Oxford Research in Plastic surgery and Hand surgery Innovation Collaboration (ORPHIC)

Our studies though seemingly diverse are linked.

i)  Principally we are investigating the utility of VCA (vascularised composite allograft) sentinel skin flaps to monitor the immunological status of solid organ transplant recipients especially in intestinal, pancreas (pancreas alone, pancreas and kidney), heart and lung transplants. Apart from improving clinical information to titrate immunosuppression, prevent and treat rejection and prevent transplant organ damage leading to better long-term function and survival we are also combining clinical observation with protocol and event biopsies in the hope to identify key early immunological markers in rejection. We are also studying the psychological aspects of having a visible transplant and the physiological changes to VCA after transplantation. In addition, we are studying the influence of the skin microbiome on rejection of the skin flap or the solid organ transplant.

ii)  We are working on improving islet of Langerhans transplantation by modifying the immediate blood mediated inflammatory response and improving islet re-vascularisation.

iii)  We are performing laboratory perfusion studies of composites of skin and other tissues called flaps in order to preserve them for prolonged periods of time. This ability will facilitate transplantation of Vascularised Composite Allografts such as hand and face transplants by increasing the time available to perform surgery especially in multiple transplants, or reducing the immunogenicity by flushing out antigens, or to increase flap versatility in plastic surgical reconstruction including the ability to modify the flap prior to re-attachment by cellular or other therapies.

iv)  We are working with NHSBT with mesenchymal stem cells (MSC) to improve transplantation or infection treatments

v)  We perform clinical trials in plastic, hand and transplant surgery

vi)  We devise experimental procedures to treat difficult surgical problems,