Woman with days to live is saved thanks to the box that mimics the human body



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Helen Rawlinson was lying in her hospital bed, hours after death, writing farewell letters to her family.

Beside him, the fiance Darryl Flynn held her hand, not wanting to give up hope.

At only 29 years of age and waiting for a second liver transplant, the brave Helen seemed to have no chance of living.

Because of her medical history and fear that her body would reject a new liver, it was well below the list of priorities for the healthiest transplant organs available – usually from donors who were in life support.

And she was so ill that she was given little chance of a "lower quality" donation after the liver with circulatory death (DCD) – probably damaged by lack of blood circulation after death from heart or lung failure.

But, almost miraculously, Helen was about to receive the best gift of her life.

A liver wrapped in a box.

While he was dying, his consultant liver specialist at St James's University Hospital in Leeds decided to launch one last set of data.

Magdy Attia was involved in clinical trials with the American company TransMedics, which built a pioneering Body Care System machine that mimicked the conditions of the human body, keeping a donated liver healthy and "alive" with blood flowing through it.

Attia told the company Helen's situation and surprisingly they agreed to send the box – still in the process of trial in Massachusetts – on a 3,500-mile journey to Britain in case a donor could be found.

Crucially it also meant that any liver DCD inside could be thoroughly tested by doctors before the operation to ensure that it was feasible.

With little hope of a new liver and time running out, Helen's consultant contacted a doctor in the United States, who was testing a new device that keeps the donated organs healthy.

Surprisingly, doctors in Massachusetts have agreed to ship one of the devices to the UK.

While all this was being quietly organized, Professor Helen of Lancaster was preparing for death after years of fighting autoimmune hepatitis – a condition in which the immune system attacks the liver.

After falling ill in 2008, she was placed on the emergency transplant list and a match was found within a week. "It took me a year to recover properly from the operation," she says, "My body seemed to be broken."

Helen lived normally until 2016, when her liver was attacked again. She was also diagnosed with a heart defect that needed an op to insert a stent.

She was so weak that she was placed on the organ transplant list again in March 2017. But the risk of a second failure placed her in the 47th position for a high-quality donation after brainstem death (DBD) in the liver.

"I was so bad. I spent the next four months dying in the hospital, "says Helen. "I became extremely yellow and very thin. I looked awful.

"I was on the list, but until my turn there was nothing they could do for me. I was just waiting and waiting and I just felt lost. My family tried and tried to get me on the list, but there was no movement. "

The hospital even offered Helen and Darryl, 28, the chance to marry in their chapel, but the couple refused, as Helen thought that would mean she was giving up on her chance at life. She says, "I always kept hoping to get better." But in August, Helen deteriorated so much that she was put into palliative care – and asked to go home to die. She says, "I gave up all hope. I had struggled for so long and tried to stay positive. I asked Darryl to take me home to die. He was disturbed. It was absolutely horrendous for us.

"I was on my deathbed. I wrote letters to my family when I was away.

The pioneering device kept her donor organ healthy until she had her second liver transplant

But just one day after she asked to be taken home, a matching donor with a liver of "inferior quality" was found in northern England.

In a race against time, the Transmedics box was placed on a flight to the UK and its donor's head. And her incredible preservation techniques meant that all of Helen's boxes were marked.

The magic box was then taken to Leeds and Helen was ready for an operation that would save her life – and made her the first person in the UK to undergo a second transplant with the help of the machine.

Helen says: "We were all absolutely on the moon. They said I only had until the end of the week. I did not think I could get a new liver – I had to accept death.

"The machine saved my life and can save many others. All I've been told is that the giver was in the north of England.

"The liver was put into the machine and sent to me in Leeds. He preserved the organ, kept it healthy for me, and made it possible. Without it, I would not be here now.

"What the company did to send me the machine was absolutely incredible. They saved me completely and changed my life. "

In a few days, Helen's jaundice disappeared and she was allowed to go home only 10 days after surgery.

Now healthy, Helen is eager to marry her fiancé Darryl next year

In a few days, Helen's jaundice disappeared – and 10 days after surgery, she was allowed to return home. Mr. Attia told us that the machine is the "Rolls-Royce" of organ transplantation. He said: "DCD livers are of poor quality and are at higher risk for transplants. The machine tests the function of the organ.

"It's also a way to avoid damaging the liver.

"It is kept warm and oxygen is supplied. With Helen, a DBD liver was not available to us. She was very sick and was hampered by the allocation system.

"The only way to treat her was with a liver DCD using the machine. She needed an urgent transplant and we approached TransMedics for compassionate reasons. They agreed to send it to us for free without hesitation.

"They responded within 24 hours and the machine was available to us within a week."

Similar machines that are part of a European test are being used in a handful of hospitals in the UK, but there were none available to Helen in Leeds.

The OCS perfusion machine is not readily available to patients as it is still undergoing US testing, due to be completed by December 2020. Helen is now looking to the future and will marry welding inspector Darryl in May 2020 in your local church. . She says her marriage will be "full of music, love and laughter."

Over the past eight months, Helen has surprised doctors with her perfect recovery and says she feels healthier now than she has for years.

"I could not thank the company or my doctors enough. I can not put into words the luck I feel," she says. "I have a life now. There is no greater gift.

Raising the lid in a miracle

The OCS perfusion machine is not readily available to patients as it is still undergoing US testing

The Transmedics Organ Care System (OCS) is described by its inventors as "portable multi-organ preservation technology".

The box mimics conditions within the human body, minimizing the chance of organ damage due to insufficient blood supply and ensuring that they are kept in top condition.

There are three types of OCS machines – lung, liver and heart.

Warm, oxygenated blood is pumped through the organs as if they are in a functional, living state. As a result, the lung breathes, the heart beats and the liver produces bile.

The machine analyzes organ function and provides better conditions than cold storage – the normal way to preserve organs.

The OCS liver machine underwent its first clinical trials in August 2015. They have so far involved 300 people and focused on side effects and post-transplant results. The results will be known in 2020.

Similar machines are being tested by another company in Europe. If successful, they are expected to be available around the world.

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