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Castells-Sala C, Pérez ML, Agustí E, Aiti A, Tarragona E, Navarro A, Tabera J, Fariñas O, Pomar JL, Vilarrodona A. Last twenty-years activity of cardiovascular tissue banking in Barcelona. Cell Tissue Bank 2024; 25:11-26. [PMID: 36849631 PMCID: PMC9970124 DOI: 10.1007/s10561-022-10059-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/04/2022] [Indexed: 03/01/2023]
Abstract
The Barcelona Tissue Bank was established from the merge of two previous multi-tissue banks. Potential donors are screened by Donor Center staff and multi-tissue retrieval is performed by specialized own teams. Tissue processing and preservation is performed in clean room facilities by specialised personnel. After quality control of both donor and all tissues results, the heart valves and vascular segments are stored until medical request. The aim of this report is to present the cardiovascular tissue activity and retrospectively evaluate the outcomes of the changes performed in last 20 years. Cardiovascular tissue from 4088 donors was received, specifically 3115 hearts and 2095 vascular segments were processed and evaluated. A total of 48% of the aortic valves, 68% of the pulmonary valves and 75% of the vascular segments were suitable for transplant. The main reason for discarding tissue was macroscopic morphology followed by microbiological results, for both valves and arteries. Altogether, 4360 tissues were distributed for transplantation: 2032 (47%) vascular segments, 1545 (35%) pulmonary valves and 781 (18%) aortic valves. The most common indication for aortic valve surgery was the treatment of endocarditis, while for pulmonary valves, it was congenital malformation reconstruction. Vascular segments were mainly used for reconstruction after ischemia. During this period, a number of changes were made with the goal of enhancing tissue quality, safety and efficacy. These improvements were achieved through the use of a new antibiotic cocktail, increasing of donor age criteria and changing the microbiological control strategy.
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Affiliation(s)
- C. Castells-Sala
- Barcelona Tissue Bank, Banc de Sang i Teixits (BST), Barcelona, Spain
- Biomedical Research Institute (IIB-Sant Pau; SGR1113), Barcelona, Spain
- Barcelona Tissue Bank (BTB), Banc de Sang i Teixits (BST, GenCAT) Passeig Taulat 116, E-08005 Barcelona, Spain
| | - M. L. Pérez
- Barcelona Tissue Bank, Banc de Sang i Teixits (BST), Barcelona, Spain
- Vall Hebron Institute of Research (VHIR), Barcelona, Spain
| | - E. Agustí
- Barcelona Tissue Bank, Banc de Sang i Teixits (BST), Barcelona, Spain
- Vall Hebron Institute of Research (VHIR), Barcelona, Spain
| | - A. Aiti
- Barcelona Tissue Bank, Banc de Sang i Teixits (BST), Barcelona, Spain
| | - E. Tarragona
- Barcelona Tissue Bank, Banc de Sang i Teixits (BST), Barcelona, Spain
| | - A. Navarro
- Organització Catalana de Trasplantaments (OCATT), Barcelona, Spain
| | - J. Tabera
- Barcelona Tissue Bank, Banc de Sang i Teixits (BST), Barcelona, Spain
- Biomedical Research Institute (IIB-Sant Pau; SGR1113), Barcelona, Spain
| | - O. Fariñas
- Barcelona Tissue Bank, Banc de Sang i Teixits (BST), Barcelona, Spain
- Biomedical Research Institute (IIB-Sant Pau; SGR1113), Barcelona, Spain
| | - J. L. Pomar
- Institute for Cardiovascular Diseases. Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain
| | - A. Vilarrodona
- Barcelona Tissue Bank, Banc de Sang i Teixits (BST), Barcelona, Spain
- Vall Hebron Institute of Research (VHIR), Barcelona, Spain
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Ren ZY, Pan B, Wang FF, Lyu SC, He Q. Effects of different preservation methods of human iliac veins. Cell Tissue Bank 2023; 24:571-582. [PMID: 36441442 DOI: 10.1007/s10561-022-10055-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/18/2022] [Indexed: 11/30/2022]
Abstract
With the progress of vascular anastomosis technology, the radical resection surgery of cancer combining with vascular resection and reconstruction has been focused by surgeon. As a natural substitute material for blood vessel, vascular allografts have good vascular compliance and histocompatibility. Generally, the donated veins could not be used immediately, and need to be well preserved. So, it is greatly significant to do research in the preservation effects of different preservation methods on veins. In this study, the effects of different preservative methods of human iliac veins were compared and analyzed in terms of cell viability, vascular wall structure and tension resistance. The donated human iliac veins were randomly divided into three groups: Cold Storage Group (4 °C) (CSG), Frozen Storage Group (-186 °C) (FSG)and Fresh Control Group (FCG). Six detection time-points of preservation for 1, 3, 5, 7, 14, 28 days were set respectively. There are ten samples in each group and