Martin A Birchall

University College London Hospitals NHS Foundation Trust, Londinium, England, United Kingdom

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Publications (170)952.72 Total impact

  • Journal of Pediatric Gastroenterology and Nutrition 10/2015; 61(4):509. DOI:10.1097/MPG.0000000000000923 · 2.63 Impact Factor
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    ABSTRACT: Tissue engineered organs require effective and validated cell seeding protocols when translated clinically. To adequately design these protocols, simple, reliable and reproducible cell-tracking techniques are required. Techniques already available are often either invasive, overly labour intensive, not entirely specific or limited to analysis of a small segment of the graft. Bioluminescence imaging (BLI) is a well-established method of in vivo imaging that is commonly used in real-time analysis of disease and efficacy of drugs. We determined the applicability of BLI as a method to track cells in bioreactor cultures and eventually in vivo, in the development of tissue engineering applications. Lentiviral transduction of various cell types was performed using a transfer vector that constitutively expresses a florescent protein and luciferase. The BLI system was characterised through comparison to pre-established techniques (Alamar Blue and CyQuant). The potential of the system as a cell tracking method in tissue engineering applications was examined by tracking cells on both synthetic and biological tubular scaffolds in a closed bioreactor system and in vivo. BLI was comparable to well-established techniques for cell tracking in vitro. Viable transduced cells could be accurately detected and tracked when seeded in all conditions tested. In addition, BLI was shown to deliver information on cell distribution on the scaffold and could provide a comprehensive assessment of the cells over the entire duration of the experiment. This is an effective, non-invasive and simple cell tracking method that is proven to be a valuable tool in tissue engineering of bioartificial complex organs.
    2015 4th TERMIS World Congress, Boston, Massachusetts, USA; 09/2015
  • M Mat Baki · R Yu · J S Rubin · E Chevretton · G Sandhu · M A Birchall
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    ABSTRACT: To explore unilateral vocal fold paralysis patients' perception of a proposed randomised, controlled trial of laryngeal reinnervation versus thyroplasty, and to identify patients' concerns regarding their voice. Seventeen patients from five voice clinics in London were identified as being eligible for the randomised, controlled trial. Eleven of these patients (9 females and 2 males; age range, 18-65 years) were interviewed using a semi-structured topic guide (they were given a minimum of 2 weeks to read through the study information sheet). The interviews were recorded, transcribed and analysed using thematic analysis. The patients were satisfied with the clarity of the information sheet. Most of them perceived that reinnervation was a more 'attractive' option than thyroplasty. This may have been the result of certain phraseology used in the information sheet and by recruiters. Patients' main concern was reduced voice strength and the effects of this on work and social life. Phraseology that needed changing was identified; these changes may optimise the recruitment process for a trial. We propose using the voice handicap index 10 as the primary measure of outcome in the proposed randomised, controlled trial.
    The Journal of Laryngology & Otology 07/2015; 129(7):693-701. DOI:10.1017/S0022215115000985 · 0.67 Impact Factor
  • J C R Wormald · J M Fishman · S Juniat · N Tolley · M A Birchall
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    ABSTRACT: Tissue engineering using biocompatible scaffolds, with or without cells, can permit surgeons to restore structure and function following tissue resection or in cases of congenital abnormality. Tracheal regeneration has emerged as a spearhead application of these technologies, whilst regenerative therapies are now being developed to treat most other diseases within otolaryngology. Methods and results: A systematic review of the literature was performed using Ovid Medline and Ovid Embase, from database inception to 15 November 2014. A total of 561 papers matched the search criteria, with 76 fulfilling inclusion criteria. Articles were predominantly pre-clinical animal studies, reflecting the current status of research in this field. Several key human research articles were identified and discussed. Conclusion: The main issues facing research in regenerative surgery are translation of animal model work into human models, increasing stem cell availability so it can be used to further research, and development of better facilities to enable implementation of these advances.
