I graduated from Oxford University Medical School in 2005. After completing my MRCS I then embarked on Specialist Surgical Training in the Severn region. I have undertaken numerous local research projects investigating subjects such as surgical endoscopy training in England, novel methods for diagnosing GI malignancy, the management of colorectal liver metastases and the role of PET-CT in oesophageal cancer. My main area of clinical and academic interest is in the field of hepatobiliary and pancreatic surgery.
- 2017 Rising Star Symposium Award, ILTS, ELITA and LICAGE
- 2017 Young Investigator Award, ILTS, ELITA and LICAGE
- 2017 Young Investigator Award, ASTS and AST
- 2017 Medawar Medal, The British Transplantation Society
- 2016 Young Investigator Scientific Award, The Transplantation Society
BMBCh, MA(Oxon), MRCS
Clinical Research Fellow in Transplant Surgery and DPhil Candidate
My research is investigating a new method of preserving livers for transplantation – normothermic machine perfusion (NMP).
880 liver transplants were carried out from deceased donors in the UK during 2013–2014, but 1186 patients were registered for a liver transplant in the same period. This shortfall is typical of transplantation services worldwide. In the UK, a patient is now more likely to die whilst waiting for a transplant than in the 12 months after the operation. Optimisation of donor livers has been identified as an essential part of a national strategy to improve outcomes after transplantation and this theme of research is considered a priority by NHSBT in delivering a world class transplant service, and is fully supported through the department of health.
The current standard practice is to store the organ in an ice box (static cold storage; SCS). With NMP, the liver is connected to a modified cardio-pulmonary bypass circuit which perfuses it with oxygenated blood, nutrients and medications at normal body temperature. This preserves the liver in a functioning physiological state which is maintained throughout the storage and transport of the organ until it is ready to be transplanted. I am comparing SCS with NMP in a multi-national randomised controlled trial involving seven liver transplant units in four countries. The trial is one of several projects being conducted by the Consortium for Organ Preservation in Europe (COPE) which is funded by an EC FP7 Award.
In addition to running the clinical trial described above, I have several areas of particular interest that I am focusing on for my DPhil. These are:
- The effect of organ preservation on mitochondrial complex activity
- Bile production during NMP
- Immunological effects of NMP
- Predicting organ viability using NMP.
Heterogeneous indications and the need for viability assessment: An international survey on the use of machine perfusion in liver transplantation
Patrono D. et al, (2022), Artificial Organs, 46, 296 - 305
Machine perfusion of the liver: applications in transplantation and beyond.
Ceresa CDL. et al, (2022), Nat Rev Gastroenterol Hepatol
Multicenter validation of the liver graft assessment following transplantation (L-GrAFT) score for assessment of early allograft dysfunction.
Agopian VG. et al, (2021), J Hepatol, 74, 881 - 892
Normothermic Machine Perfusion (NMP) of the Liver as a Platform for Therapeutic Interventions during Ex-Vivo Liver Preservation: A Review.
Dengu F. et al, (2020), J Clin Med, 9
Transient Cold Storage Prior to Normothermic Liver Perfusion May Facilitate Adoption of a Novel Technology.
Ceresa CDL. et al, (2019), Liver Transpl, 25, 1503 - 1513