Pub Date : 2023-07-14DOI: 10.3390/transplantology4030012
L. C. Álvarez-Perdomo, J. U. Cataño-Bedoya, Maribel Plaza-Tenorio, Ana María Botero-Mora, Isabel del Pilar Cardozo-Moreno, L. M. Barrera-Lozano, J. A. Ramírez-Arbeláez, Carlos-Martín Ardila
The purpose of the study was to characterize lower extremity peripheral arterial disease (LEPAD) in a series of kidney transplant patients and to assess the impact on adverse outcomes. A retrospective cohort study was conducted including kidney transplant recipient patients who underwent screening for LEPAD. The outcomes evaluated were classified as perioperative and post-transplant, including cardiovascular events, amputation, mortality, and loss of the graft. A total of 141 renal transplant patients screened for LEPAD were identified, with an average follow-up of 3 years. LEPAD occurred in 14.2% (20/141). No differences in cardiovascular risk factors were found between the groups, except for smoking (45% vs. 24%, p < 0.05). In the group with LEPAD, the most compromised anatomical segment was the infrapopliteus, with no iliac involvement found. The Cox proportional hazards model indicated that the variables age, gender, and weight were significant in patients with LEPAD. There were no differences between the groups in terms of graft loss and death. The infrapopliteal segment is the area of greatest stenosis in kidney transplant patients with LEPAD. Together with smoking, they can explain the presence of major amputations in kidney transplant patients; however, they had no impact on graft functionality or death.
{"title":"Lower Extremity Peripheral Arterial Disease and Its Relationship with Adverse Outcomes in Kidney Transplant Recipients: A Retrospective Cohort Study","authors":"L. C. Álvarez-Perdomo, J. U. Cataño-Bedoya, Maribel Plaza-Tenorio, Ana María Botero-Mora, Isabel del Pilar Cardozo-Moreno, L. M. Barrera-Lozano, J. A. Ramírez-Arbeláez, Carlos-Martín Ardila","doi":"10.3390/transplantology4030012","DOIUrl":"https://doi.org/10.3390/transplantology4030012","url":null,"abstract":"The purpose of the study was to characterize lower extremity peripheral arterial disease (LEPAD) in a series of kidney transplant patients and to assess the impact on adverse outcomes. A retrospective cohort study was conducted including kidney transplant recipient patients who underwent screening for LEPAD. The outcomes evaluated were classified as perioperative and post-transplant, including cardiovascular events, amputation, mortality, and loss of the graft. A total of 141 renal transplant patients screened for LEPAD were identified, with an average follow-up of 3 years. LEPAD occurred in 14.2% (20/141). No differences in cardiovascular risk factors were found between the groups, except for smoking (45% vs. 24%, p < 0.05). In the group with LEPAD, the most compromised anatomical segment was the infrapopliteus, with no iliac involvement found. The Cox proportional hazards model indicated that the variables age, gender, and weight were significant in patients with LEPAD. There were no differences between the groups in terms of graft loss and death. The infrapopliteal segment is the area of greatest stenosis in kidney transplant patients with LEPAD. Together with smoking, they can explain the presence of major amputations in kidney transplant patients; however, they had no impact on graft functionality or death.","PeriodicalId":36461,"journal":{"name":"Cell and Organ Transplantology","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75328335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Petriv, Raft Mohammad Daoud Almhairat, Milan Vorody, Boris Luzan, Y. Tsymbaliuk, Viktorya Vaslovych, T. Malysheva, V. Tsymbaliuk
Peripheral nerve injury is an extremely important problem during the war in Ukraine. In the overall pattern of injury, 5% of patients have peripheral nerve injuries and 1% have brachial plexus injuries. Under conditions of hostilities, this indicator increases to 70% or more. The victims are mainly young people of working age, which indicates the great medical and socio-economic significance of the problem. Materials and methods. The study was conducted on 28 rabbits Group 1 (n=7): suture of the sciatic nerve and implantation of the non-working antenna of the electrical stimulation device. Group 2 (n=7): sciatic nerve suture + implantation of an electric stimulator antenna in the same route as in group 1 and the beginning of stimulation on the 2nd day. Group 3 (n=7): sciatic nerve suture + implantation of an electric stimulator antenna in the same route as in group 1 and the beginning of stimulation 3 weeks after operation, when the first signs of regeneration occurred. Group 4 (n=7): autograft of the sciatic nerve + implantation of an electric stimulator antenna and the beginning of stimulation at a time point that will coincide with the beginning of signs of reinnervation of the effector muscle. Сontrol of regeneration was carried out in 12 weeks. The axial cylinder (AC) diameter, myelin thickness (MS) and MS/AC ratio were analyzed using electron mycroscopy. Results. It was showed a statistically significant increase of AC and MS indicators in the study group 2 relatively to comparison group 1, respectively, by 1.8 and 1.75 times. The increase of AC and MS in group 2, relatively to the comparison group and a visual decrease at the ultrastructural level of the number of destructively changed myelin sheaths (strengthening of reparative and regenerative processes) were detected. Conclusion. Therefore, long-term invasive electrostimulation of the damaged peripheral nerve has a positive effect on the regeneration of the neuromuscular complex.
