Non-ABO blood group systems phenotyping in non-human primates for blood banking laboratory and xenotransplantation

Some biomedical research procedures, such as organ xenotransplantation, usually require intensive hemotherapy. Knowledge of the whole phenotype of blood donor and graft could be useful in the field of xenotransplantation. Human and simian-type categories of blood groups have been established and they can be tested by standard methods used for human blood grouping. The aim of this work was to study the incidence of non-ABO blood group systems in different species of non-human primates, which are employed in biomedical research. The phenotype of Rh, Lewis, Kidd, Kell, MNSs, Lutheran, P and Duffy antigens was investigated in olive baboon (n = 48), chacma baboon (n = 9), Guinea baboon (n = 14), Rhesus macaque (n = 38) and squirrel monkey (n = 30) by using commercial microtyping cards. Kell, Lutheran, Kidd and Duffy antigens have been detected in all species, Rh in squirrel monkey, MNSs in rhesus macaque and squirrel monkey, and Lewis in baboon and rhesus macaque. There were differences in frequency and haemagglutination scores between species regardless of their gender and age. The main differences were found in squirrel monkey when compared with baboons and macaques. This typing system provides a tool to assess the presence of antigens in animals used for experimental procedures, such as xenotransplantation and xenotransfusion.

Assessment of in vitro heparin complement regulation capacity during real-time cell analyzer antibody-mediated cytolysis assay: compatibility studies for pig-to-baboon xenotransplantation

OBJECTIVE

To assess the effect of sodium heparin concentrations on antibody- and complement-mediated cytolysis by means of a real-time cell analyzer system (RTCA) investigating the complement regulation ability of heparin to reduce or prevent hyperacute in an in vitro model of pig-to-baboon xenotransplantation.

MATERIALS AND METHODS

Fibroblasts isolated from the skin of two transgenic pigs were cultured in microelectronic 96-well plates for 9 hours. Then, we added 20 μL of normal sera from two healthy adult olive baboons (Papio anubis) or two volunteer healthy humans. Simultaneous cultures had added heparin at 3.5, 5, 7.5, 15, and 30 IU. Moreover, rabbit complement was added for the exogenous complement group (ExC) versus the other group only with the complement present in the sera as an endogenous complement group (EnC). Cellular cultures were monitored over 150 hours after challenge. With cellular index (CI) data recorded by the xCELLigence software system, we calculate area under the curve versus concentration (AUC) and minimum CI (CImin) versus concentration.

RESULTS

All cultures showed decreased CI after challenge with human or baboon sera. There was a high correlation for AUC (r(2) > 0.90) and CImin versus concentration (r(2) > 0.970) during the first 40 hours postchallenge among the EnC group, regardless of human or baboon sera. However, there was no correlation for AUC and CImin for the ExC group. There was a reduction of CImin related to increased heparin concentrations.

CONCLUSIONS

The addition of heparin did not reduce antibody- and complement-mediated cytolysis assessed in vitro by RTCA in pig-to-baboon compatibility assays.

Emotional-type psychopathologic symptoms among patients with terminal chronic alcohol-induced liver cirrhosis

INTRODUCTION

Patients with toxic substance abuse syndrome, such as alcohol abuse, have elevated psychopathologic morbidity and mortality such as mood disorders.

OBJECTIVE

To evaluate the emotional-type psychopathologic symptoms in patients with alcohol-induced hepatic cirrhosis on the liver transplant waiting list.

MATERIALS AND METHODS

Patients with alcoholic liver cirrhosis who were candidates for liver transplant (n = 41) completed the SA-45 questionnaire (González y Cuevas; 88), which assesses nine dimensions: somatizations, obsessive-compulsivity, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. A control group consisted of patients with chronic nonalcoholic terminal hepatopathies (n = 22).

