NICE has opened consultation on draft guidance recommending four specialist liver preservation machines for routine NHS use, in a move that could widen access to transplant technology for people waiting for life-saving surgery in England.
The devices are designed to keep donated livers functioning outside the body after retrieval, allowing clinicians to better assess organ quality before transplantation and potentially use livers that might otherwise have been declined.
What the draft guidance means for transplant patients
The draft recommendation covers Liver Assist (XVIVO BV), metra (OrganOx Ltd), PerLife Pro (Aferetica Srl) and VitaSmart Hypothermic Oxygenated Perfusion System (Bridge to Life Ltd). NICE said the machines could be funded through core NHS money, rather than relying on local charity support, which has contributed to uneven access across the country.
According to NICE, around 600 adults and children are currently on the active waiting list for a liver transplant in England, while 874 liver transplants from deceased donors took place across the UK in 2024/25. The median waiting time is about five months for adults and six months for children and young people.
Cold storage typically preserves a liver for only 8 to 12 hours, and delays during transport can leave an organ unsafe to transplant. The new machines actively pump a specially formulated solution through the liver’s blood vessels, which may reduce deterioration and, in some cases, allow surgeons to assess how well the organ is working before the operation.
Patients describe the human cost of waiting
NICE said evidence from people with direct experience of transplant waiting shaped the assessment. Monica Walsh, who received a liver transplant nine and a half years ago, described the emotional strain of repeated call-ups when a donated organ turned out not to be suitable. Charlotte Vockins, who lived with a rare liver condition since childhood, said machine perfusion was essential to make her split liver transplant possible.
Both accounts highlighted the uncertainty faced by patients and families, as well as the frustration of unequal access. NICE said some transplant centres have already used charity funding to obtain these machines, while others have not had the same opportunity.
Aiming to end postcode-based variation
Dr Anastasia Chalkidou, NICE’s HealthTech Programme Director, said where a patient lives should not determine access to the best available care. The organisation said its economic analysis found all four devices represent good value for the NHS.
The consultation remains open until 10 June 2026, with a second committee meeting planned for 25 June 2026 and final guidance expected in August 2026. If adopted, the recommendation could help reduce the number of donated organs that go unused and improve the chances for patients waiting for a transplant.
Read more from NICE’s news pages: NICE draft guidance on liver preservation machines.