    The Journal of Laryngology & Otology 06/2015; 129(8):1-8. DOI:10.1017/S0022215115001577 · 0.67 Impact Factor
  • Cytotherapy 06/2015; 17(6):S14-S15. DOI:10.1016/j.jcyt.2015.03.332 · 3.29 Impact Factor
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    ABSTRACT: In 2010, a tissue-engineered trachea was transplanted into a 10-year-old child using a decellularized deceased donor trachea repopulated with the recipient's respiratory epithelium and mesenchymal stromal cells. We report the child's clinical progress, tracheal epithelialization and costs over the 4 years. A chronology of events was derived from clinical notes and costs determined using reference costs per procedure. Serial tracheoscopy images, lung function tests and anti-HLA blood samples were compared. Epithelial morphology and T cell, Ki67 and cleaved caspase 3 activity were examined. Computational fluid dynamic simulations determined flow, velocity and airway pressure drops. After the first year following transplantation, the number of interventions fell and the child is currently clinically well and continues in education. Endoscopy demonstrated a complete mucosal lining at 15 months, despite retention of a stent. Histocytology indicates a differentiated respiratory layer and no abnormal immune activity. Computational fluid dynamic analysis demonstrated increased velocity and pressure drops around a distal tracheal narrowing. Cross-sectional area analysis showed restriction of growth within an area of in-stent stenosis. This report demonstrates the long-term viability of a decellularized tissue-engineered trachea within a child. Further research is needed to develop bioengineered pediatric tracheal replacements with lower morbidity, better biomechanics and lower costs. © 2015 The Authors. American Journal of Transplantation published by Wiley Periodicals, Inc. on behalf of American Society of Transplant Surgeons.
    American Journal of Transplantation 06/2015; DOI:10.1111/ajt.13318 · 5.68 Impact Factor
  • Cytotherapy 06/2015; 17(6):S69. DOI:10.1016/j.jcyt.2015.03.541 · 3.29 Impact Factor
  • M Rollin · A Jaulim · F Vaz · G Sandhu · S Wood · M Birchall · K Dawas
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    ABSTRACT: Adult ingestion of caustic substances is an unusual but serious surgical problem, with injuries likely to be more extensive than those in the corresponding paediatric population. After initial stabilisation and airway management, clinicians are presented with a complex multisystemic problem, frequently requiring a multidisciplinary approach involving several surgical disciplines and associated therapies. A new multidisciplinary team was convened to discuss complex ingestion injury in adults and established techniques were used to bring forward a proposed treatment algorithm. An algorithm may potentially improve clinical efficacy and risk in the management of these complex patients.
    Annals of The Royal College of Surgeons of England 05/2015; 97(4). DOI:10.1308/003588415X14181254789286 · 1.27 Impact Factor
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    ABSTRACT: Trauma to the central and peripheral nervous systems often lead to serious morbidity. Current surgical methods for repairing or replacing such damage have limitations. Tissue engineering offers a potential alternative. Here we show that functionalized α-helical-peptide hydrogels can be used to induce attachment, migration, proliferation and differentiation of murine embryonic neural stem cells (NSCs). Specifically, compared with undecorated gels, those functionalized with Arg-Gly-Asp-Ser (RGDS) peptides increase the proliferative activity of NSCs; promote their directional migration; induce differentiation, with increased expression of microtubule-associated protein-2, and a low expression of glial fibrillary acidic protein; and lead to the formation of larger neurospheres. Electrophysiological measurements from NSCs grown in RGDS-decorated gels indicate developmental progress toward mature neuron-like behavior. Our data indicate that these functional peptide hydrogels may go some way toward overcoming the limitations of current approaches to nerve-tissue repair.
