A few lines of Introduction and History
Liver transplantation is the most effective therapy for any end-stage liver disease. Liver transplantation is widely accepted as a therapeutic treatment for certain patients diagnosed with the symptoms of hepatocellular carcinoma. With recent advances in the therapeutic field of medicine and the efforts to rise the number of the donor pool, liver transplantation has been carefully extended to patients with other primary or secondary ailments in the liver. Cholangiocarcinoma, hepatic epithelioid haemangioendothelioma, and colorectal and neuroendocrine liver metastases are amongst the most significant new indications.

As per the record, the first successful living donor liver transplantation (LDLT) was performed in 1989 in a child in Brisbane and in an adult in 1994 by the Shinshu group. In recent years, with the increase of LDLT worldwide has established an alternative to the deceased donor liver transplantation.

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Liver can survive outside the human body for 12 to 15 hours. Considering the geographical factor, liver can travel farther than hearts and lungs. Since decades, an insulated container was used to place a donor liver which was a cooler quite literally while being transported over relatively short distances within regions, and thus ensuring their preservation.

The arrival of the OCS transportation system changes that standard. OCS places the liver in a heated portable carrier where the organ is connected to a pumping system that maintains a steady flow of oxygen-rich blood from the donor along with stabilizing fluid (a complex mixture of nutrients, electrolytes and hormones), mimicking the liver’s natural function in the body. Theoretically, the system allows for transportation over much greater distances and for longer periods of time to a waiting patient without compromising the organ’s viability.

Major Growth Drivers
The rising intake of heavy alcohol, growing instances of obesity, and the metabolic syndrome are some of the major factors which are going to contribute in the growth of the global organ care system for liver. According to the European Association for the Study of Liver, Cirrhosis is the 11th most common reason of death around the world along with liver cancer is the 16th leading reason of death.

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Alcoholic Liver Disease
Liver cirrhosis, fatty liver, and alcoholic hepatitis are the most prevailing types of alcoholic liver disease. As people adhere to heavy alcohol intake, they develop diseases like fatty liver which leads to hepatitis and finally, to cirrhosis. These diseases can also occur subsequently.

Research found that around 20 percent of alcoholics and heavy drinkers develop fatty liver, or steatosis. However, fatty liver can be cured properly if the alcohol consumption rate is reduced in a significant way. On the contrary, the condition can be fatal if alcohol consumption continues. Some biopsies from people with fatty liver display inflammatory changes which is typically an early sign of more serious liver disease.

Alcoholic hepatitis is diagnosed when inflammatory changes, fibrosis, liver degeneration, and other changes to the liver cells are displayed in a liver biopsy. The rate of mortality in severe cases goes up to 50 percent. If the drinking habit is not taken care of, about 40 percent of cases of alcoholic hepatitis develops into cirrhosis.

Cirrhosis of the liver is the most serious form of Alcoholic Liver Disease which is responsible for many deaths and critical illnesses. Liver cirrhosis defines a disease when scar tissue replaces normal liver tissue which disrupts blood flow through the liver and prevents it from working properly.

Liver cirrhosis is counted as a major cause of death in the United States. Higher rates of death have been recorded in countries such as France, Spain, and Italy- the countries where people traditionally consume more alcohol than in the United States.

Growing prevalence of obesity
Another liver disease becoming more and more prevalent in the U.S. is the one by obesity. Researchers surveyed nationwide health survey data collected in five cycles between 1988 and 2016. During this period, the proportion of adults with what’s known as non-alcoholic fatty liver disease (NAFLD) rose from 20% to 28.3%, mirroring increases in rates of obesity and diabetes over the same period. The proportion of the population with obesity rose from 22.2% to 38.9%, a recent report states.

Metabolic syndrome
The pervasiveness of the metabolic syndrome (MetS) can be defined as a cluster of cardiovascular risk factors associated with obesity and insulin resistance. This syndrome is intensely increasing in Western and developing countries. This disorder is not only associated with a higher risk of appearance of type 2 diabetes and cardiovascular events, but impacts on the liver in different ways.

Nonalcoholic fatty liver disease (NAFLD) is the major hepatic disorder in patients with metabolic syndrome, and indeed it is the most common cause of abnormal liver function tests in the working population in industrialized countries.

PRC expected to become the most lucrative market for Organ Care System market for Liver
Countries such as China, India, and Taiwan are seen to be more focused on the advanced liver transplant facility, state of the art infrastructure with best surgeons, to reduce surgical complications & improve patient safety. Thus, it is anticipated to witness a rapid growth of organ care system market for liver in Asia-Pacific region.

In People of Republic China, factors such as high incidence of liver diseases and improvisation in living standards are rising the demand for liver transplantation. PRC has various aspects such as medical, ethical and social and the advancements in this practices it is estimated that PRC will continue to grow in the rankings of countries which performs transplantation of liver. Thus, PRC can be considered as lucrative market for investors of organ care system market for liver.

China is to upsurge the number of organ transplant hospitals from 169 to about 300 by 2020, according to the chairman of the National Organ Donation and Transplantation Committee.

Future Perspective
According to a report published by the ResearchDive, the key players include

• TransMedics Inc.
• Bridge to Life Ltd.
• XVIVO Perfusion AB
• Preservation Solution Inc.
• Paragonix Technologies Inc.
• Organ Assist B.V.
• Organ Recovery Systems Inc.
• Organ Transport System Inc.
• Water Medical System LLC
• OrganOx Limited
• Preservation Solution Inc.

These players are initiating various steps in order strengthen their presence such as merger & acquisitions, new product development. For instance, in January 2019, the UK’s national institute for Health and care excellence approved OrganOx’s liver perfusion machine. With all these stats, the report also predicts that the global organ care system market will garner $40.5 million by 2026 from $21.2 million in 2018. In addition, encouragement of Collaboration programs between and health care and transplantation centers along with constant increase in donation after circulatory death (DCD) can drive the global market.

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