each time-point separately. Survival and apoptosis of vascular cell were evaluated by MTT assay and Tunel fluorescence staining. Tensile test was used to evaluate mechanical properties of vessels. The changes of vascular endothelial cells, smooth muscle cells, collagen fibers and elastic fibers were evaluated by HE staining, Masson staining and EVG staining. Furthermore, the changes of organelles were observed by transmission electron microscope. With the extension of preservation period, the vascular cell viability and tension resistance of two groups decreased, and the apoptotic cells increased gradually. The apoptosis index of CSG was higher than FSG at each time point (P < 0.05). In terms of cell viability, CSG was higher within 3 days (P < 0.05), both groups were same between 3 and 14 days, and then CSG lower than FSG after 14 days (P < 0.05). In terms of tension resistance, CSG was stronger than FSG (P < 0.05) in first 7 days, both groups were same in 2nd week, and then CSG was weaker in 4th week (P < 0.05). In terms of vascular wall structure, in CSG, vascular endothelial cells were damaged and shed, smooth muscle cells were edema after 14 days, but the cell membrane and intercellular connection were still intact. In 4th week, endothelial cells were completely damaged and shed, the boundary of smooth muscle cell membrane was unclear, intercellular connection was damaged. Moreover, organelles were destroyed and disappeared, perinuclear condensation of chromatin was observed, and some cells had incomplete nuclear membrane or nuclear fragmentation; However, there were no obvious changes in the FSG within 28 days. Finally, local exfoliation and destruction of endothelial cells and edema-like changes of organelles were observed; the collagen fibers and elastic fibers of blood vessels in the two groups had no obvious damage and change within 28 days. For excised human iliac vein, cold and frozen storage can effectively preserve the cell viability, wall structure and tension resistance of blood vessels. With the extension of preservation time, the related performance of vessels declined in varying degrees. Within first week, the effect of cold storage is better than frozen storage, but frozen storage is significantly better than cold storage after 2 weeks.
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Affiliation(s)
- Zhang-Yong Ren
- Department of Hepatobiliary Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Bing Pan
- Department of Hepatobiliary Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Fang-Fei Wang
- Department of Hepatobiliary Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Shao-Cheng Lyu
- Department of Hepatobiliary Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Qiang He
- Department of Hepatobiliary Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China.
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Ren Z, Wu Q, Pan B, Liu J, He Q, Lang R, Lyu S. Effects of different preservation schemes on isolated rat artery. J Cell Mol Med 2023; 27:2362-2371. [PMID: 37357501 PMCID: PMC10424285 DOI: 10.1111/jcmm.17822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 06/05/2023] [Accepted: 06/14/2023] [Indexed: 06/27/2023] Open
Abstract
Allogeneic blood vessels are regarded as one of the best natural substitutes for diseased blood vessels due to their good vascular compliance and histocompatibility. Since the supply and demand of allograft blood vessels do not always match in time and space, a good preservation scheme for isolated blood vessels is essential. The abdominal aortas of 110 male Sprague-Dawley (SD) rats were randomly divided into three groups, including cold storage group (4°C) (CSG), frozen storage group (FSG) and ambient storage group (25 ± 2°C) (ASG). Seven time points of preservation for 1, 3, 5, 7, 14, 30 and 90 days were set for detection. The changes in vascular physiological function were evaluated by MTT test and vasoconstriction ability detection, and the changes in vascular wall structure were evaluated by the tension tolerance test and pathological staining. The vascular function of CSG was better than FSG within first the 7 days, but the result was opposite since the 14th day. The vascular wall structure, collagen and elastic fibres of vessels, in CSG, showed oedema within 30 days, and continuous disintegration and rupture at 90 days. The vessel wall structure of FSG remained intact within 90 days. The tensile strength of the vessels in CSG was better than that in FSG within 5 days, and there was no statistical difference between the two groups between the 7th and 30th day, and then, the FSG was higher than CSG on the 90th day. Both cold storage and frozen storage could be applied as safe and effective preservation schemes for isolated rat artery within first 30 days. Cold storage is recommended when the storage time is <14 days, and then, frozen storage is better.
