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1.
Sonia Gaucher Nathalie Duchange Mohamed Jarraya Jocelyne Magne Jean-Michel Rochet Jean Stéphanazzi Christian Hervé Grégoire Moutel 《Cell and tissue banking》2013,14(3):505-510
During the acute phase of a severe burn, surgery is an emergency. In this situation, human skin allografts constitute an effective temporary skin substitute. However, information about the use of human tissue can not be given to the patients because most of the allografted patients are unconscious due to their injury. This study explored the restitution of information on skin donation to patients who have been skin allografted and who have survived their injury. A qualitative study was conducted due to the limited number of patients in ability to be interviewed according to our medical and psychological criteria. 12 patients who had been treated between 2002 and 2008 were interviewed. Our results show that 10 of them ignored that they had received skin allografts. One of the two patients who knew that they had received allografts knew that skin had been harvested from deceased donor. All patients expressed that there is no information that should not be delivered. They also expressed their relief to have had the opportunity to discuss their case and at being informed during their interview. Their own experience impacted their view in favor of organ and tissue donation. 相似文献
2.
Burns are tissue wounds caused by thermal, electrical, chemical cold or radiation injuries. Deep injuries lead to dermal damage
that impairs the ability of the skin to heal and regenerate on its own. Skin autografting following burn excision is considered
the current gold standard of care, but lack of patient’s own donor skin or unsuitability of the wound for autografting may
require the temporary use of dressings or skin substitutes to promote wound healing, reduce pain, and prevent infection and
abnormal scarring. These alternatives include deceased donor skin allograft, xenograft, cultured epithelial cells and biosynthetic
skin substitutes. Allotransplantation is the transplantation of cells, tissues, or organs, sourced from a genetically non-identical
member of the same species as the recipient. Human deceased donor skin allografts represent a suitable and much used temporizing
option for skin cover following burn injury. The main advantages for its use include dermoprotection and promotion of reepithelialisation
of the wound and their ability to act as skin cover until autografting is possible or re-harvesting of donor sites becomes
available. Disadvantages of its use include the limited abundance and availability of donors, possible transmission of disease,
the eventual rejection by the host and its handling storing, transporting and associated costs of provision. This paper will
explore the role of allograft skin in burn care, defining the indications for its use in burn management and the future potential
for allograft tissue banking. 相似文献
3.
Summary Isoenzymes of glucose-6-phosphate isomerase (GPI: E.C. 5.3.1.9) were used as markers to determine the origin of cells which give rise to new muscle formed in allografts of whole intact muscle. GPI isoenzymes were also employed to see whether host precursor cells, which have been shown to contribute to muscle formation in grafts of minced muscle, can be derived from muscle lying adjacent to grafts.Excellent muscle regeneration was found in allografts of extensor digitorum longus (EDL) muscle examined after 58 days: 12 of 16 grafts contained 80% or more new muscle. Isoenzyme analysis showed that most, and in 2 instances all, new muscle was derived from implanted donor cells; however, there was strong evidence that in 5 grafts some, or all, new muscle must have resulted from host cells moving into the graft. Although hybrid isoenzyme was not detected this was attributed to factors associated with host tolerance which appear to interfere with fusion between host and donor myoblasts.Isografts of minced muscle were placed next to whole EDL muscle allografts to see if cells from allografts moved into adjacent regenerating tissue. Unfortunately, muscle regeneration in minced isografts was poor; only 3 contained 50% or more new muscle and most contained large amounts of fibrous connective tissue. Only a single isoenzyme band was detected in 11 isografts, but in five instances, the presence of a second band showed that cells from EDL allografts were also present. As no hybrid isoenzyme was detected, it is not known whether these cells which had moved into the regenerating minced grafts were muscle precursors, fibroblasts or some other cell types. 相似文献
4.