RESULTS

Seventy-six percent of patients had some kind of psychopathologic symptom compared to 68% of the patients in the control group with other nonalcoholic etiologies (P > .05). The emotional-type clinical symptoms were: (1) somatizations: 37% of patients with alcoholic cirrhosis had this type of clinical symptoms compared to 32% of the control group (P > .05); (2) obsessive-compulsivity: 56% versus 46%, respectively (P > .05); (3) interpersonal sensitivity: 19% versus 9%, respectively (P > .05); (4) depression: 54% versus 27%, respectively (P = .045); (5) anxiety: 59% versus 46%, respectively (P > .05); (6) hostility: 29% versus 5%, respectively (P = .021); (7) phobic anxiety: 10% versus 14%, respectively (P > .05); (8) paranoid Ideation: 7% versus 5%, respectively (P > .05); (9) psychoticism: 5% versus 4%, respectively (P > .05).

CONCLUSIONS

The patients with alcoholic liver cirrhosis on the liver transplant waiting list had elevated psychopathologic symptoms. Depressive- and hostile-type emotional alterations were most frequent in this type of patients.

Generation of human-to-pig chimerism to induce tolerance through transcutaneous in utero injection of cord blood-derived mononuclear cells or human bone marrow mesenchymals cells in a preclinical program of liver xenotransplantation: preliminary results

OBJECTIVE

Using a percutaneous ecoguided injection system to obtain chimeric piglets through a less invasive and traumatic technique than previously reported.

MATERIALS AND METHODS

The two types of human cells included umbilical cord blood mononuclear elements and mesenchymal stem cells cultured from bone marrow. Four sows at gestational day 50 were anesthetized. A needle was inserted through the skin and uterine wall to reach the peritoneal cavity of the fetuses under continuous ultrasound guidance. Fourteen piglets were injected with various cell concentrations.

RESULTS

All sows carried pregnancies to term yielding 69 piglets, among which 67 were alive and two mummified. Two piglets died during the first 48 hours of life. Chimerism was detected using flow cytometry and by quantitative polymerase chain reaction (q-PCR) to detect Alu gene in blood or tissues samples. The analysis detected blood chimerism in 13 piglets (21%) by flow cytometry and the presence of the human Alu gene in 33 (51%) by q-PCR. The results suggest cell trafficking between littermates after in utero injection.

CONCLUSIONS

Transcutaneous echo-guided injection succeeded to produce chimeric piglets without disadvantages to the sow or the fetuses and avoiding abortions or fetal death.

Selective extraction of astaxanthin from crustaceans by use of supercritical carbon dioxide

An on-line supercritical fluid extraction (SFE) system coupled to a continuous flow manifold including a UV detector was used as a screening system to extract astaxanthin from crayfish, which was found to be the major carotenoid present in the samples. This compound constitutes the principal additive used to dye salmon flesh. The flow manifold was used to confirm the presence of astaxanthin in the crustacean samples. Also, an HPLC/UV-vis method was used to ascertain that this compound was the major carotenoid extracted under the optimum SFE conditions employed. The influence of SFE operating variables such as pressure, temperature, equilibration time, extraction time, trap temperature, and volume of CO(2) modifier was examined in order to maximize the efficiency of analyte extraction. The use of supercritical CO(2) enables the expeditious, selective, quantitative extraction of astaxanthin from crustaceans.

Multivariate analysis to determine the factors affecting the attitudes toward organ donation of healthcare assistants in Spanish and Mexican healthcare centers

BACKGROUND

Healthcare assistants are an important group of workers who can influence public opinion. Their attitudes toward organ donation may influence public awareness of healthcare matters; negative attitudes toward donation and transplantation could have a negative impact on public attitudes. Our objective was analyze the attitudes of healthcare assistants, in Spanish and Mexican healthcare centers toward organ donation and determine factors affecting them using a multivariate analysis.

MATERIAL AND METHODS

As part of the "International Collaborative Donor Project," 32 primary care centers and 4 hospitals were selected in Spain and 5 hospitals in Mexico. A randomized sample of healthcare assistants was stratified according to healthcare services. Attitudes were evaluated using a validated questionnaire of the psychosocial aspects of donation, which was self-completed anonymously by the respondent. Statistical analysis used the chi-square test, Student t test, and logistic regression analysis.

RESULTS

Of 532 respondents, 66% in favored donation and 34% were against it or undecided. Upon multivariate analysis, the following variables had the most weight: 1) country of origin (Mexicans were more in favor than Spanish; odds ratio [OR]) = 1.964; P = .014); 2) a partner with a favorable attitude (OR = 2.597; P = .013); 3) not being concerned about possible bodily mutilation after donation (OR = 2.631; P = .006); 4) preference for options apart from burial for handling the body after death (OR = 4.694; P < .001) and 5) accepting an autopsy if one was needed (OR = 3.584; P < .001).

