Research Group

  • Dr Varuna Aluvihare, Principal Investigator
  • Prof. John O’Grady, Co-Investigator
  • Prof. Nigel Heaton, Collaborator
  • Prof. Alberto Sanchez-Fueyo, Collaborator

Location

  • King’s College Hospital, London, UK

Title

  • Improving our Understanding of Acute Liver Failure, Who to Transplant and How?

Acute liver failure is a devastating illness that predominantly affects younger people. The main factor that determines how they are treated and what happens to them, is whether their own liver can repair the damage or if not, whether they need a liver transplant. Every year, a significant number of patients are transplanted for this condition and the results can be good in carefully selected patients. However, the decision of who to transplant, when and how, is based on tests that were developed more than 20 years ago. Furthermore, these decisions often have to be made swiftly in patients who are critically ill. As a result, some patients die without getting transplanted and others who may recover on their own get transplanted.
In patients who have acute liver failure, we have shown that the expression of small miRNA molecules in the liver differs significantly between those that will regenerate (and therefore may not need liver transplantation) and those that fail to regenerate (and therefore may die without transplantation). We intend to use these findings to develop tests of miRNA expression in the liver and blood that can predict which patients will regenerate their liver without a need for transplantation and which patients will not. Furthermore, these tests will also enable us to better match the type of transplant and liver organ to the type of patient. Ultimately this will ensure that only those patients who most need an emergency transplant get one and that those that have a high chance of recovery on their own do not. Since a number of different transplant techniques and types of organ can be used, developing these tests should also ensure that the right type of transplant is carried out on the right patient, in order to improve long-term survival.