Ken Urabe Kouji Naruse Masataka Uchino Masashi Takaso Mamoru Fujita Katsufumi Uchiyama Takamitsu Okada Midori Kasahara Moritoshi Itoman 《Cell and tissue banking》2009,10(3):259-265
Demand for banked bone allografts is increasing in Japan; however, there are too few bone banks and the bone bank network
is not well-established. One reason for this was lack of funding for banks. Bone banks had to bear all material expenses of
banked bone allografts themselves because this was not designated a covered expense. In December 2004, the Japanese government
started a new “Advanced Medical Treatment” administration system which allowed an approved institution to charge the expense
of authorized advanced medical treatments directly to patients. The treatment named “Cryopreserved allogenic bone and ligamentous
tissue retrieved from cadaveric donor” was approved as an advanced medical treatment in March 2007. We present the calculation
method and the expense per implantation of a banked bone allograft from a cadaveric donor under this treatment and raise issues
which affect this advanced medical treatment and remain to be resolved in the Japanese orthopaedic field. 相似文献
5.
Fuchimoto Y Yamada K Shimizu A Yasumoto A Sawada T Huang CH Sachs DH 《Journal of immunology (Baltimore, Md. : 1950)》1999,162(10):5704-5711
The persistence of donor leukocytes in recipients of organ allografts has been associated with long-term graft acceptance. However, it remains unclear whether this peripheral donor cell microchimerism plays an active role in graft acceptance or is simply a consequence of the maintenance of sufficient immunosuppression to avoid rejection. A model of kidney transplantation between swine leukocyte Ag (SLA)-matched miniature swine, in which tolerance can be established with or without immunosuppressive treatment, has been used to study the correlation between donor leukocyte chimerism and kidney graft acceptance. SLA-identical kidney transplants were performed from animals positive for an allelic pig leukocyte Ag to animals negative for this marker. SLA-identical kidney transplant recipients given a 12-day course of cyclosporine (CyA) (n = 3) became tolerant, showing stable serum creatinine levels (1-2 mg/dl) after cessation of CyA treatment. Donor cell chimerism (0.2-0.7%) was present by FACS in all three animals with peak levels detected at 3 wk. Two control animals receiving SLA-identical kidney grafts without CyA also showed stable serum creatinine levels and became tolerant. However, in neither of these animals could donor leukocytes be detected in the peripheral blood beyond 1 wk following transplantation. In one additional control animal, ureteral obstruction occurred at day 10, and was associated with additional peripheral chimerism, presumably related to inflammation rather than to immune status. These results indicate that the persistence of donor cell chimerism is not a requirement for the maintenance of tolerance to organ allografts in this model. 相似文献
6.
7.
We analyzed the incidence and predisposing factors for overall discard rate after retrieval of 295 femoral head allografts. The aim of the present study was to evaluate the quality system of institutional bone banking and to ensure that we can provide high standard allografts with low infection rate. Audit of bone banking was conducted on 295 donors and 180 recipients. Of the 295 donated femoral heads 77 were discarded, giving an overall discard rate of 26.1 %. At retrieval, 37 allografts were positive, giving an overall contamination rate of 12.54 %. The organism most commonly identified was Staphylococcus species. Seven (2.37 %) of the 295 allografts failed the blood screening tests. Twelve allografts (4.06 %) were discarded because of suspected damage of the packaging or disuse during surgery. Due to donor death or inability to perform serology retests, 21 (7.11 %) allografts were discarded. In the postoperative survey an infection rate of 2.22 % was found. After 7 years of bone banking, our results show that overall discard rate and allograft related infection rate are in accordance with the international standards. The leading cause of allograft discarding was bacterial contamination influenced by the surgical team. We suggest stringent aseptic allograft handling during harvesting and thawing within highly concentrated antibiotic solution to reduce a possibility of its contamination. 相似文献
8.
This article aims to discuss the role of deceased donor skin within the treatment of burn injuries with particular reference to the management of major burn disasters. The article begins with a review of wound healing before progressing to outline the development of the current modern day approach to burns surgery from its historical origins and the role of deceased donor skin within this. A detailed review of mass disasters within the UK over the past 29 years provides an indication as to the frequency and extent of mass disasters that might be predicted to occur. Combining this with a recent review of allograft requirements within burns surgery at a regional UK centre allows for more accurate planning and stockpiling of deceased donor skin reserves. UK awareness and emergency preparedness for major burn disasters can thus be improved. 相似文献
9.
