1
|
Yerger J, Hill MA, Fitzgerald DC, Rajab TK. Animal models for partial heart transplantation. Pediatr Transplant 2024; 28:e14788. [PMID: 38766977 PMCID: PMC11132797 DOI: 10.1111/petr.14788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 04/22/2024] [Accepted: 05/05/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Partial heart transplantation delivers growing heart valve implants by transplanting the part of the heart containing the necessary heart valve only. In contrast to heart transplantation, partial heart transplantation spares the native ventricles. This has important implications for partial heart transplant biology, including the allowable ischemia time, optimal graft preservation, primary graft dysfunction, immune rejection, and optimal immunosuppression. AIMS Exploration of partial heart transplant biology will depend on suitable animal models. Here we review our experience with partial heart transplantation in rodents, piglets, and non-human primates. MATERIALS & METHODS This review is based on our experience with partial heart transplantation using over 100 rodents, over 50 piglets and one baboon. RESULTS Suitable animal models for partial heart transplantation include rodent heterotopic partial heart transplantation, piglet orthotopic partial heart transplantation, and non-human primate partial heart xenotransplantation. DISCUSSION Rodent models are relatively cheap and offer extensive availability of research tools. However, rodent open-heart surgery is technically not feasible. This limits rodents to heterotopic partial heart transplant models. Piglets are comparable in size to children. This allows for open-heart surgery using clinical grade equipment for orthoptic partial heart transplantation. Piglets also grow rapidly, which is useful for studying partial heart transplant growth. Finally, nonhuman primates are immunologically most closely related to humans. Therefore, nonhuman primates are most suitable for studying partial heart transplant immunobiology and xenotransplantation. CONCLUSIONS Animal research is a privilege that is contingent on utilitarian ethics and the 3R principles of replacement, reduction and refinement. This privilege allows the research community to seek fundamental knowledge about partial heart transplantation, and to apply this knowledge to enhance the health of children who require partial heart transplants.
Collapse
Affiliation(s)
- Julia Yerger
- Medical University of South Carolina, Charleston, South Carolina, USA
| | - Morgan A Hill
- Medical University of South Carolina, Charleston, South Carolina, USA
| | | | | |
Collapse
|
2
|
Manawar S, Myrick E, Awad P, Hung V, Hinton C, Kenter K, Bovid K, Li Y. Use of allograft bone matrix in clinical orthopedics. Regen Med 2024; 19:247-256. [PMID: 39028538 DOI: 10.1080/17460751.2024.2353473] [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: 03/05/2024] [Accepted: 05/07/2024] [Indexed: 07/20/2024] Open
Abstract
Clinical orthopedics continuously aims to improve methods for bone formation. Clinical applications where bone formation is necessary include critical long bone defects in orthopedic trauma or tumor patients. Though some biomaterials combined with autologous stem cells significantly improve bone repair, critical-size damages are still challenged with the suitable implantation of biomaterials and donor cell survival. Extracellular matrix (ECM) is the fundamental structure in tissues that can nest and nourish resident cells as well as support specific functions of the tissue type. ECM also plays a role in cell signaling to promote bone growth, healing and turnover. In the last decade, the use of bone-derived ECMs or ECM-similar biomaterials have been widely investigated, including decellularized and demineralized bone ECM. In this article, we reviewed the current productions and applications of decellularized and demineralized bone matrices. We also introduce the current study of whole limb decellularization and recellularization.