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Affiliation(s)
- Zhang‐Yong Ren
- Department of Hepatobiliary Surgery, Beijing Chao‐Yang HospitalCapital Medical UniversityBeijingChina
- Beijing Organ Transplant CenterBeijingChina
| | - Qiao Wu
- Department of Hepatobiliary Surgery, Beijing Chao‐Yang HospitalCapital Medical UniversityBeijingChina
- Beijing Organ Transplant CenterBeijingChina
| | - Bing Pan
- Department of Hepatobiliary Surgery, Beijing Chao‐Yang HospitalCapital Medical UniversityBeijingChina
- Beijing Organ Transplant CenterBeijingChina
| | - Jia‐Zong Liu
- Department of Hepatobiliary Surgery, Beijing Chao‐Yang HospitalCapital Medical UniversityBeijingChina
- Beijing Organ Transplant CenterBeijingChina
| | - Qiang He
- Department of Hepatobiliary Surgery, Beijing Chao‐Yang HospitalCapital Medical UniversityBeijingChina
- Beijing Organ Transplant CenterBeijingChina
| | - Ren Lang
- Department of Hepatobiliary Surgery, Beijing Chao‐Yang HospitalCapital Medical UniversityBeijingChina
- Beijing Organ Transplant CenterBeijingChina
| | - Shao‐Cheng Lyu
- Department of Hepatobiliary Surgery, Beijing Chao‐Yang HospitalCapital Medical UniversityBeijingChina
- Beijing Organ Transplant CenterBeijingChina
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Radulova-Mauersberger O, Weitz J, Riediger C. Vascular surgery in liver resection. Langenbecks Arch Surg 2021; 406:2217-2248. [PMID: 34519878 PMCID: PMC8578135 DOI: 10.1007/s00423-021-02310-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 08/18/2021] [Indexed: 01/04/2023]
Abstract
Vascular surgery in liver resection is a standard part of liver transplantation, but is also used in oncological liver surgery. Malignant liver tumors with vascular involvement have a poor prognosis without resection. Surgery is currently the only treatment to provide long-term survival in advanced hepatic malignancy. Even though extended liver resections are increasingly performed, vascular involvement with need of vascular reconstruction is still considered a contraindication for surgery in many institutions. However, vascular resection and reconstruction in liver surgery-despite being complex procedures-are safely performed in specialized centers. The improvements of the postoperative results with reduced postoperative morbidity and mortality are a result of rising surgical and anesthesiological experience and advancements in multimodal treatment concepts with preconditioning measures regarding liver function and systemic treatment options. This review focuses on vascular surgery in oncological liver resections. Even though many surgical techniques were developed and are also used during liver transplantation, this special procedure is not particularly covered within this review article. We provide a summary of vascular reconstruction techniques in oncological liver surgery according to the literature and present also our own experience. We aim to outline the current advances and standards in extended surgical procedures for liver tumors with vascular involvement established in specialized centers, since curative resection improves long-term survival and shifts palliative concepts to curative therapy.
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Affiliation(s)
- Olga Radulova-Mauersberger
- Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
- National Center for Tumor Diseases (NCT/UCC), Dresden, Germany.
- German Cancer Research Center (DKFZ), Heidelberg, Germany.
- Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
- Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Dresden, Germany.
| | - Jürgen Weitz
- Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
- National Center for Tumor Diseases (NCT/UCC), Dresden, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Dresden, Germany
| | - Carina Riediger
- Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
- National Center for Tumor Diseases (NCT/UCC), Dresden, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Dresden, Germany
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5
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Microbiological assessment of arterial allografts processed in a tissue bank. Cell Tissue Bank 2021; 22:539-549. [PMID: 34549351 DOI: 10.1007/s10561-021-09951-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/09/2021] [Indexed: 10/20/2022]
Abstract
The transmission of microbial infection through tissue allografts is one of the main risks that must be controlled in tissue banks. Therefore, microbiological monitoring controls and validated protocols for the decontamination of tissues during processing have been implemented. This study is based on the evaluation of data from microbiological cultures of arteries (mainly long peripheral arteries) processed in the tissue bank of Valencia (Spain). Donors' profile, pre- and post-disinfection tissue samples were assessed. The presence of residual antibiotics in disinfected tissues was determined and the antimicrobial potential of these tissues was tested. Our overall contamination rate was 23.69%, with a disinfection rate (after antibiotic incubation) of 87.5%. Most (76.09%) of the microbial contaminants were identified as Gram positive. Arterial allografts collected from body sites affected by prior organ removal showed higher risk of contamination. Only vancomycin was detected as tissue release. The antimicrobial effect on Candida albicans was lower than that for bacterial species. Risk assessment for microbial contamination suggested the donor's skin and the environment during tissue collection as the main sources for allograft contamination. Antibiotic-disinfected arterial allografts showed antimicrobial potential.