Wang L Han R Lee I Hancock AS Xiong G Gunn MD Hancock WW 《Journal of immunology (Baltimore, Md. : 1950)》2005,175(10):6311-6318
Chemokine receptor blockade can diminish the recruitment of host effector cells and prolong allograft survival, but little is known of the role of chemokine receptors in promoting host sensitization. We engrafted fully allogeneic islets into streptozotocin-treated normal mice or mice with the autosomal recessive paucity of lymph node T cell (plt) mutation; the latter lack secondary lymphoid expression of the CCR7 ligands, secondary lymphoid organ chemokine (CCL21) and EBV-induced molecule-1 ligand chemokine (CCL19). plt mice showed permanent survival of islets engrafted under the kidney capsule, whereas controls rejected islet allografts in 12 days (p < 0.001), and consistent with this, plt mice had normal allogeneic T cell responses, but deficient migration of donor dendritic cell to draining lymph nodes. Peritransplant i.v. injection of donor splenocytes caused plt recipients to reject their allografts by 12 days, and sensitization at 60 days posttransplant of plt mice with well-functioning allografts restored acute rejection. Finally, islet allografts transplanted intrahepatically in plt mice were rejected approximately 12 days posttransplant, like controls, as were primarily revascularized cardiac allografts. These data show that the chemokine-directed homing of donor dendritic cell to secondary lymphoid tissues is essential for host sensitization and allograft rejection. Interruption of such homing can prevent T cell priming and islet allograft rejection despite normal T and B cell functions of the recipient, with potential clinical implications. 相似文献
10.
Schubert T Bigaré E Van Isacker T Gigi J Delloye C Cornu O 《Cell and tissue banking》2012,13(3):421-429
Bone and tissue allografts are widely used in transplantation. The increasing demand for safe allografts must be met, while minimizing disease transmission. We analysed the incidence and potential risk factors of allograft contamination and the effectiveness of disinfection, by reviewing 22 years of tissue bank activity and 474 donor procurements. We also compared different disinfection procedures used over the 22 years. The overall contamination rate was 10.1%. Risk factors were related to the donor or procurement method. Immediate culture at the tissue recovery site diminished the rate of false positives by reducing later sample manipulation. High-virulence allograft contamination was mainly related to donor factors, while low-virulence contamination was related to procurement methods. Analysis of donor-related risk factors showed no statistical differences for age, sex, or cause of death. An intensive care unit stay was associated with less contamination with high-virulence microbes. Procurement in a setting other than an operating theatre was associated with higher contamination rate. Team experience reduced contamination. Pelvic and tendon allografts were most frequently contaminated. Proper disinfection considerably reduced the contamination rate to 3.6%. We conclude that procurement must be performed under aseptic conditions, with short delays, and by trained personnel. Grafts should be disinfected and packed as soon as possible. 相似文献
11.
Therese Garrick Nina Sundqvist Timothy Dobbins Liza Azizi Clive Harper 《Cell and tissue banking》2009,10(4):309-315
Whilst mainstream transplant literature provides valuable insights into the influences on families to donate organs and tissues
for transplant, the relevance of these findings in relation to organ donation for research remain speculative. The present
study aims to expand the research donation literature, by exploring factors that influence a family’s decision to donate brain
tissue to neuroscience research. The verbal responses of the senior available next-of-kin (NOK), to the question of brain
donation for research, are analysed. The donation rate was high (54%) over the 5-year-period. NOK relationship to the deceased,
and post mortem interval were the main factors associated with a positive donation. Parents were most likely to donate and
this may result from a lifetime of decision-making on behalf of the deceased. Also, the longer the interval between death
of the potential donor and the question being asked, the greater the likelihood of donation. 相似文献
12.
