Unique collaboration at Westmead Hospital transferring human tissue from surgery to lab

Andrew Harman (pictured standing centre) (All photographs were taken in a mock clinical setting)

A ground-breaking partnership has been formed between Westmead Hospital surgeons and the Westmead Institute for Medical Research (WIMR) team to transfer human tissue from surgery to lab to help uncover new information on sexually transmitted diseases.

Western Sydney Local Health District (WSLHD) surgeons, Dr Nimalan Pathma-Nathan, A/Prof James Toh and A/Prof Gregory Jenkins, are three of the surgeons at Westmead Hospital who have partnered with WIMR’s Andrew Harman to work on the innovative research.

This project originally began with the late Grahame Ctercteko and his belief in theatre-to-bench research.

Nimalan said Grahame was “tireless in trying to understand the immunology of the conditions we treat as surgeons” and Andrew, as Deputy Director of the Centre for Virus Research at WIMR, was a vital cog in getting the research actually done.

“Andrew’s expertise in immunology research, funding and in assembling a team is incredible,” Nimalan said.

“I took over as head of colorectal surgery and aim to continue Grahame’s work and expand it to include other hospital surgeons. Surgeons such as Gregory Jenkins in gynaecology and James French in breast surgery have already joined the team.” 

The collaboration is unique because of the direct input from surgery to the lab with the specimen sent off fresh and immediately analysed.

“I am amazed at the brainpower of the researchers. Our job is simple: we get the specimen as part of a routine operation,” said Nimalan.

“The feeling of being part of a successful team is fantastic. As the non-brainy part of the collaboration, I as a surgeon, feel appreciated and included.  I hope that this partnership continues, and I am heartened to see other surgical teams being brought in on the same model.”

Andrew started working at Westmead Hospital 20 years ago when he initially came over as a post doc from England after his PhD at the University of Cambridge.

When he moved over to WIMR he started approaching surgeons to get access to human tissue to give himself a cutting edge in research.

Human immunodeficiency virus (HIV) doesn’t infect animals – the only animal HIV infects is a human being – so you can’t do these experiments on anything else.”

Andrew Harman

“We began using human abdominal skin enabling us to look at real human cells and how HIV actually affects them and then I thought – well hang on a minute – HIV isn’t transmitted across someone’s abdomen; it’s transmitted across someone’s genital tissues and so gradually over the years I’ve built up collaborations with a whole range of surgeons at Westmead Hospital to get access to the right material.”

With WIMR positioned next to Westmead Hospital the advantage is the tissue can be fresh into Andrew’s lab within 15 minutes of its removal from the body.

Andrew was presenting at the University of Cambridge recently where it was mentioned to him by multiple researchers in the audience, from across the globe, that we “might be the only lab and hospital collaboration in the world with access to every single human tissue type that HIV might encounter during transmission”.

The project is ethically sound with surgeons seeking consent from patients via a form and the donated human tissue goes a long way in uncovering revolutionary research.

Andrew had a study published in the Nature Communications journal in 2019 when he discovered a brand-new cell no-one had discovered before which was specifically enriched in what’s called a type two mucosa (For example; vagina, inner foreskin and anal canal), which is also one of the primary HIV target cells, that binds to viruses and delivers it to the immune system.

In another Nature Communications paper in 2021 “we discovered how the proportions of the cells in these tissues differ to other parts of the body and in a Cell Reports paper in 2022 we specifically mapped out the dynamics of transmission in colorectal tissues with Nimalan and his team,” Andrew said.

Andrew also works with Western Sydney Local Health District’s (WSLHD) Andrew Brooks and Gregory Jenkins who provide penile and vaginal tissue from operations they perform.

“The supply of fresh specimens is difficult to organise and the logistic factors alone make this collaboration unique. As a clinician I am very pleased to be involved,” Andrew (Brooks) said.