{"title":"Ultrastructural changes of injured sciatic nerve after neurosurgical reconstruction and long-term electrostimulation in rabbits","authors":"T. Petriv, Raft Mohammad Daoud Almhairat, Milan Vorody, Boris Luzan, Y. Tsymbaliuk, Viktorya Vaslovych, T. Malysheva, V. Tsymbaliuk","doi":"10.22494/cot.v11i1.151","DOIUrl":"https://doi.org/10.22494/cot.v11i1.151","url":null,"abstract":"Peripheral nerve injury is an extremely important problem during the war in Ukraine. In the overall pattern of injury, 5% of patients have peripheral nerve injuries and 1% have brachial plexus injuries. Under conditions of hostilities, this indicator increases to 70% or more. The victims are mainly young people of working age, which indicates the great medical and socio-economic significance of the problem. Materials and methods. The study was conducted on 28 rabbits Group 1 (n=7): suture of the sciatic nerve and implantation of the non-working antenna of the electrical stimulation device. Group 2 (n=7): sciatic nerve suture + implantation of an electric stimulator antenna in the same route as in group 1 and the beginning of stimulation on the 2nd day. Group 3 (n=7): sciatic nerve suture + implantation of an electric stimulator antenna in the same route as in group 1 and the beginning of stimulation 3 weeks after operation, when the first signs of regeneration occurred. Group 4 (n=7): autograft of the sciatic nerve + implantation of an electric stimulator antenna and the beginning of stimulation at a time point that will coincide with the beginning of signs of reinnervation of the effector muscle. Сontrol of regeneration was carried out in 12 weeks. The axial cylinder (AC) diameter, myelin thickness (MS) and MS/AC ratio were analyzed using electron mycroscopy. Results. It was showed a statistically significant increase of AC and MS indicators in the study group 2 relatively to comparison group 1, respectively, by 1.8 and 1.75 times. The increase of AC and MS in group 2, relatively to the comparison group and a visual decrease at the ultrastructural level of the number of destructively changed myelin sheaths (strengthening of reparative and regenerative processes) were detected. Conclusion. Therefore, long-term invasive electrostimulation of the damaged peripheral nerve has a positive effect on the regeneration of the neuromuscular complex.","PeriodicalId":36461,"journal":{"name":"Cell and Organ Transplantology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46161797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Shchotkina, Y. Palamarchuk, I. Skorokhod, L. Dolinchuk, A. Sokol, V. Motronenko, A. Besarab, M. Frohme, M. Herzog
Patients with congenital heart defects and cardiovascular diseases are required new approaches to surgical intervention. The use of biological cardiac implants, which are made from the extracellular matrix, is a promising trend in modern regenerative medicine. These bioimplants can completely replace defective tissue or organs, and when manufactured with strict protocols and quality control measures, can be safe and effective for therapeutic applications. The process of manufacturing bioimplants involves various risks that need to be assessed and mitigated with ongoing monitoring and evaluation necessary to ensure the highest standards of quality. Overall, this study was successfully evaluated the requirements for introducing a new medical device into practice and created a technical file that meets all necessary documentation for certification.
{"title":"Features of technological regulation for cardiac bioimplants","authors":"N. Shchotkina, Y. Palamarchuk, I. Skorokhod, L. Dolinchuk, A. Sokol, V. Motronenko, A. Besarab, M. Frohme, M. Herzog","doi":"10.22494/cot.v11i1.147","DOIUrl":"https://doi.org/10.22494/cot.v11i1.147","url":null,"abstract":"Patients with congenital heart defects and cardiovascular diseases are required new approaches to surgical intervention. The use of biological cardiac implants, which are made from the extracellular matrix, is a promising trend in modern regenerative medicine. These bioimplants can completely replace defective tissue or organs, and when manufactured with strict protocols and quality control measures, can be safe and effective for therapeutic applications. The process of manufacturing bioimplants involves various risks that need to be assessed and mitigated with ongoing monitoring and evaluation necessary to ensure the highest standards of quality. Overall, this study was successfully evaluated the requirements for introducing a new medical device into practice and created a technical file that meets all necessary documentation for certification.","PeriodicalId":36461,"journal":{"name":"Cell and Organ Transplantology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43672933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Our preliminary studies indicate the significant value of assessing skeletal maturity in adolescents, which characterizes the development of the skeleton in an individual and can be used as a biomarker of regenerative potential in children and adolescents, which significantly affects the choice of treatment tactics for diseases of the hip and knee joints. In particular, we have established the dependence of reparative regeneration processes in children and adolescents on skeletal maturity in such diseases of the hip and knee joints as slipped capital of femoral epiphysis (SCFE), Perthes’ disease, femoro-acetabular conflict syndrome, spastic hip dislocation in patients with cerebral palsy, Blount’s disease. The intensity of regeneration processes in the prepubertal development allows the use of less invasive methods of surgical interventions. The purpose is to develop a methodology for determining skeletal maturity as a biomarker for establishing indications for regenerative interventional technologies in adolescent patients with hip and knee joint diseases. Materials and methods. The group for the development of the examination methodology consisted of 157 patients (86 boys and 71 girls) with hip joint pathology (hip dysplasia, Perthes disease, juvenile epiphysiolysis of the femoral head, aseptic necrosis of the femoral head, and without diagnosed hip joint pathology) and 129 patients (58 boys and 71 girls) with knee joint diseases (Blount disease, axial deformities of the lower extremities, meniscal damage and patients who were examined for complaints of pain in the knee joint area) aged 10 to 18 years. The group of a differentiated approach to the use of regenerative interventional technologies consisted of 46 adolescent