Vicente Mirabet Manuel Álvarez Mar Luis-Hidalgo Juan Galán Nieves Puig Luis Larrea Cristina Arbona 《Cell and tissue banking》2017,18(3):335-341
The implementation of nucleic acid testing in donor screening has improved the safety of tissue allografts. Although infectious disease transmission can be considered a rare event, the detection of occult hepatitis B infection remains challenging. The studies concerning this risk are mainly based on testing blood specimens. This work shows the correlation between results of samples obtained from donor blood and the corresponding tissue washing solution. Hepatitis B virus deoxyribonucleic acid was detected both in bone allografts from donors with serological profiles associated to active hepatitis B infection and occult hepatitis B infection. These results suggest that hepatitis B virus seems to concentrate in bone marrow even when a low viral load is present in peripheral blood. Even detection at molecular level is not enough to avoid the risk of hepatitis B virus transmission and a multiparametrical evaluation is required in tissue donor screening. The role of clinicians in recognition and reporting of allograft-associated infections is a major concern for the acquisition of experience to be applied in risk control of disease transmission. 相似文献
13.
Astrid Lobo Gajiwala 《Cell and tissue banking》2018,19(2):241-248
Amendments to India’s Transplantation of Human Organs Act, 1994, have established the legality of tissue donation and transplantation from deceased donors and the conditions under which they are permitted. The amended Act, now known as The Transplantation of Human Organs and Tissues Act, 1994, seeks to prevent the commercialization of tissue donation and to guarantee the safety of indigenous allografts. Registration of tissue banks, compliance with national standards and the appointment of transplant co-ordinators in hospitals registered under the Act are now mandatory. A national registry and Regional and State networks for donation and transplantation of tissues have been introduced. Despite the amendments a few anomalies of the principal Act persist as some of the differences between tissue and organ donation and transplantation have been overlooked. These include the possibility of skin donation in locations other than hospitals; the donation of medical and surgical tissue residues which does not pose any risk to the living donor; the non-requirement for compatibility between donor and recipient; the delayed time factor between tissue donation and transplantation which makes identification of a recipient at the time of donation impossible; and the easy availability of alternatives to tissues which make waiting lists redundant for many tissues. Rules for the implementation of the amended Act were framed in 2014 but like the Act must be adopted by the State health assemblies to become universally applicable in the country. 相似文献
14.
The deaths of otherwise healthy patients that are attributable to contaminated allografts have heightened concerns about the
screening, processing, and use of such tissues. We present one tertiary care institution’s experience with musculoskeletal
allografts and determine the frequency of postoperative Clostridium infection. We used an institutional microbiology database to identify all records of culture-confirmed Clostridium infection from January 1990 through July 2006. A comprehensive musculoskeletal database was cross-referenced to include all
possible allograft samples surgically collected or implanted from January 1990 through July 2004 to determine the frequency
of Clostridium infection associated with use of allograft musculoskeletal tissue. Musculoskeletal allografts were implanted in 16,314 patients
during the study period. After a minimum follow-up of 2 years, no patient had development of a definite Clostridium infection that was attributable to the use of musculoskeletal allograft tissue. These outcomes can be achieved with established
screening and processing techniques for donor tissue. 相似文献
15.
