Research overview
This project will use our laboratory’s unique artificial placenta platform to undertake three interlinked work packages, each addressing a key unmet clinical need in the care of preterm infants.
The studies will employ large animal models of pregnancy, with pre-clinical validation using human samples.
By:
- advancing the pre-clinical development of artificial placenta technology for extremely preterm infants,
- developing a novel extracorporeal membranous oxygenation (ECMO) platform for moderately preterm infants with respiratory failure, and
- establishing the world’s first objective test for fetal hypoxic-ischemic injury
the overarching objective of this project is to generate the data we need to improve the survival and life-long health of preterm babies around the world.
Why this project is important
Preterm birth is the single greatest cause of death and disability in children up to five years of age in the developed world.
Advanced maternal age, increasingly common co-morbidities (i.e. high BMI, gestational diabetes), and greater use of assisted reproductive technology means that preterm birth will increasingly harm the health of our population.
Extremely preterm infants (21–24 weeks’ gestation) continue to suffer unacceptably high rates of death, and life-long disability. Extremely preterm infants are, due to their extremely immature lungs and skin, at the highest risk of death. Extremely preterm infant survivors are at greatly elevated risk of infection, cerebral palsy, learning deficits, cardio-pulmonary diseases, or blindness.
If we are to improve outcomes for extremely preterm infants, we must recognise that they are not just ‘small babies’, rather, they are a unique patient demographic that, due to their extremely underdeveloped lungs, skin, and limited cardiovascular capacity, require an entirely different treatment approach to that of older preterm infants.
There is strong consensus that a new life support approach, such as artificial placenta technology, is needed for these patients.
WIRF has undertaken world-leading studies to develop artificial placenta technology designed to save the lives of extremely preterm babies born at the border of viability.
There is now a clear translational road map for this project, with a strong understanding of the research challenges that remain to be solved before we can bring this exciting technology to the clinic.
Project background
Our laboratory has developed artificial placenta technology to circumvent the need for ventilation and lung injury by connecting a membranous oxygenator (‘artificial placenta’) to the umbilical cord (one vein and two arteries) in a simple, rapid procedure.
In a series of experiments conducted over the past nine years, we have developed a high-efficiency, arterio-venous gas exchange system driven solely by the fetal heart.
In 2016, we achieved optimal maintenance of physiological parameters in preterm lambs for one week and successfully transferred an artificial placenta-treated lamb to pulmonary ventilation. All lambs were infection-free.
In 2017 we extended this healthy survival period to two weeks.
In 2018, we were the first to make the decisive step of adapting our model to support extremely premature lambs (90d preterm lambs, 600g, 23-24 weeks’ human equivalent) for 120h.
In 2019, we advanced further by incorporating clinically-relevant antenatal insults (e.g. infection, inflammation) common in extremely preterm deliveries.
We are the only group to successfully use an artificial placenta to treat extremely preterm fetuses with chorioamnionitis for 120h.
In 2022-2023, we became the first group to maintain extremely preterm fetuses for a period of 2 weeks without cardiac failure.
This achievement marks a shift in artificial placenta field, allowing the focus on long-term survival and the optimisation of fetal growth and organ health.
Thus, we have demonstrated the strong translational potential of artificial placenta technology using extremely preterm fetuses, making us the world leaders in artificial placenta technology.
We are uniquely well placed to claim first-to-clinic advantage in translational development of artificial placenta technology.
Project researchers
Dr Haruo Usuda
Professor Matt Kemp
Dr Erin Fee
Partners
National University of Singapore
Tohoku University Hospital, Sendai, Japan
Nipro Corporation
Tohoku University
Project timeline
2025 – current