    04/2015; 1(6). DOI:10.1021/acsbiomaterials.5b00051
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    ABSTRACT: Children suffer from damaged or loss of hollow organs i.e. trachea, oesophagus or arteries from birth defects or diseases. Generally these organs possess an outer matrix consisting of collagen, elastin, and cells such as smooth muscle cells (SMC) and a luminal layer consisting of endothelial or epithelial cells, whilst presenting a barrier to luminal content. Tissue engineering research enables the construction of such organs and this study explores this possibility with a bioabsorbable nanocomposite biomaterial, polyhedral oligomeric silsesquioxane poly(ε-caprolactone) urea urethane (POSS–PCL).Our established methods of tubular graft extrusion were modified using a porogen-incorporated POSS–PCL and a new lamination method was explored. Porogen (40, 60 or 105 µm) were introduced to POSS–PCL, which were fabricated into a bilayered, dual topography matching the exterior and luminal interior of tubular organs. POSS–PCL with different amounts of porogen were tested for their suitability as a SMC layer by measuring optimal interactions with human adipose derived stem cells. Angiogenesis potential was tested with the chorioallantoic membrane assay. Tensile strength and burst pressures of bilayared tubular grafts were determined. Scaffolds made with 40 µm porogen demonstrated optimal adipose derived stem cell integration and the scaffolds were able to accommodate angiogenesis. Mechanical properties of the grafts confirmed their potential to match the relevant physiological and biophysical parameters. This study presents a platform for the development of hollow organs for transplantation based on POSS–PCL. These bilayered-tubular structures can be tailor-made for cellular integration and match physico-mechanical properties of physiological systems of interest. More specific luminal cell integration and sources of SMC for the external layer could be further explored.
    Journal of Materials Science Materials in Medicine 03/2015; 26(3):5477. DOI:10.1007/s10856-015-5477-4 · 2.59 Impact Factor
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    ABSTRACT: Tissue engineered tracheae have been successfully implanted to treat a small number of patients on compassionate grounds. The treatment has not become mainstream due to the time taken to produce the scaffold and the resultant financial costs. We have developed a method for decellularization (DC) based on vacuum technology, which when combined with an enzyme/detergent protocol significantly reduces the time required to create clinically suitable scaffolds. We have applied this technology to prepare porcine tracheal scaffolds and compared the results to scaffolds produced under normal atmospheric pressures. The principal outcome measures were the reduction in time (9 days to prepare the scaffold) followed by a reduction in residual DNA levels (DC no-vac: 137.8±48.82 ng/mg vs. DC vac 36.83±18.45 ng/mg, p<0.05.). Our approach did not impact on the collagen or glycosaminoglycan content or on the biomechanical properties of the scaffolds. We applied the vacuum technology to human tracheae, which, when implanted in vivo showed no significant adverse immunological response. The addition of a vacuum to a conventional decellularization protocol significantly reduces production time, whilst providing a suitable scaffold. This increases clinical utility and lowers production costs. To our knowledge this is the first time that vacuum assisted decellularization has been explored. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
    Journal of Tissue Engineering and Regenerative Medicine 02/2015; DOI:10.1002/term.1979 · 5.20 Impact Factor
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    G. Z. Teoh · C. Crowley · M. A. Birchall · A. M. Seifalian
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    ABSTRACT: Congenital tracheal defects and prolonged intubation following premature birth have resulted in an unmet clinical need for tracheal replacement. Advances in stem cell technology, tissue engineering and material sciences have inspired the development of a resorbable, nanocomposite tracheal and bronchial scaffold. A bifurcated scaffold was designed and constructed using a novel, resorbable nanocomposite polymer, polyhedral oligomeric silsesquioxane poly(ϵ-caprolactone) urea urethane (POSS-PCL). Material characterization studies included tensile strength, suture retention and surface characteristics. Bone marrow-derived mesenchymal stem cells (bmMSCs) and human tracheobronchial epithelial cells (HBECs) were cultured on POSS-PCL for up to 14 days, and metabolic activity and cell morphology were assessed. Quantum dots conjugated to RGD (l-arginine, glycine and l-aspartic acid) tripeptides and anticollagen type I antibody were then employed to observe cell migration throughout the scaffold. POSS-PCL exhibited good mechanical properties, and the relationship between the solid elastomer and foam elastomer of POSS-PCL was comparable to that between the cartilaginous U-shaped rings and interconnective cartilage of the native human trachea. Good suture retention was also achieved. Cell attachment and a significant, steady increase in proliferation were observed for both cell types (bmMSCs, P = 0·001; HBECs, P = 0·003). Quantum dot imaging illustrated adequate cell penetration throughout the scaffold, which was confirmed by scanning electron microscopy. This mechanically viable scaffold successfully supports bmMSC and HBEC attachment and proliferation, demonstrating its potential as a tissue-engineered solution to tracheal replacement. © 2015 BJS Society Ltd. Published by John Wiley & Sons Ltd.
