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Project title
Composite tissue Transplant: Ex Vivo Normothermic Perfusion
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Grant Holder: Mr Mo Akhavani
Position: Consultant Plastic Surgeon, Royal Free Hospital
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Date of award
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Date of report
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Grant Awarded (i.e. £10,000)
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£10,000
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Is this an interim, or final, report
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Interim
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Summary of progress /findings (approx 300 words)
We have now carried out a pilot study into studying the skeletal muscle ischaemia reperfusion injury (IRI) concept using a 4 male pig models. The pig was sacrificed to harvest the solid organs and the upper limb was amputated to study IRI. The first two limbs we used were disarticulated at the shoulder of the male pig. This proved to be too bulky and very difficult to place on the transfusion pump. Furthermore, the bleeding was too heavy from the cut edges of the muscle. The next two limbs used, were disarticulated at the elbow joint. This seemed to be a more manageable in terms of size, however, due to nature of the dissection some parts of the limb were not perfused. The data in terms of re-warming of the limb post transfusion, acid/base measurements and muscle biopsies indicate inadequate reperfusion.
As a result, we are now developing a different model to study muscle IRI. This will be on a free musculocutaneous flap raised whilst the animal is alive. We will need to re-apply to alter the surgical harvest from the local ethics committee.
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What is the relevance/value of this research to hand surgery
Skeletal muscle ischaemia is on of the most critical factors in achieving a good outcome from composite tissue transplantation such as the upper limb. The longer the ischaemia the worse the outcome. This research, aims to establish a robust model to study muscle IRI and investigate novel ways to modulate the IRI.
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If final report, please provide bullet point list of conclusions/important findings
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Please list presentations based on work performed in this study
Akhavani, MA
Composite graft EVNP: Potential applications in limb transplantation and beyond
National Ex Vivo Normothermic Perfusion Symposium, Cambridge, July 2015,
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Please list publications based on work performed in this study
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Please state what additional research this study has/is leading to
- Once we have established the free flap model to study the skeletal muscle/composite tissue IRI in a more controlled manner, the plan is to use mitochondrial modulation to study IRI.
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Please list any further funding or grant applications (with outcome), which have resulted from the award of this grant
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How has this grant awards helped your career development?
- I am a newly appointed consultant. This grant has enabled me to kick start my own research idea in collaboration with another unit. My aim is to provide a robust proof of concept and then to apply for larger grants and have my own research student/s.
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On a separate sheet, please list how your grant was actually spent – this will help us assess grant applications in the future.
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Expenditure to date (please itemise all individual costs over £500) and include copies of receipts (keep originals for final report)
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Salaries
Consumables (X-rays, postage, reagents)
- 4 autologous blood transfusion kits
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Cost
Total
£8000
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