(MRC DTP) Enabling the reattachment of traumatically amputated tissues via prolonged preservation using ex-vivo perfusion.

Traumatic amputation of peripheral tissues is a frequent complication in patients with multiple life-threatening injuries. The surgical team must prioritise interventions that save the individuals life, and as such reattachment of amputated tissues including digits, hands and feet, is not considered in the first 24-48 hours following admission into the hospital setting. Currently it is not possible to preserve tissues for this length of time outside of the body, so in most cases, amputated tissues are discarded. This has significant physical and psychological impact on the patient. Loss of these vital structures can lead to lifelong disability and heavy reliance on health and social care.

However, the transplant community have developed new technologies that enable the prolonged preservation of organs and tissues outside of the body using ex-vivo perfusion. This involves connecting the vasculature to a circuit and pumping nutrient rich, oxygenated blood through the tissues. Using this approach, our group have been able to maintain entire limbs for 24 hours in a physiological environment. The injury response, propagation of inflammatory cascades and definition of the zone of trauma cannot easily be evaluated in the acute setting hence, the purpose of this project will be to evaluate the resolution of these cascades and return to homeostasis in these tissues on ex vivo perfusion.

For the purposes of the proposed study, we now intend to develop a protocol, device and solutions that enable the long-term storage of amputated tissues, with the aim of reaching 48 hours. We will evaluate novel ancillary tools including vascular and thermal imaging, haemofiltration, and immuno-modulatory approaches combined with advanced perfusion. Specifically we will aim to study and enhance the restoration of homeostasis in these tissues after critical injury. If successful, this innovation would provide the surgical team sufficient time to stabilise patients with poly-trauma and enable the reattachment of traumatically amputated tissues, restoring form and function to patients.

James Fildes: https://www.research.manchester.ac.uk/portal/james.fildes.html

Jason Wong: https://www.research.manchester.ac.uk/portal/jason.k.wong.html

Entry Requirements:
Applicants must have obtained, or be about to obtain, at least an upper second class honours degree (or equivalent) in a relevant subject.

UK applicants interested in this project should make direct contact with the Primary Supervisor to arrange to discuss the project further as soon as possible. International applicants (including EU nationals) must ensure they meet the academic eligibility criteria (including English Language) as outlined before contacting potential supervisors to express an interest in their project. Eligibility can be checked via the University Country Specific information page (https://www.manchester.ac.uk/study/international/country-specific-information/).

If your country is not listed you must contact the Doctoral Academy Admissions Team providing a detailed CV (to include academic qualifications – stating degree classification(s) and dates awarded) and relevant transcripts.

Following the review of your qualifications and with support from potential supervisor(s), you will be informed whether you can submit a formal online application.

To be considered for this project you MUST submit a formal online application form - full details on how to apply can be found on the MRC Doctoral Training Partnership (DTP) website www.manchester.ac.uk/mrcdtpstudentships