    British Journal of Surgery 01/2015; 102(2):e140-e150. DOI:10.1002/bjs.9700 · 5.54 Impact Factor
  • Nanoscale 01/2015; DOI:10.1039/C5NR03867G · 7.39 Impact Factor
  • Lange P · Fishman JM · De Coppi P · Birchall MA
    Gene and Cell Therapy: Therapeutic Mechanisms and Strategies, Fourth Edition, 4th 01/2015: chapter 32: pages 819-832; CRC Press., ISBN: 9781466572003
  • Lange P · Jonathan Fishman · De Coppi P · Birchall MA
    Gene and Cell Therapy: Therapeutic Mechanisms and Strategies, Fourth Edition, 4th 01/2015: chapter Surgical and Translational Aspects of Tissue Engineering: pages 819-832; CRC Press., ISBN: 9781466572003
  • European Journal of Surgical Oncology 12/2014; 40(12):S6–S7. DOI:10.1016/j.ejso.2014.11.026 · 3.01 Impact Factor
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    ABSTRACT: There has been significant and exciting recent progress in the development of bioengineering approaches for generating tracheal tissue that can be used for congenital and acquired tracheal diseases. This includes a growing clinical experience in both pediatric and adult patients with life-threatening tracheal diseases. However, not all of these attempts have been successful, and there is ongoing discussion and debate about the optimal approaches to be used. These include considerations of optimal materials, particularly use of synthetic versus biologic scaffolds, appropriate cellularization of the scaffolds, optimal surgical approaches and optimal measure of both clinical and biologic outcomes. To address these issues, the International Society of Cell Therapy convened a first-ever meeting of the leading clinicians and tracheal biologists, along with experts in regulatory and ethical affairs, to discuss and debate the issues. A series of recommendations are presented for how to best move the field ahead.
    Cytotherapy 11/2014; 16(12). DOI:10.1016/j.jcyt.2014.10.012 · 3.29 Impact Factor
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    ABSTRACT: Tissue engineering ex vivo and direct cellular application with bioscaffolds in vivo has allowed surgeons to restore and establish function throughout the human body. The evidence for regenerative surgery is growing, and consequently there is a need for the development of more advanced regenerative surgery facilities. Regenerative medicine in the surgical field is changing rapidly and this must be reflected in the design of any future operating suite. The theater environment needs to be highly adaptable to account for future significant advances within the field. Development of purpose built, combined operating suites and tissue-engineering laboratories will provide the facility for modern surgeons to treat patients with organ deficits, using bespoke, regenerated constructs without the need for immunosuppression.
    Regenerative Medicine 11/2014; 9(6):785-791. DOI:10.2217/rme.14.46 · 2.79 Impact Factor
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    ABSTRACT: α-Helical peptide hydrogels are decorated with a cell-binding peptide motif (RGDS), which is shown to promote adhesion, proliferation, and differentiation of PC12 cells. Gel structure and integrity are maintained after functionalization. This opens possibilities for the bottom-up design and engineering of complex functional scaffolds for 2D and 3D cell cultures.