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He B, Musk GC, Ng ZQ, Kershaw H, DeBoer B, Hamdorf JM. Investigation of a method for long-term preservation of the vascular allograft. Vascular 2021; 30:568-576. [PMID: 33966508 DOI: 10.1177/17085381211012945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND/OBJECTIVE During multiple organ procurement, blood vessels are routinely retrieved and stored in University of Wisconsin solution and then discarded after two weeks, if not used at organ transplantation owing to lack of a method for long-term preservation. Therefore, the aim of this study is to investigate a method for long-term preservation of vascular allografts in ethanol. METHODS Aorta and vena cava allografts were retrieved and stored in 75% ethanol solution for 12 months at 4°C. Four pigs were divided into two groups. A segment of aorta was excised and replaced by insertion of preserved aorta graft (Group A) or vena cava graft (Group V). The pigs were observed for six weeks. A laparotomy was performed and the vascular graft was harvested for histopathology followed by euthanasia at the end of study. RESULTS Three pigs recovered uneventfully, while one pig died from venous graft rupture in the third week after surgery. There was no aneurysmal formation or thrombosis in the grafts. Some calcification was seen over aorta allograft. On histopathology, the elastic pattern was almost normal, although the endothelial cells degenerated after preservation. After implantation, the formation of the endothelium cell-like layer was seen in both aorta and vena cava allografts. CONCLUSION Vascular allografts were functional after preservation for 12 months. The vena cava grafts had much less wall calcification than the aorta grafts. Further studies are necessary to investigate vascular graft remodelling with a longer observation period after implantation.
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Affiliation(s)
- Bulang He
- Medical School, The University of Western Australia, Crawley, WA, Australia.,Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | | | - Zi Qin Ng
- Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Helen Kershaw
- Animal Care Services, The University of Western Australia, Crawley, WA, Australia
| | | | - Jeffrey M Hamdorf
- Medical School, The University of Western Australia, Crawley, WA, Australia
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7
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Georges G, Allard B, Dakkak M, Nourissat G, Febrer G. Appraising 5 years in activity of the largest public Canadian vascular graft bank. J Vasc Surg 2021; 74:972-978. [PMID: 33684476 DOI: 10.1016/j.jvs.2021.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 02/08/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND In Canada, tissue distribution is managed by provincial entities. In 2014, Hema-Quebec established a cryopreserved vascular tissue bank accessible to all Canadian hospitals. The objectives of this report were to review the first 5 years of activity of Hema-Quebec's vascular bank and to briefly assess the competitiveness of its products. METHODS Deceased donors, ages 15 to 60, were screened for common blood-borne diseases. Grafts were treated in a triple-antibiotic solution at 35°C before preservation at -100°C. Hema-Quebec's vascular graft records were analyzed from 2014 to 2019 inclusively. RESULTS The average donor age was 35 years old and 78% of donors were men. Overall, 63% of harvested grafts cleared the quality management system. Positive microbial cultures and morphologic defects were the major reasons for graft discard. As such, a total of 60 grafts were delivered between 2016 and 2019 to 8 hospital centers. Moreover, the bank achieved a mean activity increase of 55% per year and Hema-Quebec's homografts were 48% less costly compared with similar homographs from for-profit organizations. CONCLUSIONS Our findings demonstrate that Hema-Quebec has established a viable cryopreserved vascular tissue bank with steady increase in activity and an acceptable graft discard rates and pricing. Based on our findings, we recommend that efforts should be directed to expand the tissue bank graft distribution outside the province of Quebec.
