A pioneering new method to assess the quality of organs for donation could revolutionise the transplant system, potentially saving lives and tens of millions of pounds. 
The digital health package, which has received over £1 million in funding from the National Institute for Health and Care Research (NIHR), works in the same way as artificial intelligence-based facial recognition technology to evaluate the quality of an organ.
It’s estimated the technology, known as OrQA – Organ Quality Assessment – could result in up to 200 more patients receiving kidney transplants and 100 more liver transplants a year in the UK.
More patients receiving life-saving transplants
Colin Wilson, transplant surgeon at Newcastle upon Tyne Hospitals NHS Foundation Trust and co-lead of the project, said: “Transplantation is the best treatment for patients with organ failure, but unfortunately some organs can’t be used due to concerns they won’t function properly once transplanted.
“The software we have developed ‘scores’ the quality of the organ and aims to support surgeons to assess if the organ is healthy enough to be transplanted.
“Our ultimate hope is that OrQA will result in more patients receiving life-saving transplants and enable them to lead healthier, longer lives.”
How does OrQA work?
Professor Hassan Ugail, Director of the Centre for Visual Computing at the University of Bradford, whose team is designing the image analysis programme said: “Currently, when an organ becomes available, it is assessed by a surgical team by sight, which means, occasionally, organs will be deemed not suitable for transplant.
“We are developing a deep machine learning algorithm which will be trained using thousands of images of human organs to assess images of donor organs more effectively than what the human eye can see.
“This will ultimately mean a surgeon could take a photo of the donated organ, upload it to OrQA and get an immediate answer as to how best to use the donated organ.”
There are currently nearly 7,000 patients awaiting organ transplant in the UK. The waiting list for liver transplants has increased significantly since before the pandemic.
An organ can only survive out of the body for a limited time and in most cases, only one journey from the donor hospital to the recipient hospital is possible, meaning it is essential that the right decision is made quickly.
A key part of the OrQA assessment is to look for damage, pre-existing conditions and how well the blood has been flushed out of the organ (organ perfusion). Organs blocked with clots will not be able to connect to the recipient’s blood system during implantation.
Support when it’s most needed
Mr Wilson, who is also honorary clinical senior lecturer at Newcastle University and general secretary of the British Transplantation Society, added: “Up until now, we haven’t had anything to help us as surgeons at the time of organ retrieval. This is a really important step for professionals and patients to make sure people can get the right transplant as soon as possible.
“OrQA will help us professionals make the best decision at a really stressful time for all those involved in organ donation and transplantation.”
The project is being supported by NHS Blood and Transplant (NHSBT), Quality in Organ Donation (QUOD) biobank and an NIHR Blood and Transplant Research Unit to deliver research for the NHS. It also involves academics from the Universities of Oxford and New South Wales. 
Exciting development
Professor Derek Manas, Medical Director of NHSBT Organ Donation and Transplantation (OTDT) said: “This is an exciting development in technological infrastructure that, once validated, will enable surgeons and transplant clinicians to make more informed decisions about organ usage and help to close the gap between those patients waiting for and those receiving lifesaving organs. We at NHSBT are extremely committed to making this exciting venture a success.”
Health Minister Neil O’Brien said: “Technology has the ability to revolutionise the way we care for people and this cutting edge technology will improve organ transplant services. Developed here in the UK, this pioneering new method could save hundreds of lives and ensure the best use of donated organs.
“I encourage everyone to register their organ donation decision. Share it with your family so your loved ones can follow your wishes and hopefully save others.”
Real promise
Chief Executive of the NIHR, Professor Lucy Chappell said: “Funded by our Invention for Innovation Programme, this deep machine learning algorithm aims to increase the number of liver and kidney donor organs suitable for transplantation. This is another example of how AI can enhance our healthcare system and make it more efficient. Once clinically validated and tested, cutting edge technology such as this holds the real promise of saving and improving lives.”
‘Proof of concept’ work has been carried out in liver, kidney and pancreas transplantation as well as at an advanced stage of pre-clinical testing in liver and kidney.
It is hoped the OrQA software will be ready for a licensing study within the NHS within two years. There is also the possibility of marketing the tool worldwide.
The value of information
Jackie Leach Scully, Professor of Bioethics and Director of a research institute at the University of New South Wales, Australia, had a liver transplant in 2015.
Professor Scully, who is also involved in the OrQA project, said: “Like any other transplant patient I’ve been aware of the chronic shortage of suitable organs, and the need to encourage organ donation, but it was only after becoming involved in this project that I realised that valuable organs may be wasted because of difficulty in evaluating their suitability.  
“This has really brought home the value of an information-providing tool to support surgeons’ decision-making. I believe it’s also essential for patients and the wider public to understand that this system could make it more likely that their donated organs will be used successfully and equitably in transplant.”