Collapse
Affiliation(s)
- Shaan Manawar
- Department of Orthopedic Surgery, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI 49008, USA
| | - Erica Myrick
- Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI 49008, USA
| | - Peter Awad
- Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI 49008, USA
| | - Victor Hung
- Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI 49008, USA
| | - Cassidy Hinton
- Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI 49008, USA
| | - Keith Kenter
- Department of Orthopedic Surgery, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI 49008, USA
| | - Karen Bovid
- Department of Orthopedic Surgery, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI 49008, USA
| | - Yong Li
- Department of Orthopedic Surgery, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI 49008, USA
| |
Collapse
|
3
|
Zahedi L, Mohammadi M, Kalantari M, Arabsolghar M, Ranjbar H. Horizontal ridge augmentation with particulate cortico-cancellous freeze-dried bone allograft alone or combined with injectable-platelet rich fibrin in a randomized clinical trial. Clin Implant Dent Relat Res 2024; 26:127-137. [PMID: 38093400 DOI: 10.1111/cid.13295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 11/08/2023] [Accepted: 11/11/2023] [Indexed: 02/09/2024]
Abstract
OBJECTIVES The objective of this study is to assess the effectiveness of horizontal ridge augmentation using FDBA in combination with injectable-platelet rich fibrin (i-PRF) versus FDBA alone. To fulfill this aim, the radiographic and histomorphometric outcomes are compared. METHOD The study involved 41 patients who had horizontal alveolar ridge defects categorized as either B (2.5-7 mm) or C (0-2.5 mm). The control group received FDBA alone (n = 20), while the test group received FDBA in combination with i-PRF (n = 21). The horizontal dimensions of the alveolar ridge were measured at 0, 2, 4, and 6 mm from the bone crest using CBCT before and 6 months after alveolar ridge augmentation. In the second-stage surgery, 24 biopsies were taken from the augmented bone - 13 from the control group and 11 from the test group, and were examined histologically and histomorphometrically. The data were analyzed using Pearson correlation coefficient, chi-square, paired-t, and two-sample t tests. RESULTS There was no significant difference (p > 0.05) in the increase of mean ridge width between the test group and the control group after 6 months at distances of 0, 2, 4, and 6 mm from the crest, with differences of -0.28, 0.12, 0.52, and 1.04 mm, respectively. However, the amount of newly formed bone and material residues was significantly higher in the FDBA + i-PRF group compared to the FDBA alone group (45.01% and 13.06% vs 54.03% and 8.48%, respectively). There was no significant difference in the amount of soft tissue between the two groups (41.02% and 37.5%, p > 0.05). CONCLUSION The study found that there was no statistically significant difference in the increase of horizontal ridge width between the FDBA + i-PRF group and the FDBA group. However, the histomorphometric analysis revealed that the FDBA + i-PRF group had a higher proportion of newly formed bone, less connective tissue, and fewer residual particles. This suggests a superior quality of bone formation compared to the FDBA group.
Collapse
Affiliation(s)
- Leili Zahedi
- Oral and Dental Diseases Research Center, Department of Periodontics, Kerman Dental School, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Mohammadi
- Oral and Dental Diseases Research Center, Department of Periodontics, Kerman Dental School, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahsa Kalantari
- Department of Oral and Maxillofacial Pathology, Oral and Dental Diseases Research Center, Kerman Dental School, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohaddeseh Arabsolghar
- Oral and Dental Diseases Research Center, Department of Periodontics, Kerman Dental School, Kerman University of Medical Sciences, Kerman, Iran
| | - Hadi Ranjbar
- Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
4
|
Hubbell PJ, Roth B, Block JE. Comparative Evaluation of Mineralized Bone Allografts for Spinal Fusion Surgery. J Funct Biomater 2023; 14:384. [PMID: 37504879 PMCID: PMC10381653 DOI: 10.3390/jfb14070384] [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: 06/12/2023] [Revised: 07/19/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023] Open
Abstract
The primary objective of this review is to evaluate whether the degree of processing and the clinical utility of commercially available mineralized bone allografts for spine surgery meet the 2020 US Food and Drug Administration's (FDA) guideline definitions for minimal manipulation and homologous use, respectively. We also assessed the consistency of performance of these products by examining the comparative postoperative radiographic fusion rates following spine surgery. Based on the FDA's criteria for determining whether a structural allograft averts regulatory oversight and classification as a drug/device/biologic, mineralized bone allografts were judged to meet the Agency's definitional descriptions for minimal manipulation and homologous use when complying with the American Association of Tissue Banks' (AATB) accredited guidelines for bone allograft harvesting, processing, storing and transplanting. Thus, these products do not require FDA medical device clearance. Radiographic fusion rates achieved with mineralized bone allografts were uniformly high (>85%) across three published systematic reviews. Little variation was found in the fusion rates irrespective of anatomical location, allograft geometry, dimensions or indication, and in most cases, the rates were similar to those for autologous bone alone. Continued utilization of mineralized bone allografts should be encouraged across all spine surgery applications where supplemental grafts and/or segmental stability are required to support mechanically solid arthrodeses.
