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Improving Outcomes Of Transplantation By Targeting Retrieval, Care And Complications
Funder
National Health and Medical Research Council
Funding Amount
$70,750.00
Summary
Our aim is to find out what the problems related to organ transplantation are in order to suggest ways of intervening to help reduce these problems for patients and the health care system. We will work closely with the team at one of Australia's leading transplant centres at Westmead Hospital to try and find safe and economic ways to tackle issues of organ shortage, those that come up during the organ donation and in the wider care of patients improve the practice.
Bridging The Gap In Kidney Transplantation Using Pigs As Donors
Funder
National Health and Medical Research Council
Funding Amount
$1,452,341.00
Summary
Chronic kidney failure results in patients suffering significant morbidity and mortality ultimately requiring life-supporting dialysis. Kidney transplantation and lifelong immunosuppression are the only treatment, but (i) is limited by the shortage of human donors and (ii) carries risks associated with these anti-rejection drugs. This project aims to solve both problems by using humanized pigs as donors combined with a novel approach to inducing acceptance of the transplanted kidneys.
Unraveling Mechanisms Of Liver Transplant Tolerance
Funder
National Health and Medical Research Council
Funding Amount
$694,822.00
Summary
Liver transplants are unique amongst solid organs as they are spontaneously accepted across different individuals and induce acceptance of other organs from the same donor co-transplanted at the same time. Using a new mouse liver transplantation model, this proposal will elucidate how the liver tissue performs this function and identify new markers associated with tolerance in the blood of mice. This knowledge will be used to identify liver transplant patients with reduced rejection risk.
Improving Kidney Transplant Outcomes Using Normothermic Machine Perfusion
Funder
National Health and Medical Research Council
Funding Amount
$778,232.00
Summary
Kidneys donated for transplantation are at risk of damage that prevent the organ from working and reduce its lifespan. Normothermic machine perfusion is a device that can circulate oxygenated blood at normal body temperature through a donor kidney prior to transplantation. In doing so it is able to resuscitate the kidney and prevent injury. We will determine how machine perfusion achieves this remarkable effect and investigate new treatments for kidney injury.
Delayed Phase Of Remote Ischemic Preconditioning: Clinical Application And The Role Of Kallikrein-kinin Pathway.
Funder
National Health and Medical Research Council
Funding Amount
$159,197.00
Summary
Brief episodes of interruption of blood flow to the arm or leg provide strong protection against prolonged interruption of blood flow to a target organ (e.g., heart or lung). This is known as remote ischemic preconditioning (RIPC). The strongest protection occurs 24 hours after blood flow interruption to the limb and may be mediated by a humoral cascade known as kallikrein-kinin. RIPC may provide protection against heart attack and stroke.
Manufacture And Testing Of Next Generation Orthopaedic Implants Harnessing Periosteum's Regenerative Power
Funder
National Health and Medical Research Council
Funding Amount
$508,314.00
Summary
Tissue defects, e.g. due to trauma or tumor removal, are too large to heal without reconstructive surgery. Complications associated with defect repair may diminish the patient's quality of life and productivity, posing significant medical and psychosocial costs. Here we propose a plan to define technical specifications for next generation, "smart" orthopaedic implants that deliver cells and the signals they need to build new tissue using nature's paradigms.
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
CD39 Protects Against Renal Ischaemic-reperfusion Injury
Funder
National Health and Medical Research Council
Funding Amount
$441,584.00
Summary
In many medical settings, such as heart attacks, strokes, transplantation, heart surgery, shock and infection, the blood supply to an organ may be compromised resulting in damage. The cessation of blood flow depletes the organ of oxygen and generates a number of toxic changes. Re-establishing blood flow to the organ is essential to prevent further damage, however the reestablishment of blood flow itself can be harmful to the organ. The return of blood flow, oxygen and energy can actually promote ....In many medical settings, such as heart attacks, strokes, transplantation, heart surgery, shock and infection, the blood supply to an organ may be compromised resulting in damage. The cessation of blood flow depletes the organ of oxygen and generates a number of toxic changes. Re-establishing blood flow to the organ is essential to prevent further damage, however the reestablishment of blood flow itself can be harmful to the organ. The return of blood flow, oxygen and energy can actually promote more widespread injury - a process known as ischaemia-reperfusion injury (IRI). A greater understanding of IRI should aid in the development of drugs that minimise its impact. The overall aim of this work is to examine the role of a molecule - CD39 - in IRI. This molecule is ideally situated to minimise injury - it is located on cells that line blood vessels and, as such, is able to directly neutralise toxins released in response to this injury. We, therefore, believe that it will be protective in this setting. We have developed animals that express this molecule and have preliminary results to suggest that these animals are protected in experimental models of IRI as well as in several other models including heart transplantation surgery; processes that share many features with IRI. Moreover, mice deplete of this molecule are prone to more severe IRI. We aim to investigate this by using animals both lacking and expressing CD39. Blood flow to the kidneys will be interrupted for 30 minutes and kidney function assessed at 24 and 48 hours. We will then delve into the potential mechanisms underpinning IRI by determining whether the kidney itself or the blood cells afford protection, which has direct clinical implications.Read moreRead less
Guaranteeing Survival Into Adulthood, Physical Health And Psychological Well-being To Children Born With Single Ventricles.
Funder
National Health and Medical Research Council
Funding Amount
$342,773.00
Summary
Being born with a single pumping heart chamber is the most severe heart condition but thanks to several operations we can see them survive. A growing population of young functional adults now face an uncertain future and we have no options for them. A/Pr Y d’Udekem is a leading paediatric cardiac surgeon. His research aims to provide the medications, reinterventions and artificial hearts that are necessary to give them a longer and fulfilling life.
Effects Of Ischemia/ Reperfusion Injury On Enteric Neurons And Neuroprotective Strategies
Funder
National Health and Medical Research Council
Funding Amount
$566,277.00
Summary
The intestine can suffer restricted blood flow, creating a region of damaged or dead bowel. This leads to severe medical emergencies, complications and even death. Loss of blood flow and damage can be a serious complication for intestinal transplant surgery, which compromises patient survival and recovery. The project brings together transplant surgeons and basic scientists to solve problems caused by intestinal ischemia. A major result will be to improve outcomes for Australian patients