patients with diseases of the hip and knee joints (SCFE, Perthes’ disease, Blount’s disease, the pathology of menisci). Results. A methodology for the use of skeletal maturity as a biomarker for establishing indications for regenerative interventional technologies in adolescent patients with diseases of the hip and knee joints has been developed, which includes the following steps: establishing the period of sexual development of the patient based on the determination of skeletal maturity based on radiographs of the hip and knee joints, establishing additional risk factors (heredity, individual characteristics of the connective tissue, the presence of chronic systemic diseases) and the severity of the disease (according to the results of questionnaires). According to the results of the analysis of the application of the methodology of distinguishing skeletal maturity as a biomarker of indications for regenerative interventional technologies in adolescent patients with diseases of the hip and knee joints, it was established that in prepuberty only 3 out of 16 examined patients (which amounted to 19%) have indications for regenerative interventional technologies, during the induction of puberty, 4 out of 9 examined patients (that
{"title":"Skeletal maturity as a biomarker for determining indications for regenerative interventional technologies in adolescent patients with hip and knee diseases","authors":"V. Filipchuk, S. Strafun, Y. Holiuk, M. Melnyk","doi":"10.22494/cot.v11i1.150","DOIUrl":"https://doi.org/10.22494/cot.v11i1.150","url":null,"abstract":"Our preliminary studies indicate the significant value of assessing skeletal maturity in adolescents, which characterizes the development of the skeleton in an individual and can be used as a biomarker of regenerative potential in children and adolescents, which significantly affects the choice of treatment tactics for diseases of the hip and knee joints. In particular, we have established the dependence of reparative regeneration processes in children and adolescents on skeletal maturity in such diseases of the hip and knee joints as slipped capital of femoral epiphysis (SCFE), Perthes’ disease, femoro-acetabular conflict syndrome, spastic hip dislocation in patients with cerebral palsy, Blount’s disease. The intensity of regeneration processes in the prepubertal development allows the use of less invasive methods of surgical interventions. The purpose is to develop a methodology for determining skeletal maturity as a biomarker for establishing indications for regenerative interventional technologies in adolescent patients with hip and knee joint diseases. Materials and methods. The group for the development of the examination methodology consisted of 157 patients (86 boys and 71 girls) with hip joint pathology (hip dysplasia, Perthes disease, juvenile epiphysiolysis of the femoral head, aseptic necrosis of the femoral head, and without diagnosed hip joint pathology) and 129 patients (58 boys and 71 girls) with knee joint diseases (Blount disease, axial deformities of the lower extremities, meniscal damage and patients who were examined for complaints of pain in the knee joint area) aged 10 to 18 years. The group of a differentiated approach to the use of regenerative interventional technologies consisted of 46 adolescent patients with diseases of the hip and knee joints (SCFE, Perthes’ disease, Blount’s disease, the pathology of menisci). Results. A methodology for the use of skeletal maturity as a biomarker for establishing indications for regenerative interventional technologies in adolescent patients with diseases of the hip and knee joints has been developed, which includes the following steps: establishing the period of sexual development of the patient based on the determination of skeletal maturity based on radiographs of the hip and knee joints, establishing additional risk factors (heredity, individual characteristics of the connective tissue, the presence of chronic systemic diseases) and the severity of the disease (according to the results of questionnaires). According to the results of the analysis of the application of the methodology of distinguishing skeletal maturity as a biomarker of indications for regenerative interventional technologies in adolescent patients with diseases of the hip and knee joints, it was established that in prepuberty only 3 out of 16 examined patients (which amounted to 19%) have indications for regenerative interventional technologies, during the induction of puberty, 4 out of 9 examined patients (that","PeriodicalId":36461,"journal":{"name":"Cell and Organ Transplantology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43218373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-25DOI: 10.3390/transplantology4030011
S. Aguado Ibáñez, R. Laporta Hernández, M. Aguilar Pérez, C. García Fadul, Cristina López García Gallo, G. Díaz Nuevo, S. Salinas Castillo, R. Castejón Díaz, C. Salas Anton, A. Royuela Vicente, F. B. Bernabéu Andreu, M. P. Ussetti Gil
The usefulness of bronchoalveolar lavage fluid (BALF) to support the diagnosis of acute cellular (ACR) rejection in lung transplant (LTX) recipients remains controversial. ACR has been associated with blood eosinophil counts (EOS) in other solid organ recipients, but there are few studies in relation to lung transplants. Our aim was to assess the usefulness of the combined analysis of BALF cellularity and EOS for the diagnosis of ACR in lung transplant recipients. This is a retrospective study of findings observed simultaneously in 887 transbronchial biopsies (TBB), BALF, and blood samples obtained from 363 LTx patients transplanted between 2014 and 2020. The variables collected were: demographics, ACR degree, BALF cellularity, and simultaneous blood EOS counts. The lymphocyte count in BALF was significantly higher in patients with ACR than in those without (11.35% vs. 6.11%; p < 0.001). In parallel, EOS counts were also significantly higher in patients with ACR than in the non-ACR group (EOS 213 ± 206/mm3 vs. 83 ± 129/mm3; p < 0.001). Increases in both parameters were associated with an increased risk of ACR (lymphocytes OR 1.100; 95% CI 1.080–1.131; EOS OR 1.460; 95% CI 1.350–1.580). The diagnostic specificity of ACR for a lymphocyte count > 12% was 71.1%, which increased to 95.8% when taking into account a simultaneous blood EOS count > 200/mm3. Simultaneous assessment of BALF lymphocyte counts and blood eosinophil counts may be useful for diagnosing ACR in patients with risk factors for TBB or in the presence of inconclusive histological samples.
