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Oxford Transplant Centre, Churchill Hospital, Oxford, OX3 7LE

Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), Churchill Hospital, Oxford OX3 7LE

NHS Blood and Transplant (NHSBT) Blood Donor Centre, John Radcliffe Hospital, Oxford, OX3 9BQ


April 2020

PROJECT TITLE                         

Defatting of donor transplant livers during normothermic perfusion – a randomised clinical trial


Professor Peter Friend and Professor Leanne Hodson

Hussain Abbas

BM, BMedSci, MRCS(Ed)

DPhil Student and Clinical Research Fellow in Transplant Surgery

I am a General Surgery Registrar with an interest in HPB and Liver Transplant Surgery. I am currently working towards completion of my DPhil (final year) at the Nuffield Department of Surgical Sciences. 

My research

Liver disease is the third leading cause of premature death in the UK. Liver transplantation is the only successful treatment for end-stage liver disease but is limited by a shortage of suitable donor organs. In order to meet waiting list demands, there has been an increase in utilisation of organs from extended criteria donors i.e. donation after cardiac death (DCD), steatosis (fatty liver) and older age. However, these organs do not tolerate ischaemia-reperfusion injury (IRI) during the transplant procedure, making them higher-risk.

Normothermic machine perfusion (NMP) maintains donor livers in a functioning state (similar to that in the body) with provision of blood, oxygen and nutrients at body temperature. Crucially, it also provides a platform to recover extended-criteria donor organs with opportunity to perform functional assessment to enable safer transplantation.

My research, supervised by Professor Peter Friend and Professor Leanne Hodson aims to utilise NMP as a platform to improve functionality and suitability of higher risk donor organs for transplantation with focus on clinical translation including (i) the use pharmacological agents to improve fat metabolism and protect donor livers from ischaemia-reperfusion injury; (ii) use of specialist filters to remove circulating fat and inflammatory mediators from the ex-situ NMP circuit and; (iii) development of novel tests that are able to provide an objective assessment of liver function during normothermic preservation (beyond current measures i.e. lactate clearance, transaminase levels). 

At present, I am running a NIHR funded multicentre clinical trial (The DeFat Study) under supervision of Chief Investigators (CIs) Professor Peter Friend and Mr Simon Knight. The trial aims to understand whether an innovative ‘defatting’ strategy will make fatty livers more suitable for transplantation. The trial involves random assignment of 60 livers from donors with a high risk of fatty liver disease to either NMP alone or NMP with fat removal treatment. The livers will be assessed for suitability to transplant (based on function) and, in those that are transplanted, outcomes will be followed up after the operation. The main objective is to demonstrate whether this treatment is safe and ultimately help us design a future, larger study which will test the extent to which fat removal leads to additional transplants.


I studied medicine at the University of Southampton and qualified as a doctor in 2012. During my undergraduate medical training, I undertook a period of research exploring ‘the role of the PI3/Akt pathway in periostin induced invasion of oesophageal adenocarcinoma’ under supervision of Professor Tim Underwood leading to attainment of a BMedSci degree in 2011.  

My foundation training was in the South Thames Deanery with rotations at St Richard’s, St Helier and the Royal Marsden Hospital. I moved to Oxford in 2014 for my Core Surgical Training and was appointed as Specialist Registrar within the Thames Valley (Oxford) Higher Surgical Training Programme in 2016.


Pancreatic enzyme replacement therapy in patients with pancreatic cancer: A national prospective study. Pancreatology. 2021;21(6):1127-1134.

Abbas SH, Friend PJ. Current status of organ preservation for transplantation. Surgery in Practice and Science. 2020. 

The Impact of Neoadjuvant Treatment on Survival in Patients Undergoing Pancreatoduodenectomy with Concomitant Portomesenteric Venous Resection: An International Multicenter Analysis. Annals od Surgery. 2021. doi: 10.1097/SLA.0000000000005132.

Defining Benchmark Outcomes for Pancreaticoduodenectomy with Portomesenteric Venous Resection. Annals of Surgery. 2020;272(5):731-737

Dengu F, Abbas SH, Ebeling G, Nasralla D. Normothermic Machine Perfusion (NMP) of the Liver as a Platform for Therapeutic Interventions during Ex-Vivo Liver Preservation: A Review. Journal of Clinical Medicine. 2020;9(4). pii: E1046. doi: 10.3390/jcm9041046

Abbas SH, Ghazanfar MA, Gordon-Weeks AN, Reddy SR, Soonawalla Z, Silva MA. Acalculous Cholecystitis: Is an Elective Interval Cholecystectomy Necessary? Digestive Surgery. 2017;35(2):171–6.