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Affiliation(s)
- Gabriel Georges
- Laval University, Cardiac Surgery Department, Institut Universitaire de Cardiologie et de Pneumologie de Québec (IUCPQ), Quebec City, Canada.
| | | | - Mazen Dakkak
- Héma-Québec, Côte-Vertu Ouest, Saint-Laurent, Canada
| | - Ghislain Nourissat
- Laval University, Vascular Surgery Department, Saint-François d'Assise Hospital, Quebec City, Canada
| | - Guillaume Febrer
- Hôpital du Sacré-Coeur de Montréal, Vascular Surgery Department, Montreal, Canada
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Gavin-Plagne L, Perold F, Osteil P, Voisin S, Moreira SC, Combourieu Q, Saïdou V, Mure M, Louis G, Baudot A, Buff S, Joly T, Afanassieff M. Insights into Species Preservation: Cryobanking of Rabbit Somatic and Pluripotent Stem Cells. Int J Mol Sci 2020; 21:ijms21197285. [PMID: 33023104 PMCID: PMC7582889 DOI: 10.3390/ijms21197285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/18/2020] [Accepted: 09/28/2020] [Indexed: 12/11/2022] Open
Abstract
Induced pluripotent stem cells (iPSCs) are obtained by genetically reprogramming adult somatic cells via the overexpression of specific pluripotent genes. The resulting cells possess the same differentiation properties as blastocyst-stage embryonic stem cells (ESCs) and can be used to produce new individuals by embryonic complementation, nuclear transfer cloning, or in vitro fertilization after differentiation into male or female gametes. Therefore, iPSCs are highly valuable for preserving biodiversity and, together with somatic cells, can enlarge the pool of reproductive samples for cryobanking. In this study, we subjected rabbit iPSCs (rbiPSCs) and rabbit ear tissues to several cryopreservation conditions with the aim of defining safe and non-toxic slow-freezing protocols. We compared a commercial synthetic medium (STEM ALPHA.CRYO3) with a biological medium based on fetal bovine serum (FBS) together with low (0-5%) and high (10%) concentrations of dimethyl sulfoxide (DMSO). Our data demonstrated the efficacy of a CRYO3-based medium containing 4% DMSO for the cryopreservation of skin tissues and rbiPSCs. Specifically, this medium provided similar or even better biological results than the commonly used freezing medium composed of FBS and 10% DMSO. The results of this study therefore represent an encouraging first step towards the use of iPSCs for species preservation.
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Affiliation(s)
- Lucie Gavin-Plagne
- Univ Lyon, Université Claude Bernard Lyon 1, Inserm, INRAE, Stem Cell and Brain Research Institute U 1208, USC 1361, F-69500 Bron, France; (L.G.-P.); (F.P.); (P.O.); (S.V.); (S.C.M.); (Q.C.); (V.S.); (M.M.)
- Univ Lyon, Université Claude Bernard Lyon 1, VetAgro Sup, UPSP ICE 2016.A104, F-69280 Marcy l’Etoile, France; (S.B.); (T.J.)
| | - Florence Perold
- Univ Lyon, Université Claude Bernard Lyon 1, Inserm, INRAE, Stem Cell and Brain Research Institute U 1208, USC 1361, F-69500 Bron, France; (L.G.-P.); (F.P.); (P.O.); (S.V.); (S.C.M.); (Q.C.); (V.S.); (M.M.)
| | - Pierre Osteil
- Univ Lyon, Université Claude Bernard Lyon 1, Inserm, INRAE, Stem Cell and Brain Research Institute U 1208, USC 1361, F-69500 Bron, France; (L.G.-P.); (F.P.); (P.O.); (S.V.); (S.C.M.); (Q.C.); (V.S.); (M.M.)
| | - Sophie Voisin
- Univ Lyon, Université Claude Bernard Lyon 1, Inserm, INRAE, Stem Cell and Brain Research Institute U 1208, USC 1361, F-69500 Bron, France; (L.G.-P.); (F.P.); (P.O.); (S.V.); (S.C.M.); (Q.C.); (V.S.); (M.M.)
| | - Synara Cristina Moreira
- Univ Lyon, Université Claude Bernard Lyon 1, Inserm, INRAE, Stem Cell and Brain Research Institute U 1208, USC 1361, F-69500 Bron, France; (L.G.-P.); (F.P.); (P.O.); (S.V.); (S.C.M.); (Q.C.); (V.S.); (M.M.)
| | - Quitterie Combourieu
- Univ Lyon, Université Claude Bernard Lyon 1, Inserm, INRAE, Stem Cell and Brain Research Institute U 1208, USC 1361, F-69500 Bron, France; (L.G.-P.); (F.P.); (P.O.); (S.V.); (S.C.M.); (Q.C.); (V.S.); (M.M.)