    Advanced Healthcare Materials 09/2014; 3(9). DOI:10.1002/adhm.201400065 · 5.80 Impact Factor
  • M Mat Baki · G Wood · M Alston · P Ratcliffe · G Sandhu · J S Rubin · M.A. Birchall
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    ABSTRACT: Objective To evaluate the agreement between OperaVOX and MDVP.DesignCross sectional reliability study.SettingUniversity Teaching Hospital.Methods Fifty healthy volunteers and 50 voice disorder patients had supervised recordings in a quiet room using OperaVOX by the iPod's internal microphone with sampling rate of 45kHz. A five seconds recording of vowel /a/ was used to measure fundamental frequency (F0), jitter, shimmer and noise–to–harmonic ratio (NHR). All healthy volunteers and 21 patients had a second recording. The recorded voices was also analysed using the MDVP. The inter- and intra-software reliability was analysed using intraclass correlation (ICC) test and Bland Altman (BA) method. Mann Whitney test was used to compare the acoustic parameters between healthy volunteers and patients.ResultsNine of 50 patients had severe aperiodic voice. The ICC was high with a confidence interval of >0.75 for the inter- and intra-software reliability except for the NHR. For the inter-software BA analysis, excluding the severe aperiodic voice datasets, the bias (95% LOA) of F0, jitter, shimmer and NHR was 0.81(11.32, -9.71); -0.13 (1.26, -1.52); -0.52 (1.68, -2.72); and 0.08 (0.27, -0.10). For the intra-software reliability, it was -1.48 (18.43, -21.39); 0.05 (1.31, -1.21); -0.01 (2.87, -2.89); and 0.005 (0.20, -0.18), respectively. Normative data from the healthy volunteers was obtained. There was a significant difference in all acoustic parameters between volunteers and patients measured by the OperaVOX (p<0.001) except for F0 in females (p=0.87).Conclusion OperaVOX is comparable to MDVP and has high internal consistency for measuring the F0, jitter and shimmer of voice except for the NHR.This article is protected by copyright. All rights reserved.
    Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 09/2014; 40(1). DOI:10.1111/coa.12313 · 2.11 Impact Factor

Publication Stats

2k Citations
952.72 Total Impact Points


  • 2015
    • University College London Hospitals NHS Foundation Trust
      Londinium, England, United Kingdom
  • 2009–2015
    • University College London
      • • Ear Institute
      • • Division of Surgery and Interventional Science
      • • Centre for Stem Cells and Regenerative Medicine
      Londinium, England, United Kingdom
  • 2014
    • London Centre for Nanotechnology
      Londinium, England, United Kingdom
  • 2010–2014
    • UCL Eastman Dental Institute
      Londinium, England, United Kingdom
    • Baylor College of Medicine
      • Center for Cell and Gene Therapy
      Houston, TX, United States
  • 2013
    • Royal Free London NHS Foundation Trust
      Londinium, England, United Kingdom
  • 2000–2012
    • University of Bristol
      • • School of Veterinary Sciences
      • • School of Cellular and Molecular Medicine
      Bristol, England, United Kingdom
  • 2011
    • Umeå University
      • Department of Integrative Medical Biology (IMB)
      Umeå, Västerbotten, Sweden
  • 2008
    • Yale University
      New Haven, Connecticut, United States
  • 2007
    • Royal United Hospital Bath NHS Trust
      Bath, England, United Kingdom
  • 2004–2007
    • University of Liverpool
      Liverpool, England, United Kingdom
    • Aintree University Hospital NHS Foundation Trust
      Liverpool, England, United Kingdom
  • 2006
    • The Australian Society of Otolaryngology Head & Neck Surgery
      Evans Head, New South Wales, Australia
  • 2003
    • Royal College of Surgeons of England
      Londinium, England, United Kingdom
  • 1998
    • Bristol Hospital
      Bristol, Connecticut, United States