支气管肺泡灌洗液(BALF)在支持肺移植(LTX)受者急性细胞(ACR)排斥诊断中的作用仍然存在争议。在其他实体器官受者中，ACR与血嗜酸性粒细胞计数(EOS)有关，但与肺移植有关的研究很少。我们的目的是评估BALF细胞量和EOS联合分析对肺移植受者ACR诊断的有用性。这是一项回顾性研究，同时观察了2014年至2020年间移植的363例LTx患者的887例经支气管活检(TBB)、BALF和血液样本。收集的变量包括:人口统计学、ACR程度、BALF细胞度和同时的血液EOS计数。ACR患者BALF淋巴细胞计数明显高于无ACR患者(11.35% vs. 6.11%;P < 0.001)。与此同时，ACR患者的EOS计数也显著高于非ACR组(EOS 213±206/mm3 vs 83±129/mm3;P < 0.001)。这两个参数的增加与ACR(淋巴细胞OR 1.100;95% ci 1.080-1.131;Eos或1.460;95% ci 1.350-1.580)。当淋巴细胞计数> 12%时，ACR的诊断特异性为71.1%，当同时血液中EOS计数> 200/mm3时，ACR的诊断特异性增加到95.8%。同时评估BALF淋巴细胞计数和血液嗜酸性粒细胞计数可能有助于诊断有TBB危险因素或存在不确定组织学样本的患者的ACR。
{"title":"A Combination of Cytological Biomarkers as a Guide in the Diagnosis of Acute Rejection in Lung Transplant Recipients","authors":"S. Aguado Ibáñez, R. Laporta Hernández, M. Aguilar Pérez, C. García Fadul, Cristina López García Gallo, G. Díaz Nuevo, S. Salinas Castillo, R. Castejón Díaz, C. Salas Anton, A. Royuela Vicente, F. B. Bernabéu Andreu, M. P. Ussetti Gil","doi":"10.3390/transplantology4030011","DOIUrl":"https://doi.org/10.3390/transplantology4030011","url":null,"abstract":"The usefulness of bronchoalveolar lavage fluid (BALF) to support the diagnosis of acute cellular (ACR) rejection in lung transplant (LTX) recipients remains controversial. ACR has been associated with blood eosinophil counts (EOS) in other solid organ recipients, but there are few studies in relation to lung transplants. Our aim was to assess the usefulness of the combined analysis of BALF cellularity and EOS for the diagnosis of ACR in lung transplant recipients. This is a retrospective study of findings observed simultaneously in 887 transbronchial biopsies (TBB), BALF, and blood samples obtained from 363 LTx patients transplanted between 2014 and 2020. The variables collected were: demographics, ACR degree, BALF cellularity, and simultaneous blood EOS counts. The lymphocyte count in BALF was significantly higher in patients with ACR than in those without (11.35% vs. 6.11%; p < 0.001). In parallel, EOS counts were also significantly higher in patients with ACR than in the non-ACR group (EOS 213 ± 206/mm3 vs. 83 ± 129/mm3; p < 0.001). Increases in both parameters were associated with an increased risk of ACR (lymphocytes OR 1.100; 95% CI 1.080–1.131; EOS OR 1.460; 95% CI 1.350–1.580). The diagnostic specificity of ACR for a lymphocyte count > 12% was 71.1%, which increased to 95.8% when taking into account a simultaneous blood EOS count > 200/mm3. Simultaneous assessment of BALF lymphocyte counts and blood eosinophil counts may be useful for diagnosing ACR in patients with risk factors for TBB or in the presence of inconclusive histological samples.","PeriodicalId":36461,"journal":{"name":"Cell and Organ Transplantology","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73680364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-06DOI: 10.3390/transplantology4020010
Sandro Hügli, P. Müller, M. Pfister, F. Rössler
Background: Despite great progress in graft survival and complication rates, pronounced inflammatory responses are common after pancreas transplantation (PT). Subsequent to the first postoperative increase in inflammatory markers, we have frequently observed a second peak of C-reactive protein (CRP) and white blood cells (WBCs) following PT. This analysis is to assess the incidence and clinical relevance of late-onset increases in inflammatory markers following PT. Materials and methods: We analyzed all consecutive PTs over a 20-year period. The second peak of CRP (SCP) and WBCs (SWP) was defined as an increase >3 days after PT subsequent to a relevant initial decrease. Results: Of 116 patients, 60 (51.7%) developed SCP. SCP was not associated with pancreas graft loss or with thrombosis at discharge or at 90 days after PT (6.7% vs. 0.0%, p = 0.1; 8.3% vs. 1.8%, p = 0.2; and 15.0% vs. 3.6%, p = 0.06, respectively). Patients with SCP had more complications overall at discharge and at 90 days (85.0% vs. 50.0%, p < 0.001 and 93.3% vs. 76.8%, p = 0.02). In multivariable analysis, SCP was significantly associated with pre-transplant HbA1c (OR 2.1 (95% CI: 1.3–3.8); p = 0.005) and female gender (OR 0.03 (95% CI: 0.004–0.14); p ≤ 0.001). No significant association was found between SCP and pancreas cold ischemia time (OR 1.0 (95% CI: 1.0–1.0); p = 0.1), donor age (OR 1.01 (95% CI: 0.96–1.06); p = 0.7), recipient age (OR 0.9 (95% CI: 0.9–1.0); p = 0.1), or recipient BMI (OR 0.9 (95% CI: 0.9–1.4); p = 0.3). SWP did not differ in patients with or without SCP (p = 0.07) and there was no correlation with pancreas graft loss or relaparotomy (p = 0.3 and p = 0.6, respectively). Insulin-free graft survival after 1, 5, and 10 years did not differ between patients with SCP and those without SCP (95.0%, 90.2%, 90.2% vs. 96.1%, 91.2%, 88.7%, respectively; p = 0.964). Conclusion: Late-onset inflammatory reactions are frequently seen in PT and are correlated with higher overall complication rates. They are not correlated, however, with graft-specific complications or insulin-free graft survival.