CONCLUSIONS

The attitudes of healthcare assistants toward organ donation varied considerably according to the respondent's country of origin. The psycho-social profile of a person with a positive attitude to donation was similar to that described within the general public.

Psychological care: social and family support for patients awaiting a liver transplant

INTRODUCTION

In patients awaiting a transplant, the help received from friends and/or family members is considered to be an important factor in the transplantation process. Our objective was to determine the level of social/family support for patients on the liver transplant waiting list and to determine the relationship between clinical psychopathology and the level of social/family support.

MATERIALS AND METHODS

The study population consisted of 70 patients on the liver transplant waiting list. We used the following instruments: (1) Medical Outcomes Study-Social Support Survey (MOS) Questionnaire. For size of the social network, four support dimensions and a global support index for emotional support, material/instrumental support, leisure/free time activities, and love/care; (2) Family Apgar Questionnaire for personal perception of family function; (3) SA-45 questionnaire of psychopathologic symptoms for somatizations, obsessive-compulsivity, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism.

RESULTS

The MOS showed that the mean size of the social network of these patients was 12 people. In these patients, social/family support was nonfunctional in 20% of the cases. By dimensions, the patients had the following percentage of nonfunctional support: 24% in emotional support; 10% material/instrumental support; 23% social relations of leisure/free-time activities; and 11% compassionate love/care support. The patients with nonfunctional support had the following associated psychopathologic symptoms (SA-45): depression (79% vs 39%; P = .008), anxiety (86% vs 46%; P = .008), hostility (43% vs 12%; P = .009), and psychoticism (14% vs 2%; P = .039) compared to functional patients. The Family Apgar showed that 27% of patients perceived a family dysfunction. These patients had greater interpersonal sensitivity-type emotional symptoms (32% vs 8%; P = .012), depression (79% vs 35%; P = .001), anxiety (79% vs 45%; P = .011), and hostility (42% vs 10%; P = .002) compared to normally functioning patients.

CONCLUSIONS

Nearly a quarter of patients on the liver transplant waiting list have social/family support that is nonfunctional, which leads to greater emotional psychopathologic symptoms that would need to be treated.

Donation and transplantation among personnel in the hospital emergency department: a multicenter study conducted in Spain and Mexico

INTRODUCTION

The promotion of different means of procuring both deceased and living organs (kidney and liver) is a necessity given the current organ shortage. Emergency department personnel are involved in the donation and transplantation process. Our objective was to analyze the attitude to the different kinds of organ donation of emergency services personnel in hospital centers in Spain and Mexico.

MATERIALS AND METHODS

A randomized sample was obtained from the "International Collaborative Donor Project" and was stratified according to emergency services and job category in nine hospitals, in Spain and in Mexico (n = 22). Attitude was evaluated using a validated survey.

RESULTS

Of the respondents, 76% were in favor of deceased organ donation and 24% were not in favor. This attitude toward deceased donation was associated with the respondent's country of origin, age, and job category; Mexicans (P = .036), younger respondents (P = .023), and physicians were most in favor (P < .001). With regard to attitude toward living kidney donation, 89% were in favor of related donation. Regarding living liver donation, 85% were in favor of related donation. In attitude toward living kidney and liver donation, relevant factors were related to donation and transplantation.

CONCLUSIONS

Professionals in emergency departments in hospital centers in Spain and Mexico had a favorable attitude toward the different kinds of donation, although it was less favorable than the attitude reported in other professional hospital groups.

Validation of xCELLigence real-time cell analyzer to assess compatibility in xenotransplantation with pig-to-baboon model

OBJECTIVE

To validate the use of a microelectronic real-time cell analyzer system (RTCA) we developed a complement-mediated antibody cytotoxicity assay to investigate the compatibility of a graft and a recipient in pig-to-baboon xenotransplantation.