| | - Véronique Saïdou
- Univ Lyon, Université Claude Bernard Lyon 1, Inserm, INRAE, Stem Cell and Brain Research Institute U 1208, USC 1361, F-69500 Bron, France; (L.G.-P.); (F.P.); (P.O.); (S.V.); (S.C.M.); (Q.C.); (V.S.); (M.M.)
| | - Magali Mure
- Univ Lyon, Université Claude Bernard Lyon 1, Inserm, INRAE, Stem Cell and Brain Research Institute U 1208, USC 1361, F-69500 Bron, France; (L.G.-P.); (F.P.); (P.O.); (S.V.); (S.C.M.); (Q.C.); (V.S.); (M.M.)
| | - Gérard Louis
- Univ Paris, Université Descartes Paris V, LVTS, Inserm UMRS 1148, F-75018 Paris, France; (G.L.); (A.B.)
| | - Anne Baudot
- Univ Paris, Université Descartes Paris V, LVTS, Inserm UMRS 1148, F-75018 Paris, France; (G.L.); (A.B.)
| | - Samuel Buff
- Univ Lyon, Université Claude Bernard Lyon 1, VetAgro Sup, UPSP ICE 2016.A104, F-69280 Marcy l’Etoile, France; (S.B.); (T.J.)
| | - Thierry Joly
- Univ Lyon, Université Claude Bernard Lyon 1, VetAgro Sup, UPSP ICE 2016.A104, F-69280 Marcy l’Etoile, France; (S.B.); (T.J.)
- Univ Lyon, Université Claude Bernard Lyon 1, ISARA-Lyon, UPSP ICE 2016.A104, F-69007 Lyon, France
| | - Marielle Afanassieff
- Univ Lyon, Université Claude Bernard Lyon 1, Inserm, INRAE, Stem Cell and Brain Research Institute U 1208, USC 1361, F-69500 Bron, France; (L.G.-P.); (F.P.); (P.O.); (S.V.); (S.C.M.); (Q.C.); (V.S.); (M.M.)
- Correspondence: ; Tel.: +33-472-913-458
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9
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Tong Y, Febrer G, Mao J, Wawryko P, Mao Y, Le-Bel G, How D, Philippe E, Zhou T, Zhang Z, Wang L, Germain L, Guidoin R. Limb salvage after aneurysmal degeneration of a cryopreserved vein allograft: Searching the autologous veins of the arm is worth the effort. Morphologie 2020; 104:202-213. [PMID: 32518049 DOI: 10.1016/j.morpho.2020.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 04/29/2020] [Accepted: 05/14/2020] [Indexed: 06/11/2023]
Abstract
CLINICAL DATA We hereby report a case of limb salvage involving a 64-year-old man who was hospitalized with ischemic foot ulcers for two months. Endarterectomy with patching and stenting of the left iliofemoral artery failed. A composite bypass of two segments of the endarterectomized superficial femoral artery and a cryopreserved saphenous vein graft was implanted one week later. On day 4 postoperatively, an infection (Staphylococcus epidermidis and Pseudomonas aeruginosa) was treated empirically with antibiotics. Four months later, the femoro-tibial bypass thrombosed and the patency was restored by thrombolysis. The aneurysmal cryopreserved vein was excised. Iterative complications followed and final success was attained after implantation of autologous cephalic and basilic veins. Four years later, this femoro-tibial is still patent. PATHOLOGICAL ANALYSES After a gross observation, the explant was dissected and the most significant sections were processed for histology, followed by analyses in scanning electron microscopy, light microscopy and transmission electron microscopy. RESULTS The explanted specimen showed a smooth flow surface proximally but a severe distortion distally, with an accumulation of poorly organized mural thrombi. The wall of the arterialized vein was accompanied with an important inflammatory reaction. The degradation of the collagen structure was evidenced in TEM. The fibrils of collagen were still individualized but were fragmented and did not display parallelly. The regular banding was preserved. The presence of Pseudomonas aeruginosa was shown inside the wall of the homologous vein. COMMENTS In case of sepsis, the most aggressive antibiotic treatments cannot fully eliminate the bacteremic colonizations within the wall of an alternative conduit. The cephalic and basilic autologous veins are proved to be preferable in absence of the autologous saphenous vein. The amputation was prevented and four years later the bypass is still patent. This is an outstanding result based upon the comorbidities of the patient. The most aggressive harvesting shall be recommended. This patient represented a considerable challenge and the clinical result is highly gratifying: the search for the autologous cephalic and basilic veins proved to be worth the effort.