{"title":"The Role of Late-Onset Inflammatory Markers in the Prediction of Complications and Graft Survival after Pancreas Transplantation","authors":"Sandro Hügli, P. Müller, M. Pfister, F. Rössler","doi":"10.3390/transplantology4020010","DOIUrl":"https://doi.org/10.3390/transplantology4020010","url":null,"abstract":"Background: Despite great progress in graft survival and complication rates, pronounced inflammatory responses are common after pancreas transplantation (PT). Subsequent to the first postoperative increase in inflammatory markers, we have frequently observed a second peak of C-reactive protein (CRP) and white blood cells (WBCs) following PT. This analysis is to assess the incidence and clinical relevance of late-onset increases in inflammatory markers following PT. Materials and methods: We analyzed all consecutive PTs over a 20-year period. The second peak of CRP (SCP) and WBCs (SWP) was defined as an increase >3 days after PT subsequent to a relevant initial decrease. Results: Of 116 patients, 60 (51.7%) developed SCP. SCP was not associated with pancreas graft loss or with thrombosis at discharge or at 90 days after PT (6.7% vs. 0.0%, p = 0.1; 8.3% vs. 1.8%, p = 0.2; and 15.0% vs. 3.6%, p = 0.06, respectively). Patients with SCP had more complications overall at discharge and at 90 days (85.0% vs. 50.0%, p < 0.001 and 93.3% vs. 76.8%, p = 0.02). In multivariable analysis, SCP was significantly associated with pre-transplant HbA1c (OR 2.1 (95% CI: 1.3–3.8); p = 0.005) and female gender (OR 0.03 (95% CI: 0.004–0.14); p ≤ 0.001). No significant association was found between SCP and pancreas cold ischemia time (OR 1.0 (95% CI: 1.0–1.0); p = 0.1), donor age (OR 1.01 (95% CI: 0.96–1.06); p = 0.7), recipient age (OR 0.9 (95% CI: 0.9–1.0); p = 0.1), or recipient BMI (OR 0.9 (95% CI: 0.9–1.4); p = 0.3). SWP did not differ in patients with or without SCP (p = 0.07) and there was no correlation with pancreas graft loss or relaparotomy (p = 0.3 and p = 0.6, respectively). Insulin-free graft survival after 1, 5, and 10 years did not differ between patients with SCP and those without SCP (95.0%, 90.2%, 90.2% vs. 96.1%, 91.2%, 88.7%, respectively; p = 0.964). Conclusion: Late-onset inflammatory reactions are frequently seen in PT and are correlated with higher overall complication rates. They are not correlated, however, with graft-specific complications or insulin-free graft survival.","PeriodicalId":36461,"journal":{"name":"Cell and Organ Transplantology","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87567466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Olha Nishkumay, Mike K.S. Chan, Y. Nalapko, N. Grygorieva, O. Nikitin, Ilya Kordubailo
Aging is an inevitable process of our civilization. Since ancient times, scientists have tried to solve the mystery of aging. The research continues to this day. The most common diseases of old age are disorders of the musculoskeletal system. Among them, osteoporosis continues to occupy the third place in the structure of overall morbidity and mortality. Such statistical data make us think about the search for a possible cause of the disease at the molecular level. The purpose of this study was to analyze the literature data on modern directions of osteoporosis treatment, including stem-cells based bioregenerative medicine. An analytical review of literature data was conducted using the information analysis of Medline (PubMed), Web of Science and Scopus databases, Google Scholar and the Cochrane Central Register of Controlled Trials (CENTRAL) from 2018 to 2022 using the keywords “osteoporosis”, bioregenerative therapy”, “stem cell therapy”. Recent results of preclinical experimental studies have shown the effectiveness of the introduction of new bioregenerative technologies. In particular, the use of mesenchymal stem cells, exosomes and miRNAs. Preclinical studies on MSC transplantation in the treatment of osteoporosis indicate an increase in osteogenic differentiation, an increase in BMD. Exosomes also may play multiple roles in the treatment of osteoporosis: improving the disbalance between osteoclasts and osteoblasts, structural modification of exosomes and transmitters’ drug function. The promotion of bone regeneration of exosomes has been shown in animal models. Exosomes with active ingredients can treat a variety of skeletal disorders including osteoporosis and osteoporotic fractures. The results of recent research of the bone disorder treatment based on stem cells therapy have shown convincing prospects for new approaches.