Donor T cell activation initiates small bowel allograft rejection through an IFN-gamma-inducible protein-10-dependent mechanism 总被引:3,自引:0,他引:3
Zhang Z Kaptanoglu L Haddad W Ivancic D Alnadjim Z Hurst S Tishler D Luster AD Barrett TA Fryer J 《Journal of immunology (Baltimore, Md. : 1950)》2002,168(7):3205-3212
The poor success in controlling small bowel (SB) allograft rejection is partially attributed to the unique immune environment in the donor intestine. We hypothesized that Ag-induced activation of donor-derived T cells contributes to the initiation of SB allograft rejection. To address the role of donor T cell activation in SB transplantation, SB grafts from DO11.10 TCR transgenic mice (BALB/c, H-2L(d+)) were transplanted into BALB/c (isografts), or single class I MHC-mismatched (L(d)-deficient) BALB/c H-2(dm2) (dm2, H-2L(d-)) mutant mice (allografts). Graft survival was followed after injection of control or antigenic OVA(323-339) peptide. Eighty percent of SB allografts developed severe rejection in mice treated with antigenic peptide, whereas <20% of allografts were rejected in mice treated with control peptide (p < 0.05). Isografts survived >30 days regardless of OVA(323-339) administration. Activation of donor T cells increased intragraft expression of proinflammatory cytokine (IFN-gamma) and CXC chemokine IFN-gamma-inducible protein-10 mRNA and enhanced activation and accumulation of host NK and T cells in SB allografts. Treatment of mice with neutralizing anti-IFN-gamma-inducible protein-10 mAb increased SB allograft survival in Ag-treated mice (67%; p < 0.05) and reduced accumulation of host T cells and NK cells in the lamina propria but not mesenteric lymph nodes. These results suggest that activation of donor T cells after SB allotransplantation induces production of a Th1-like profile of cytokines and CXC chemokines that enhance infiltration of host T cells and NK cells in SB allografts. Blocking this pathway may be of therapeutic value in controlling SB allograft rejection. 相似文献
16.
Griesemer AD Lamattina JC Okumi M Etter JD Shimizu A Sachs DH Yamada K 《Journal of immunology (Baltimore, Md. : 1950)》2008,181(6):4027-4036
We have demonstrated previously that a 12-day course of FK506 permits the induction of tolerance to fully MHC-mismatched renal transplants in miniature swine. In the present study, we examined the mechanism of this tolerance by assessing the possibility that the survival of one-haplotype mismatched third-party kidneys might be prolonged via linked suppression. Ten SLA(d/d) miniature swine received fully MHC-mismatched renal allografts from SLA(c/c) donors with 12 days of FK506. Six animals received second SLA(c/c) kidneys without immunosuppression to confirm tolerance. Regulatory mechanisms were assessed by mixed lymphocyte reaction (MLR) and cell-mediated lympholysis coculture assays and ELISA for regulatory cytokines. Linked suppression was investigated by transplanting SLA(a/c) or SLA(a/d) allografts into long-term tolerant recipients without immunosuppression. All recipients showed donor-specific unresponsiveness in standard cell-mediated lympholysis and MLR assays. Tolerant cells prestimulated with donor Ag and then cocultured with naive recipient MHC-matched cells inhibited antidonor responses, confirming the presence of regulatory cells. ELISA and MLR assays showed that TGF-beta2 was involved in mediating the suppression in vitro. SLA(a/d) renal allografts transplanted into tolerant recipients were rejected by postoperative day 8 (median, 7 days; range, 6-8). In contrast, SLA(a/c) allografts showed markedly prolonged survival (median, 52 days; range, 28-78; p = 0.0246), suggesting linked suppression. Animals not challenged with a second donor-matched graft did not manifest linked suppression consistent with in vitro data showing that re-exposure to tolerated Ags is important for generation of regulatory cells. To our knowledge, these data represent the first evidence of linked suppression across fully MHC-mismatched barriers in a large animal model. 相似文献
17.
E M Shevach C Chan H Bitter-Suermann 《Journal of immunology (Baltimore, Md. : 1950)》1982,129(2):710-715
We have developed a model for the induction of transplantation tolerance in the guinea pig by vascularized spleen allografts. Spleen allografts from strain 13 to strain 2 hosts frequently survived in healthy recipients without clinical GVHD or induced clinical GVHD. (2 x 13)F1 to strain 2 spleen allografts survived indefinitely without inducing GVHD. In contrast, strain 2 spleen allografts were rejected by strain 13 hosts. An excellent correlation was observed between the clinical course and the degree of reactivity to donor strain stimulator cells in the MLR. Animals that had rejected their grafts had normal or enhanced proliferative responses in the MLR. Strain 2 hosts with long-term surviving strain 13 or (2 x 13)F1 grafts had markedly suppressed anti-13 responses. Animals with GVHD had a suppressed MLR toward donor strain stimulator cells with simultaneous reactivity to host strain stimulator cells. Cells capable of suppressing the response of normal host strain cells to donor strain stimulators were present in some long-term surviving animals and may be responsible in part for the maintenance of the tolerant state. 相似文献
18.