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Affiliation(s)
- Yiwei Tong
- Département de chirurgie, Faculté de médecine, Université Laval ; Axe médecine régénératrice, Centre de recherche du CHU de Québec - Université Laval, Québec (QC), Canada; Comprehensive Breast Health Center, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, 200025 Shanghai, China
| | - Guillaume Febrer
- Service de chirurgie vasculaire, Département de chirurgie, Hôpital du Sacré-Cœur, Université de Montréal, Montréal (QC), Canada
| | - Jifu Mao
- Département de chirurgie, Faculté de médecine, Université Laval ; Axe médecine régénératrice, Centre de recherche du CHU de Québec - Université Laval, Québec (QC), Canada; Key Laboratory of Textile Science & Technology, Ministry of Education and College of Textiles, Donghua University, Shanghai, China
| | - Paul Wawryko
- Department of Pathology, University of Manitoba, Winnipeg (MB), Canada
| | - Ying Mao
- Département de chirurgie, Faculté de médecine, Université Laval ; Axe médecine régénératrice, Centre de recherche du CHU de Québec - Université Laval, Québec (QC), Canada; Key Laboratory of Textile Science & Technology, Ministry of Education and College of Textiles, Donghua University, Shanghai, China
| | - Gaëtan Le-Bel
- Département de chirurgie, Faculté de médecine, Université Laval ; Axe médecine régénératrice, Centre de recherche du CHU de Québec - Université Laval, Québec (QC), Canada
| | - Daniel How
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Eric Philippe
- Département de chirurgie, Faculté de médecine, Université Laval ; Axe médecine régénératrice, Centre de recherche du CHU de Québec - Université Laval, Québec (QC), Canada
| | - Tianyi Zhou
- Département de chirurgie, Faculté de médecine, Université Laval ; Axe médecine régénératrice, Centre de recherche du CHU de Québec - Université Laval, Québec (QC), Canada
| | - Ze Zhang
- Département de chirurgie, Faculté de médecine, Université Laval ; Axe médecine régénératrice, Centre de recherche du CHU de Québec - Université Laval, Québec (QC), Canada
| | - Lu Wang
- Key Laboratory of Textile Science & Technology, Ministry of Education and College of Textiles, Donghua University, Shanghai, China
| | - Lucie Germain
- Département de chirurgie, Faculté de médecine, Université Laval ; Axe médecine régénératrice, Centre de recherche du CHU de Québec - Université Laval, Québec (QC), Canada
| | - Robert Guidoin
- Département de chirurgie, Faculté de médecine, Université Laval ; Axe médecine régénératrice, Centre de recherche du CHU de Québec - Université Laval, Québec (QC), Canada.
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10
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Navarro Del-Río E, Parmentier de-León C, Chávez Villa M, Carpinteyro Espín P, Quintero-Quintero MJ, Vilatobá M, Contreras AG, Cruz Martínez R. Use of Iliac Allograft from Cadaveric Donor as a Rescue Technique in Living Donor Kidney Transplant: Two Case Reports. Transplant Proc 2020; 52:1102-1105. [PMID: 32204898 DOI: 10.1016/j.transproceed.2020.01.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 01/22/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND A short right renal vein (RRV) remains a challenge for renal transplant surgery, especially in the living donor. Different techniques exist to obtain an RRV with a suitable length in cadaveric donor; however, in living donors the options are limited. MATERIAL AND METHODS We present 2 living kidney transplants in which we obtained a very short RRV, making the implantation very difficult. We describe our technique to overcome this problem by using cadaveric iliac vessels retrieved from previous cadaveric donations and preserved at 4°C in histidine-tryptophan-ketoglutarate (HTK) solution, without intraoperative or postoperative complications. We complied with the Helsinki Congress and the Istanbul Declaration regarding the donor source. RESULTS In both cases, kidney grafts had optimal primary function, with good creatinine clearance after transplant and good patency of vascular anastomosis by Doppler ultrasounds. CONCLUSIONS We believe the use of cadaveric vessel grafts in living donor kidney transplant is a valuable resource as a rescue tool in emergency situations like the ones being presented in this article in order to avoid discarding a kidney graft with damage or short vessels. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Affiliation(s)
- Estephanía Navarro Del-Río
- Transplant Department, National Institute of Medical Science and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Catherine Parmentier de-León
- Transplant Department, National Institute of Medical Science and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Mariana Chávez Villa
- Transplant Department, National Institute of Medical Science and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Paulina Carpinteyro Espín
- Transplant Department, National Institute of Medical Science and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Marco José Quintero-Quintero
- Transplant Department, National Institute of Medical Science and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Mario Vilatobá
- Transplant Department, National Institute of Medical Science and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Alan G Contreras
- Transplant Department, National Institute of Medical Science and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Rodrigo Cruz Martínez
- Transplant Department, National Institute of Medical Science and Nutrition Salvador Zubirán, Mexico City, Mexico.