老龄化是我们文明发展的必然过程。自古以来，科学家们就试图解开衰老之谜。这项研究一直持续到今天。老年人最常见的疾病是肌肉骨骼系统疾病。其中，骨质疏松症在总体发病率和死亡率结构中继续占据第三位。这些统计数据使我们思考在分子水平上寻找疾病的可能原因。本研究的目的是分析骨质疏松症治疗的现代方向的文献数据，包括基于干细胞的生物再生医学。2018年至2022年，使用Medline（PubMed）、Web of Science和Scopus数据库、Google Scholar和Cochrane Central Register of Controlled Trials（Central）的信息分析，使用关键词“骨质疏松症”、生物再生疗法、“干细胞疗法”，对文献数据进行了分析综述。最近的临床前实验研究结果表明，引入新的生物再生技术是有效的。特别是间充质干细胞、外泌体和miRNA的用途。MSC移植治疗骨质疏松症的临床前研究表明，成骨分化增加，骨密度增加。外泌体在骨质疏松症的治疗中也可能发挥多种作用：改善破骨细胞和成骨细胞之间的不平衡，外泌体的结构修饰和递质的药物功能。外泌体对骨再生的促进作用已在动物模型中得到证实。含有活性成分的外泌体可以治疗各种骨骼疾病，包括骨质疏松症和骨质疏松性骨折。基于干细胞治疗的骨病治疗的最新研究结果显示出令人信服的新方法前景。
{"title":"Stem cell-based bioregenerative therapy of osteoporosis: literature review","authors":"Olha Nishkumay, Mike K.S. Chan, Y. Nalapko, N. Grygorieva, O. Nikitin, Ilya Kordubailo","doi":"10.22494/cot.v11i1.146","DOIUrl":"https://doi.org/10.22494/cot.v11i1.146","url":null,"abstract":"Aging is an inevitable process of our civilization. Since ancient times, scientists have tried to solve the mystery of aging. The research continues to this day. The most common diseases of old age are disorders of the musculoskeletal system. Among them, osteoporosis continues to occupy the third place in the structure of overall morbidity and mortality. Such statistical data make us think about the search for a possible cause of the disease at the molecular level. The purpose of this study was to analyze the literature data on modern directions of osteoporosis treatment, including stem-cells based bioregenerative medicine. An analytical review of literature data was conducted using the information analysis of Medline (PubMed), Web of Science and Scopus databases, Google Scholar and the Cochrane Central Register of Controlled Trials (CENTRAL) from 2018 to 2022 using the keywords “osteoporosis”, bioregenerative therapy”, “stem cell therapy”. Recent results of preclinical experimental studies have shown the effectiveness of the introduction of new bioregenerative technologies. In particular, the use of mesenchymal stem cells, exosomes and miRNAs. Preclinical studies on MSC transplantation in the treatment of osteoporosis indicate an increase in osteogenic differentiation, an increase in BMD. Exosomes also may play multiple roles in the treatment of osteoporosis: improving the disbalance between osteoclasts and osteoblasts, structural modification of exosomes and transmitters’ drug function. The promotion of bone regeneration of exosomes has been shown in animal models. Exosomes with active ingredients can treat a variety of skeletal disorders including osteoporosis and osteoporotic fractures. The results of recent research of the bone disorder treatment based on stem cells therapy have shown convincing prospects for new approaches.","PeriodicalId":36461,"journal":{"name":"Cell and Organ Transplantology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48462363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Redko, A. Dovgalyuk, Z. Nebesna, S. Kramar, A. Sverstyuk, M. Korda
Acute Respiratory Distress Syndrome (ARDS) is a severe clinical condition that can cause multi-organ dysfunction, including liver injury. Human umbilical cord-derived mesenchymal stromal cells (hUC-MSCs) have been shown to possess therapeutic potential for a variety of diseases due to their ability to differentiate into various cell types and their anti-inflammatory and immunomodulatory properties. Purpose: To investigate the potential of hUC-MSCs for treating lipopolysaccharide (LPS)-induced liver injury in rats. Materials and methods: 72 mature male Wistar rats were randomly assigned to nine groups: control, 3 days, 7 days, and 28 days after intranasal administration of LPS, 24 hours of LPS and 2 days of hUC-MSCs, 4 days of LPS and 3 days of hUC-MSCs, 14 days of LPS and 14 days of hUC-MSCs, 21 days of LPS and 7 days of hUC-MSCs injection, and control 3 days after hUC-MSCs injection. The isolation of MSCs from human umbilical cord tissue was performed using an enzymatic digestion method with collagenase I. hUC-MSCs were injected intraperitoneally at a dose of 1∙106 cells/kg body weight. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were measured using the kinetic method. The levels of hepatocellular necrosis, liver structural damage, hepatocyte vacuolation, inflammation and disseminated intravascular coagulation (DIC) were analyzed by histological scoring of sections stained with hematoxylin and eosin. The expression of TGF-β1 in the liver tissue was evaluated by immunohistochemistry. Results: The preclinical study demonstrated that treatment with hUC-MSCs significantly improved liver function and attenuated LPS-induced liver injury in rats. This was evidenced by a reduction in hepatocellular necrosis, liver structural damage, hepatocyte vacuolation, inflammation, signs of DIC, fibrosis and lower levels of serum liver markers ALT, AST and ALP in the hUC-MSCs-treated groups compared to the untreated groups. The study also revealed that the use of hUC-MSCs was more effective at the earlier stage of liver injury. Conclusions: Our findings suggest that hUC-MSCs therapy may hold promise as a potential treatment for LPS-induced liver injury. Further research is needed to better understand the underlying mechanisms and to determine the potential for hUC-MSCs therapy in clinical practice.
