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.

Publications

10 25 50

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