Detection Of Liver And Renal Function Abnormalities In The Australian & New Zealand Population Of Fontan Patients
Funder
National Health and Medical Research Council
Funding Amount
$345,080.00
Summary
Children born with complex heart defects and only one pumping chamber can now live into adulthood with an operation called the Fontan procedure. As this operation has only existed for 40 years, the long-term expectations for these children and young adults are still unclear, and their population is growing every year. There is now evidence that they may suffer from liver and kidney failure. This project will identify the severity of liver and kidney damage in our population of Fontan patients.
Preconditioning: The Molecular Basis For Protection From Hepatic Ischemia-reperfusion Injury
Funder
National Health and Medical Research Council
Funding Amount
$406,980.00
Summary
When the blood supply to the liver is cut off temporarily (ischemia) and later restored (reperfusion) the liver is damaged by a process called ischemia-reperfusion (IR) injury. This is a major problem during liver surgery and is also an underlying problem in liver transplantation; following storage of a donor liver ready for placing into the recipient it can undergo a similar process called preservation injury. We now understand a lot about how IR comes about, particularly by the formation of da ....When the blood supply to the liver is cut off temporarily (ischemia) and later restored (reperfusion) the liver is damaged by a process called ischemia-reperfusion (IR) injury. This is a major problem during liver surgery and is also an underlying problem in liver transplantation; following storage of a donor liver ready for placing into the recipient it can undergo a similar process called preservation injury. We now understand a lot about how IR comes about, particularly by the formation of damaging oxygen radicals within liver cells to start a process of programmed cell death, but it remains difficult to prevent or treat IR injury. A recent breakthrough has been recognition that subjecting the liver to only a short period (5 or 10 minutes) of ischemia protects against a later period of prolonged ischemia or IR. In the investigator s mouse model, for example, such preconditioning was 60 to 90% protective (depending on the time after IR). This project seeks to understand how preconditioning works to protect the liver against IR injury. Our idea is that preconditioning generates a limited amount of oxygen radicals, and that these turn on signalling pathways in the cell that regulate certain protective genes. Genes that encode antioxidant and other anti-stress pathways are likely to be important, but so are genes that prepare the cell to enter the cell cycle and divide into new cells that regenerate the liver. Conversely, genes that program cell death may be turned off. The outcomes of this research will be to understand the molecular and cellular basis of how preconditioning protects against ischemia-reperfusion injury of the liver. This will allow drug treatments to be devised that, by simulating preconditioning, prevent this common and severe type of liver damage.Read moreRead less
Detection, Prevention And Treatment Of Failure Of The Fontan Circulation
Funder
National Health and Medical Research Council
Funding Amount
$90,533.00
Summary
Children born with complex heart defects and only one pumping chamber can now live into adulthood with an operation called the Fontan procedure. As this operation has only existed for 40 years, the long-term expectations for these children and young adults are still unclear, and their population is growing every year. This project aims to answer questions about the follow-up and medical management of people living with a Fontan procedure.
Discovery Early Career Researcher Award - Grant ID: DE120100402
Funder
Australian Research Council
Funding Amount
$375,000.00
Summary
The effectiveness of intervention in communication and safety climate in the operating room. This project will evaluate the effectiveness of an educational intervention on teamwork behaviours in surgery. It will deliver beneficial effects for communication in service delivery, safety and patient care in support of health care in high risk environments.
Enkephalin Metabolism In Cardiac Ischemia, Heart Failure And Cardiac Surgery
Funder
National Health and Medical Research Council
Funding Amount
$327,037.00
Summary
It has recently been discovered in animal studies that heart muscle can make its own opioid proteins. Previously, it was thought that only nerves made and released opioids. We have recently found that a class of opioids called enkephalins are made and then depleted from the heart during the stress of oxygen and nutrient deprivation. Enkephalins have been found to have potent metabolic effects on the heart. Previous work has shown that opioids can protect the heart against injury incurred during ....It has recently been discovered in animal studies that heart muscle can make its own opioid proteins. Previously, it was thought that only nerves made and released opioids. We have recently found that a class of opioids called enkephalins are made and then depleted from the heart during the stress of oxygen and nutrient deprivation. Enkephalins have been found to have potent metabolic effects on the heart. Previous work has shown that opioids can protect the heart against injury incurred during disease that restricts energy and oxygen supply to the blood vessels and heart. We wish to demonstrate this for the first time in human heart, and we will explore whether the production of enkephalins is altered by the stresses of cardiac surgery and heart failure. Understanding how the human heart attempts to protect itself in disease and how enkephalins work under these conditions, may prove valuable in the development of new drug therapy with synthetic drugs which mimic the action of enkephalins for heart protection during cardiac surgery, heart transplantation and ischemic heart disease. We will test whether specific enkephalins may be used to improve donor heart viability for transplantation by improving the duration and quality of preservation during storage. Understanding what happens to enkephalin production and metabolism in the failing hearts of patients may allow us to find new therapeutic targets in heart failure.Read moreRead less