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11
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Zhao X, Li LX, Fan H, Kou JT, Li XL, Lang R, He Q. Segmental portal/superior mesenteric vein resection and reconstruction with the iliac vein after pancreatoduodenectomy. J Int Med Res 2016; 44:1339-1348. [PMID: 28322103 PMCID: PMC5536759 DOI: 10.1177/0300060516665708] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objective The results of segmental venous resection (VR) combined with pancreatoduodenectomy (PD) are controversial but may be promising. Few studies have described reconstruction of the portal/superior mesenteric vein (PV/SMV) with the iliac vein harvested from donation after cardiac death (DCD). Methods From January 2014 to April 2016, PD combined with segmental excision of the PV/SMV (VR group) was performed in 21 patients with adenocarcinoma of the head of the pancreas (ADHP). The authors established a new technique of venous reconstruction using the iliac vein from DCD and analysed patients’ long-term survival. Results The tumour dimensions and tumour staging were greater and the operation time was longer in the VR than PD group; however, no differences in the resection degree, blood loss, complications, reoperation rate, or mortality rate were found. The median survival was similar between the VR and PD groups. The long-term patency of the donor iliac vein was 90%. The degree of resection was a strong predictor of long-term survival. Conclusion Segmental PV/SMV resection combined with PD is applicable to selective patients with venous invasion by ADHP if R0 resection has probably been achieved. An iliac vein obtained by DCD provides an effective graft for venous reconstruction.
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Affiliation(s)
| | | | | | | | | | | | - Qiang He
- Qiang He, MD, Department of Hepatobiliary Surgery, Chaoyang Hospital Affiliated to Capital Medical University, No. 8 Gongti South Road, Beijing 100020, China.
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12
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Kim SH, Hwang S, Ha TY, Song GW, Jung DH, Ahn CS, Moon DB, Kim KH, Park GC, Lee SG. Usability of Cryopreserved Aortic Allografts for Middle Hepatic Vein Reconstruction During Living-Donor Liver Transplantation. J Gastrointest Surg 2016; 20:1049-55. [PMID: 26666546 DOI: 10.1007/s11605-015-3048-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 11/26/2015] [Indexed: 01/31/2023]
Abstract
Iliac vein allografts are suitable for middle hepatic vein (MHV) reconstruction during living-donor liver transplantation (LDLT), but their supply is often limited. Polytetrafluoroethylene (PTFE) grafts are easily available but have drawbacks of accidental gastric penetration and non-degradable foreign body. To replace the use of PTFE grafts, we started using cryopreserved aorta allografts (CAAs). This study presents the technical details and patency outcomes of using CAAs in MHV reconstruction. We reviewed the surgical techniques of CAA interposition and analyzed the patency rates in 74 patients who underwent LDLT during the 6-year study period. The two control groups received either cryopreserved iliac veins (n = 122) or PTFE grafts (n = 84). The surgical techniques for MHV reconstruction used to implant the CAA and PTFE grafts are very similar because the techniques developed for PTFE grafts were also applied to CAAs. We inserted an arterial patch at the liver cut surface because the CAA wall is too thick to perform direct anastomosis. Two patients (2.7 %) underwent MHV stenting during the first month. The 1-year patency rate was 69.7 % in the CAA group vs. 39.2 % in iliac vein group vs. 57.2 % in PTFE group (p = 0.000). The overall graft and patient survival rates did not differ depending on the MHV interposition vessel materials (p > 0.1). CAAs combined with small-artery patches demonstrated high patency rates that surpass other vessel grafts, and thus, we suggest that CAA can be reliably used for MHV reconstruction when CAA is available.
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Affiliation(s)
- Seok-Hwan Kim
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea
| | - Shin Hwang
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea.
| | - Tae-Yong Ha
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea
| | - Gi-Won Song
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea
| | - Dong-Hwan Jung
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea
| | - Chul-Soo Ahn
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea
| | - Deok-Bog Moon
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea
| | - Ki-Hun Kim
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea
| | - Gil-Chun Park
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea
| | - Sung-Gyu Lee
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea
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