You Make A Difference: Abdominal regional perfusion program

Dr. Anton Skaro
Dr. Anton Skaro, Surgical director of liver transplantation at LHSC

For the love of liver

Liver transplantation is the only cure for end-stage liver disease and is the treatment of choice for certain cancers. However, this exacting procedure is further limited by the availability of donor organs, as many patients die waiting for a viable liver. But the liver transplant team at London Health Sciences Centre (LHSC) think they have the answer. 

Expanding the donor pool

As a first-in-Canada initiative, the abdominal-normothermic regional perfusion program (A-NRP) will use a technique to reverse damage to organs donated after circulatory death (DCD) by restoring blood flow during the recovery process. DCD organs, particularly the liver, suffer a lot of damage during the recovery process and don’t function as well post-transplant. As a result, DCD donor selection criteria are very stringent, with only the most ideal donors being selected for donation. 

Dr. Anton Skaro, director of liver transplantation at LHSC, wants to expand the donor pool by recovering organs from DCD donors typically excluded from donation. This innovative approach will see the team perfuse the donor’s abdominal organs with re-oxygenated blood before recovering and transplanting the liver to a consenting recipient. When compared to standard DCD liver transplant, the A-NRP technique should improve organ quality and reduce complication rates. 

“Using the A-NRP technique allows more livers to be transplanted and wait times for transplants to be reduced.” 
Dr. Mayur Brahmania, hepatologist, LHSC  

Pictured (from left to right): Dr. Juan Glinka, Surgical fellow, Dr. Anton Skaro, Surgical director of liver transplantation at LHSC and Dr. Ephraim Tang, Liver transplant surgeon 

We're building a team

Now more than ever, our donors are needed to build a highly specialized research team; one designed to evolve this innovative program to benefit other organ groups such as kidneys, heart and pancreas. 


The facts

  • 10-15 per cent of people waiting for a liver die 
  • London’s organ donation rate is 10 per cent above provincial average 
  • LHSC’s liver transplant program performs over 60 transplants per year 
  • University Hospital is the birthplace of liver transplantation in Canada

A net-0 wait time

This increase in available organs could eliminate the waitlist for liver transplantation at LHSC, and be the springboard to establish the A-NRP technique throughout Ontario, as well as the rest of Canada. In short: the A-NRP program will save the lives of countless patients awaiting liver transplantation.  

Donors are the difference.