{"title":"Human umbilical cord-derived мesenchymal stromal cells mitigate lipopolysaccharide-induced liver injury in rats","authors":"O. Redko, A. Dovgalyuk, Z. Nebesna, S. Kramar, A. Sverstyuk, M. Korda","doi":"10.22494/cot.v11i1.148","DOIUrl":"https://doi.org/10.22494/cot.v11i1.148","url":null,"abstract":"Acute Respiratory Distress Syndrome (ARDS) is a severe clinical condition that can cause multi-organ dysfunction, including liver injury. Human umbilical cord-derived mesenchymal stromal cells (hUC-MSCs) have been shown to possess therapeutic potential for a variety of diseases due to their ability to differentiate into various cell types and their anti-inflammatory and immunomodulatory properties. Purpose: To investigate the potential of hUC-MSCs for treating lipopolysaccharide (LPS)-induced liver injury in rats. Materials and methods: 72 mature male Wistar rats were randomly assigned to nine groups: control, 3 days, 7 days, and 28 days after intranasal administration of LPS, 24 hours of LPS and 2 days of hUC-MSCs, 4 days of LPS and 3 days of hUC-MSCs, 14 days of LPS and 14 days of hUC-MSCs, 21 days of LPS and 7 days of hUC-MSCs injection, and control 3 days after hUC-MSCs injection. The isolation of MSCs from human umbilical cord tissue was performed using an enzymatic digestion method with collagenase I. hUC-MSCs were injected intraperitoneally at a dose of 1∙106 cells/kg body weight. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were measured using the kinetic method. The levels of hepatocellular necrosis, liver structural damage, hepatocyte vacuolation, inflammation and disseminated intravascular coagulation (DIC) were analyzed by histological scoring of sections stained with hematoxylin and eosin. The expression of TGF-β1 in the liver tissue was evaluated by immunohistochemistry. Results: The preclinical study demonstrated that treatment with hUC-MSCs significantly improved liver function and attenuated LPS-induced liver injury in rats. This was evidenced by a reduction in hepatocellular necrosis, liver structural damage, hepatocyte vacuolation, inflammation, signs of DIC, fibrosis and lower levels of serum liver markers ALT, AST and ALP in the hUC-MSCs-treated groups compared to the untreated groups. The study also revealed that the use of hUC-MSCs was more effective at the earlier stage of liver injury. Conclusions: Our findings suggest that hUC-MSCs therapy may hold promise as a potential treatment for LPS-induced liver injury. Further research is needed to better understand the underlying mechanisms and to determine the potential for hUC-MSCs therapy in clinical practice.","PeriodicalId":36461,"journal":{"name":"Cell and Organ Transplantology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41852234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Konovalov, V. Moroz, O. Deryabina, N. Shuvalova, A. Tochylovsky, P. Klymenko, V. Kordium
Ischemic stroke is the second leading cause of death and the leading cause of disability worldwide. So far, promising experimental data have been obtained regarding the elimination of neurological dysfunction and the reduction of the area of ischemic damage when using mesenchymal stromal cells (MSCs). Purpose: to characterize the influence of MSCs of different origin, MSC lysate of human Wharton cells and citicoline on the dynamics of destructive changes in the somatosensory cortex of rats with acute cerebrovascular accident according to light microscopy and micromorphometry data. Materials and methods. An experiment was performed using 190 -4-month-old male Wistar rats weighing 160-190 g, which were subjected to transient bilateral 20-minute ischemia-reperfusion (IR) of the internal carotid arteries. After modeling the pathology, the animals were injected into the femoral vein with obtained from human umbilical cord Wharton’s jelly-derived MSCs, human and rat adipose tissue-derived MSCs at a dose of 106 cells/animal. Other groups of experimental animals were intravenously injected with fetal rat fibroblasts at a dose of 106 cells/animal in 0.2 ml of physiological solution and lysate of human umbilical cord Wharton’s jelly-derived MSCs at a dose of 0.2 ml/animal. Control animals were injected IV with 0.2 ml of physiological solution. The last group of rats received a single dose of the reference drug citicoline at a dose of 250 mg/kg. The studies were conducted on the 7th and 14th day. In the somatosensory cortex, the total number of neuron nuclei per 1 mm2 was counted, and the ratio of the number of intact neuron nuclei and nuclei with pathological changes (karyorrhexis and karyopyknosis) was also determined. Results: The transplantation of stem cells, lysate of human umbilical cord Wharton’s jelly-derived MSCs, or citicoline contributed to an increase in the number of neurons with nuclei in the somatosensory cortex, as well as an increase in the number of nuclei that did not undergo pathological changes. The transplantation of human umbilical cord Wharton’s jelly-derived MSCs had the most positive effect. The number of neuron nuclei in 1 mm2 that did not undergo pathological changes in the somatosensory cortex in this group of animals approached the number of nuclei in the group of pseudo-operated animals, while the number of nuclei that did not undergo pathological changes significantly exceeded the number of nuclei with signs of destruction. Conclusion: A significant increase in the number of neurons without signs of pathological changes was observed in all experimental groups of rats during the simulation of ischemic brain damage after the introduction of various types of studied mesenchymal stromal cells, lysate or citicoline. The most positive result in the somatosensory cortex was achieved after the introduction of human umbilical cord Wharton’s jelly-derived MSCs.