MATERIALS AND METHODS

Fibroblasts isolated from the skin of five hCD55, hCD59, and hCD46 transgenic pigs (TP) were cultured in 96 microelectronic well plates for 17 hours. Then, we added to each microwell 20 μL of normal sera from nine healthy adult olive baboons (Papio anubis)-three males and six females. The evolution of the cell culture was assessed every 3 minutes during the pretreatment period, at 11 hours postaddition, and every 30 minutes from 12 to 96 hours. Simultaneously, we performed a 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Fibroblasts from wild-type (WT) pigs were used as positive controls and microwells without serum addition from each TP as negative controls. The RTCA results were expressed as a normalized cellular index (NCI).

RESULTS

Differences were observed between the five TP fibroblasts and the WT fibroblasts, with greater cytotoxicity on WT cells. Among TP, a higher cytolytic level was observed in males than females. The MTT results correlated with NCI at different times, with the minimum NCI and with the time to for NCI recovery before serum addition. The correlation was lower than that previously reported in environmental toxicity assays.

CONCLUSIONS

RTCA allows a long-term assessment of the immunocytotoxic effect of baboon sera on pig cells, providing a suitable tool to perform compatibility tests for xenotransplantation.

Evaluation of the law of presumed consent after brain death by Spanish journalism students

INTRODUCTION

Information provided by journalists is crucial to create a climate of social opinion. This is important in organ donation and transplantation (ODT), wherein the participation of the general public is essential to obtain organs.

OBJECTIVE

The objective of this study was to determine the knowledge of students taking a degree in journalism about the concept of brain death and the law of presumed consent.

MATERIALS AND METHODS

The study involved 129 journalism degree students in the 2005-2006 academic year from a university in the south-east of Spain. Attitudes on the psychosocial aspects of ODT were evaluated using a validated questionnaire. The self-administered survey was completed anonymously in classes and compulsory practical sessions.

RESULTS

The questionnaire completion rate was 98% (n=126). Of the students surveyed, 43% (n=54) understood the concept of brain death, 44% (n=56) stated that they had doubts, whereas 13% (n=16) believed that a person with brain death can recover and lead a normal life. Their knowledge was more accurate in the final than in the first year (54% vs 47%; P=.016). Most students 66% (n=83) believed that it would be interesting to receive an informative talk about ODT. Concerning legislation, 75% of students were against the law of presumed consent, whereas 25% were in favor.

CONCLUSION

More than 50% of journalism students do not understand the concept of brain death. Furthermore, up to 75% do not accept the law of presumed consent that donation must be made.

Attitudes toward living kidney donation in transplant hospitals: a Spanish, Mexican, and Cuban multicenter study

INTRODUCTION

Living donor kidney (LKD) transplantation provides better results than deceased donor donation, involving minimum risk for the donor. However, LKD donation rates are low in most countries. We analyzed attitudes toward LKD in transplant hospitals in Spain, Mexico, and Cuba.

MATERIALS AND METHODS

Data were obtained from five transplant hospitals through the International Collaborative Program "Proyecto Donante Vivo, Murcia" in three countries: Spain (n = 1168), Mexico (n = 903), and Cuba (n = 202). The random sample (2273 employees) was stratified according to job category. The instrument used to evaluate attitude was a validated questionnaire. Statistical analysis included Student t test, the chi(2) test, and multivariate analysis.

RESULTS

Eighty eight percent (n = 2002) of Spanish, Mexican, and Cuban transplant hospital personnel were in favor of related LKD and 24% nonrelated LKD (n = 555). Attitudes were more favorable among centers in Cuba 97% (n = 195), followed by Mexico 88% (n = 793) and by Spain 87% (n = 1014; P < .001). According to job category, 91% (n = 617) of physicians were in favor, 88% (n = 543) of nurses, 85% (n = 198) of health care assistants, and 85% (n = 198) of auxiliary personnel. Attitudes were related to variables of: attitude toward deceased donation (P < .001), discussion about organ donation and transplantation (P < .001), concern about body mutilation after donation (P = .001), a possible need for a transplant in the future (P < .001), and attitude toward living liver donation (P < .001).

CONCLUSIONS

Attitudes toward LKD in Hispanic/Latin Transplant Hospitals were favorable and could encourage an increase in LKD in the coming years assuming suitable sociopolitical and economic condition, as well as support from nephrologists.