Metabolic assessment of perfused livers using magnetic resonance imaging and spectroscopy
Lead Research Organisation:
University of Oxford
Department Name: RDM Radcliffe Department of Medicine
Abstract
This project focuses on using MRI techniques to assess the viability of livers being preserved using normothermic machine perfusion (NMP) technology for transplantation.
In the UK, a shortage of suitable donor organs means that 1/3 of patients have to wait longer than 1 year for a transplant and 20% of patients on the waiting list die before receiving a liver transplant. Clinical evidence suggests that enhanced preservation techniques could provide a way of saving many livers which are currently offered for donation but deemed too high risk to transplant.
Normothermic machine perfusion (NMP) is a preservation technique that keeps the liver in a functional state ex vivo by supplying it with oxygenated blood and nutrition at normal body temperature. This allows longer preservation times and provides the opportunity to make in-depth assessment of the liver's function.
The student will perform perfusion studies on human livers that have been determined unsuitable for transplantation. By using a novel perfusion system, which allows the liver to be perfused inside an MRI scanner, the student will aim to gain an understanding of the structural and metabolic changes that occur in the livers during preservation. This knowledge can then be applied to gain a better understanding of what makes a liver suitable to transplant.
Throughout this project the student will improve quantitative skills by creating the custom data analysis pipelines that will be required for this project. The student will also gain a wide range of interdisciplinary skills through learning from his three supervisors who are experts in MRI, surgery, and engineering respectively. Another key skill the student will gain during this project is an understanding of the physiology of the whole liver, by scanning complete livers and performing longer scans than could be performed on human subjects.
In the UK, a shortage of suitable donor organs means that 1/3 of patients have to wait longer than 1 year for a transplant and 20% of patients on the waiting list die before receiving a liver transplant. Clinical evidence suggests that enhanced preservation techniques could provide a way of saving many livers which are currently offered for donation but deemed too high risk to transplant.
Normothermic machine perfusion (NMP) is a preservation technique that keeps the liver in a functional state ex vivo by supplying it with oxygenated blood and nutrition at normal body temperature. This allows longer preservation times and provides the opportunity to make in-depth assessment of the liver's function.
The student will perform perfusion studies on human livers that have been determined unsuitable for transplantation. By using a novel perfusion system, which allows the liver to be perfused inside an MRI scanner, the student will aim to gain an understanding of the structural and metabolic changes that occur in the livers during preservation. This knowledge can then be applied to gain a better understanding of what makes a liver suitable to transplant.
Throughout this project the student will improve quantitative skills by creating the custom data analysis pipelines that will be required for this project. The student will also gain a wide range of interdisciplinary skills through learning from his three supervisors who are experts in MRI, surgery, and engineering respectively. Another key skill the student will gain during this project is an understanding of the physiology of the whole liver, by scanning complete livers and performing longer scans than could be performed on human subjects.
Publications
Studentship Projects
| Project Reference | Relationship | Related To | Start | End | Student Name |
|---|---|---|---|---|---|
| MR/N013468/1 | 30/09/2016 | 29/09/2025 | |||
| 1966877 | Studentship | MR/N013468/1 | 30/09/2017 | 29/09/2021 | Liam Young |
| Description | 3 month travel grant for international PhD-student |
| Amount | 45,000 kr. (DKK) |
| Organisation | Aarhus University |
| Sector | Academic/University |
| Country | Denmark |
| Start | 02/2020 |
| End | 04/2020 |
| Description | Developing Concept Fund |
| Amount | £48,968 (GBP) |
| Funding ID | RE/18/1/34212 |
| Organisation | British Heart Foundation (BHF) |
| Sector | Charity/Non Profit |
| Country | United Kingdom |
| Start | 06/2019 |
| End | 07/2020 |
| Description | Marya Antonina Czaplicka Travel Grant |
| Amount | £325 (GBP) |
| Organisation | University of Oxford |
| Department | Somerville College |
| Sector | Academic/University |