{"title":"The effect of mesenchymal stromal cells of different origin on morphological parameters in the somatosensory cortex of rats with acute cerebral ischemia","authors":"S. Konovalov, V. Moroz, O. Deryabina, N. Shuvalova, A. Tochylovsky, P. Klymenko, V. Kordium","doi":"10.22494/cot.v11i1.149","DOIUrl":"https://doi.org/10.22494/cot.v11i1.149","url":null,"abstract":"Ischemic stroke is the second leading cause of death and the leading cause of disability worldwide. So far, promising experimental data have been obtained regarding the elimination of neurological dysfunction and the reduction of the area of ischemic damage when using mesenchymal stromal cells (MSCs). Purpose: to characterize the influence of MSCs of different origin, MSC lysate of human Wharton cells and citicoline on the dynamics of destructive changes in the somatosensory cortex of rats with acute cerebrovascular accident according to light microscopy and micromorphometry data. Materials and methods. An experiment was performed using 190 -4-month-old male Wistar rats weighing 160-190 g, which were subjected to transient bilateral 20-minute ischemia-reperfusion (IR) of the internal carotid arteries. After modeling the pathology, the animals were injected into the femoral vein with obtained from human umbilical cord Wharton’s jelly-derived MSCs, human and rat adipose tissue-derived MSCs at a dose of 106 cells/animal. Other groups of experimental animals were intravenously injected with fetal rat fibroblasts at a dose of 106 cells/animal in 0.2 ml of physiological solution and lysate of human umbilical cord Wharton’s jelly-derived MSCs at a dose of 0.2 ml/animal. Control animals were injected IV with 0.2 ml of physiological solution. The last group of rats received a single dose of the reference drug citicoline at a dose of 250 mg/kg. The studies were conducted on the 7th and 14th day. In the somatosensory cortex, the total number of neuron nuclei per 1 mm2 was counted, and the ratio of the number of intact neuron nuclei and nuclei with pathological changes (karyorrhexis and karyopyknosis) was also determined. Results: The transplantation of stem cells, lysate of human umbilical cord Wharton’s jelly-derived MSCs, or citicoline contributed to an increase in the number of neurons with nuclei in the somatosensory cortex, as well as an increase in the number of nuclei that did not undergo pathological changes. The transplantation of human umbilical cord Wharton’s jelly-derived MSCs had the most positive effect. The number of neuron nuclei in 1 mm2 that did not undergo pathological changes in the somatosensory cortex in this group of animals approached the number of nuclei in the group of pseudo-operated animals, while the number of nuclei that did not undergo pathological changes significantly exceeded the number of nuclei with signs of destruction. Conclusion: A significant increase in the number of neurons without signs of pathological changes was observed in all experimental groups of rats during the simulation of ischemic brain damage after the introduction of various types of studied mesenchymal stromal cells, lysate or citicoline. The most positive result in the somatosensory cortex was achieved after the introduction of human umbilical cord Wharton’s jelly-derived MSCs.","PeriodicalId":36461,"journal":{"name":"Cell and Organ Transplantology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47639490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-22DOI: 10.3390/transplantology4020009
M. Salvadori
One of the major challenges in developing programs for kidney transplantation is represented by the presence of antibodies targeting the HLA of the donor in the recipients and, in particular cases, the incompatibility of the ABO blood groups among donor and recipient for living donors [...]
{"title":"Strategies for Access to Kidney Transplantation for Highly Sensitized and Incompatible Patients","authors":"M. Salvadori","doi":"10.3390/transplantology4020009","DOIUrl":"https://doi.org/10.3390/transplantology4020009","url":null,"abstract":"One of the major challenges in developing programs for kidney transplantation is represented by the presence of antibodies targeting the HLA of the donor in the recipients and, in particular cases, the incompatibility of the ABO blood groups among donor and recipient for living donors [...]","PeriodicalId":36461,"journal":{"name":"Cell and Organ Transplantology","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90377372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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