The EU Tissues and Cells Directive (2004/23/EC, 2006/17/EC, 2006/86/EC) (EUTCD) provides standards for quality and safety
for all aspects of banking of tissues and cells for clinical applications. Commission Directive 2006/17/EC stipulates that
the complete donor record with all the medical information is assessed for suitability before releasing tissues for clinical
use. The aim of this study was to investigate the medical reasons for post-procurement donor exclusion, to identify the various
potential sources for gathering information about donors’ medical and behavioural history and to evaluate their contribution
to maximising the safety of donations. Information was collected from the Tissue Services (TS) records of 1000 consecutive
deceased donors submitted to National Health Service Blood and Transplant (NHSBT) medical officers for authorisation for release
for subsequent tissue processing and then for transplantation. Of the 1000 donors 60 (6%) were excluded because they did not
fulfil the donor selection requirements of the EUTCD and NHSBT donor selection guidelines. The main reasons for medical exclusion
were the presence of significant local or systemic infection in 32 donors (53% of those excluded for medical reasons) and
a history of past or occult malignancy in 9 donors (15% of those excluded for medical reasons) which was not identified prior
to procurement. The information leading to post-procurement exclusion was obtained from autopsy reports in 35 of the 60 excluded
donors for medical reasons (58%) and from the general practitioner for 10 donors (17% of those excluded for medical reasons).
In summary, careful evaluation of complete donor records reduces the potential risk of disease transmission by tissue allografts
and ensures compliance with regulations and guidelines. The findings may lead to changes in donor selection policies with
the aim of improving efficiency without compromising safety. 相似文献
19.
Regulatory roles of NKT cells in the induction and maintenance of cyclophosphamide-induced tolerance
Iwai T Tomita Y Okano S Shimizu I Yasunami Y Kajiwara T Yoshikai Y Taniguchi M Nomoto K Yasui H 《Journal of immunology (Baltimore, Md. : 1950)》2006,177(12):8400-8409
We have previously reported the sequential mechanisms of cyclophosphamide (CP)-induced tolerance. Permanent acceptance of donor skin graft is readily induced in the MHC-matched and minor Ag-mismatched recipients after treatment with donor spleen cells and CP. In the present study, we have elucidated the roles of NKT cells in CP-induced skin allograft tolerance. BALB/c AnNCrj (H-2(d), Lyt-1.2, and Mls-1(b)) wild-type (WT) mice or Valpha14 NKT knockout (KO) (BALB/c) mice were used as recipients, and DBA/2 NCrj (H-2(d), Lyt-1.1, and Mls-1(a)) mice were used as donors. Recipient mice were primed with 1 x 10(8) donor SC i.v. on day 0, followed by 200 mg/kg CP i.p. on day 2. Donor mixed chimerism and permanent acceptance of donor skin allografts were observed in the WT recipients. However, donor skin allografts were rejected in NKT KO recipient mice. In addition, the donor reactive Vbeta6(+) T cells were observed in the thymus of a NKT KO recipient. Reconstruction of NKT cells from WT mice restored the acceptance of donor skin allografts. In addition, donor grafts were partially accepted in the thymectomized NKT KO recipient mice. Furthermore, the tolerogen-specific suppressor cell was observed in thymectomized NKT KO recipient mice, suggesting the generation of regulatory T cells in the absence of NTK cells. Our results suggest that NKT cells are essential for CP-induced tolerance and may have a role in the establishment of mixed chimerism, resulting in clonal deletion of donor-reactive T cells in the recipient thymus. 相似文献
20.
Ingraft chimerism in lung transplantation - a study in a porcine model of obliterative bronchiolitis
Outi E P?iv?niemi Petra Musilova Peter M Raivio Paula K Maasilta Hanni S Alho Jiri Rubes Kristiina Aittom?ki Ulla-Stina Salminen 《Respiratory research》2011,12(1):56