| Country | United Kingdom |
| Start | 05/2018 |
| End | 06/2018 |
| Description | Non-invasive detection of succinate in myocardial ischaemia using magnetic resonance spectroscopy |
| Amount | £49,904 (GBP) |
| Funding ID | RG93172/Wier-McCall/42379 |
| Organisation | Wellcome Trust |
| Sector | Charity/Non Profit |
| Country | United Kingdom |
| Start | 11/2020 |
| End | 08/2021 |
| Description | Wilma Crowther Travel Grant |
| Amount | £250 (GBP) |
| Organisation | University of Oxford |
| Department | Somerville College |
| Sector | Academic/University |
| Country | United Kingdom |
| Start | 04/2019 |
| End | 05/2019 |
| Description | Oxford-Aarhus Metabolic liver studies |
| Organisation | Aarhus University |
| Country | Denmark |
| Sector | Academic/University |
| PI Contribution | Liam Young applied with Dr Christoffer Laustsen (Aarhus University) to obtain travel funding and is spending 2 months at Aarhus University to perform a series of experiments. Oxford University have loaned a phosphorus coil for an MRI scanner to Aarhus University to be used during these experiments. |
| Collaborator Contribution | Dr Christoffer Laustsen from Aarhus University applied for a travel grant with Liam Young and has provided funding for a series of in vivo experiments on pigs while Liam is at Aarhus University. Dr Laustsen's team have provided all of the support necessary to perform a set of complicated experiments. |
| Impact | We obtained a Travel grant from Aarhus University. This is a multi-disciplinary collaboration between MR physicists at the University of Oxford and engineers and surgeons from Aarhus University Department of Medicine. |
| Start Year | 2019 |
| Description | Perfused heart assessment with Magnetic Resonance Imaging |
| Organisation | Papworth Hospital |
| Country | United Kingdom |
| Sector | Hospitals |
| PI Contribution | Liam Young has helped to develop a heart perfusion machine that is compatible with an MRI scanner with Mr Stephen Large (Papworth Hospital), Dr Jonathan Weir-McCall (University of Cambridge) and Prof Christopher Rodgers (University of Cambridge) and has setup a protocol of scans to compliment this setup. He is also travelling to Cambridge to run experiments on perfused ex vivo hearts that are connected to the perfusion machine which has been developed. |
| Collaborator Contribution | Mr Stephen Large has provided surgical expertise needed to develop the system. Dr Jonathan Weir-McCall is the primary investigator that is funding the work. |
| Impact | We have obtained funding for an initial proof of concept study of our new system through the BHF CRE Cambridge's Developing Concept Fund. This is a multi-disciplinary project between surgeons in the Department of Cardiothoracic surgery at Papworth Hospital, radiologist from Department of Radiology at the University of Cambridge and physical scientists at the Oxford Centre for Magnetic Resonance Research at the University of Oxford. |
| Start Year | 2019 |
| Description | Perfused heart assessment with Magnetic Resonance Imaging |
| Organisation | University of Cambridge |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | Liam Young has helped to develop a heart perfusion machine that is compatible with an MRI scanner with Mr Stephen Large (Papworth Hospital), Dr Jonathan Weir-McCall (University of Cambridge) and Prof Christopher Rodgers (University of Cambridge) and has setup a protocol of scans to compliment this setup. He is also travelling to Cambridge to run experiments on perfused ex vivo hearts that are connected to the perfusion machine which has been developed. |
| Collaborator Contribution | Mr Stephen Large has provided surgical expertise needed to develop the system. Dr Jonathan Weir-McCall is the primary investigator that is funding the work. |
| Impact | We have obtained funding for an initial proof of concept study of our new system through the BHF CRE Cambridge's Developing Concept Fund. This is a multi-disciplinary project between surgeons in the Department of Cardiothoracic surgery at Papworth Hospital, radiologist from Department of Radiology at the University of Cambridge and physical scientists at the Oxford Centre for Magnetic Resonance Research at the University of Oxford. |
| Start Year | 2019 |
| Description | Somerville College SCR/MCR Symposium |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Postgraduate students |
| Results and Impact | I presented an introduction to our work assessing perfused organs by MRI to current and past members of Somerville College. The diverse range of backgrounds present prompted many questions and a good discussion afterwards. |
| Year(s) Of Engagement Activity | 2018 |