viability was achieved by 22 (71%) organs, that were transplanted after a median preservation time of 18 h, with 100% 90-day survival. During the median follow up of 542 days, 4 (18%) patients developed biliary strictures requiring re-transplantation. This trial demonstrates that viability testing with NMP is feasible and in this study enabled successful transplantation of 71% of discarded livers, with 100% 90-day patient and graft survival; it does not seem to prevent non-anastomotic biliary strictures in livers donated after circulatory death with prolonged warm ischaemia.

Publication types

• Clinical Trial
• Research Support, Non-U.S. Gov't
• Graft Survival / physiology*
• Liver / metabolism
• Liver / physiology*
• Liver Function Tests / methods*
• Liver Transplantation / methods*
• Middle Aged
• Non-Randomized Controlled Trials as Topic
• Organ Preservation / methods*
• Organ Preservation / statistics & numerical data
• Perfusion / methods
• Prospective Studies
• Survival Analysis
• Temperature
• Time Factors
• Tissue Donors / statistics & numerical data*
• Tissue and Organ Harvesting / methods
• Tissue and Organ Harvesting / statistics & numerical data

Associated data

• ClinicalTrials.gov/NCT02740608

Grants and funding

• WT_/Wellcome Trust/United Kingdom
• C22436/A15958/CRUK_/Cancer Research UK/United Kingdom
• 200121/B/15/Z/WT_/Wellcome Trust/United Kingdom

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