Acute pancreatitis is an acute abdominal inflammatory process (the pancreas attempts to digest itself) with significant mortality in those patients having the severe form of the disease. The commonest causes of the disease are gallstones and excessive alcohol consumption. Approximately 80% of patients with acute pancreatitis recover, but 20% experience the severe form of the disease. In severe pancreatitis, 30% of patients die. Severe pancreatitis is associated with necrosis (cell death) of the ....Acute pancreatitis is an acute abdominal inflammatory process (the pancreas attempts to digest itself) with significant mortality in those patients having the severe form of the disease. The commonest causes of the disease are gallstones and excessive alcohol consumption. Approximately 80% of patients with acute pancreatitis recover, but 20% experience the severe form of the disease. In severe pancreatitis, 30% of patients die. Severe pancreatitis is associated with necrosis (cell death) of the pancreas which, results from reduced blood flow in the organ. This reduced blood flow may be secondary to increased pressure in the pancreatic duct following occlusion of the duct. Preliminary studies suggest that the reason why the pancreas may be susceptible to necrosis is the anatomical arrangement of its blood supply, being made up of many end arterioles (very small arteries) that do not connect with other arteries. The consequence of this arrangement is that if a particular end arteriole becomes blocked, the area of the tissue cannot obtain a blood supply from neighbouring arterioles (as in other organs). Blood supply is partly controlled by nerves. The nerve transmitter nitric oxide is one of the major chemicals involved in this regulation. Nitric oxide also regulates the pressure in the pancreatic duct by acting on the sphincter of Oddi, situated at the opening of the pancreatic duct. Consequently, the action of nitric oxide during pancreatitis may be crucial to the development of the severe disease. This proposal seeks to define the blood supply of the pancreas, its regulation, the effect that increased pancreatic duct pressure has on it and the role that nitric oxide plays in this. If the hypotheses regarding the role of nitric oxide on pancreatic blood flow is proven, then drugs which influence nitric oxide levels can be used to limit the production of pancreatic necrosis. In turn, such an effect will reduce the mortality and morbidity of acute pancreatitis.Read moreRead less
NON IMMUNOLOGICAL BARRIERS TO SUCCESSFUL TREATMENT OF DIABETES BY XENOTRANSPLANTATION
Funder
National Health and Medical Research Council
Funding Amount
$310,500.00
Summary
Tragically patients whom suffer from diabetes mellitus develop major secondary complications such as renal failure, even with today's tight glucose control. Insulin injections minimise diabetic complications but restricts lifestyle and an alternative, pancreatic islet cell transplantation, is limited by donor shortage. With genetic technology, pig donor tissue is a feasible donor source. This project will use an inbred pig colony to assess long term pig fetal and neonatal islet cell function in ....Tragically patients whom suffer from diabetes mellitus develop major secondary complications such as renal failure, even with today's tight glucose control. Insulin injections minimise diabetic complications but restricts lifestyle and an alternative, pancreatic islet cell transplantation, is limited by donor shortage. With genetic technology, pig donor tissue is a feasible donor source. This project will use an inbred pig colony to assess long term pig fetal and neonatal islet cell function in combination with a kidney graft in the absence of an immune response. Using this specifically inbred pig colony we will carefully catalogue the type, number and distribution of endogenous retroviruses within pig genes. Using new and novel techniques we will develop a new strategy by which we can block and overcome this major concern of xenotransplantation. Ultimately a unique Australian resource will be developed which may provide unlimited islets for safe, large-scale transplantation of diabetics before they develop debilitating secondary complications from their diabetes and provide an alternative to the only current method of curing endstage renal failure with a combined pancreas and kidney transplant.Read moreRead less
Examining healthcare professionals' communication across the surgical pathway to improve patient safety. Recent data show breakdowns in communication contributed to 16% of sentinel events in Australia, the majority of which were of a surgical nature. Financial costs associated with adverse events are enormous, estimated at around $A2billion/year. Economic burden is predicted to increase with further complexities surrounding patients' surgical care. This study will result in new knowledge about c ....Examining healthcare professionals' communication across the surgical pathway to improve patient safety. Recent data show breakdowns in communication contributed to 16% of sentinel events in Australia, the majority of which were of a surgical nature. Financial costs associated with adverse events are enormous, estimated at around $A2billion/year. Economic burden is predicted to increase with further complexities surrounding patients' surgical care. This study will result in new knowledge about communication patterns to inform the development of reporting methods and strategies that positively influence the practices of healthcare professionals. Strategies could be extrapolated to the broader healthcare sector, and provide tactical direction aimed at averting clinical errors, preventing patient harm and reducing healthcare costs.Read moreRead less