Collapse
Affiliation(s)
- Paul J Hubbell
- Southern Pain and Neurologic, 3939 Houma Blvd., Building 2, Suite 6, Metairie, LA 70006, USA
| | - Brandon Roth
- AZ Pain Doctors, 14420 W Meeker Blvd., Building A, Ste. 211, Sun City West, AZ 85375, USA
| | - Jon E Block
- Independent Consultant, 2210 Jackson Street, Suite 401, San Francisco, CA 94115, USA
| |
Collapse
|
5
|
Shih S, Askinas C, Caughey S, Vernice N, Berri N, Dong X, Spector JA. Sourcing and development of tissue for transplantation in reconstructive surgery: A narrative review. J Plast Reconstr Aesthet Surg 2023; 83:266-275. [PMID: 37279636 DOI: 10.1016/j.bjps.2023.05.001] [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: 03/30/2023] [Revised: 04/28/2023] [Accepted: 05/02/2023] [Indexed: 06/08/2023]
Abstract
The wealth of allogeneic and xenogeneic tissue products available to plastic and reconstructive surgeons has allowed for the development of novel surgical solutions to challenging clinical problems, often obviating the need to inflict donor site morbidity. Allogeneic tissue used for reconstructive surgery enters the tissue industry through whole body donation or reproductive tissue donation and has been regulated by the FDA as human cells, tissues, and cellular and tissue-based products (HCT/Ps) since 1997. Tissue banks offering allogeneic tissue can also undergo voluntary regulation by the American Association of Tissue Banks (AATB). Tissue prepared for transplantation is sterilized and can be processed into soft tissue or bone allografts for use in surgical reconstruction, whereas non-transplant tissue is prepared for clinical training and drug, medical device, and translational research. Xenogeneic tissue, which is most often derived from porcine or bovine sources, is also commercially available and is subject to strict regulations for animal breeding and screening for infectious diseases. Although xenogeneic products have historically been decellularized for use as non-immunogenic tissue products, recent advances in gene editing have opened the door to xenograft organ transplants into human patients. Herein, we describe an overview of the modern sourcing, regulation, processing, and applications of tissue products relevant to the field of plastic and reconstructive surgery.
Collapse
Affiliation(s)
- Sabrina Shih
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medical Center/New York-Presbyterian Hospital, New York, NY, United States of America
| | - Carly Askinas
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medical Center/New York-Presbyterian Hospital, New York, NY, United States of America
| | - Sarah Caughey
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medical Center/New York-Presbyterian Hospital, New York, NY, United States of America
| | - Nicholas Vernice
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medical Center/New York-Presbyterian Hospital, New York, NY, United States of America
| | - Nabih Berri
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medical Center/New York-Presbyterian Hospital, New York, NY, United States of America
| | - Xue Dong
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medical Center/New York-Presbyterian Hospital, New York, NY, United States of America
| | - Jason A Spector
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medical Center/New York-Presbyterian Hospital, New York, NY, United States of America.
| |
Collapse
|
6
|
It's the Biology Orthopods! Heralding a Reconstructive Revolution Through Musculoskeletal Tissue Banks (MSTB) in India. Indian J Orthop 2022; 56:1533-1546. [PMID: 36052382 PMCID: PMC9385905 DOI: 10.1007/s43465-022-00661-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/16/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND A tissue bank is an establishment that aids in retrieval, processing, storage, and distribution of human tissue for transplantation. For many years, such banks have been dispensing tissue to orthopaedic surgeons, performing reconstructive surgeries. METHODOLOGY The retrieval, preparation, and delivery of musculoskeletal tissue used for transplantation is an intricate process involving varying practices among different musculoskeletal tissue banks. RESULTS Musculoskeletal allografts are used in various orthopaedic surgeries ranging from primary bone defects, trauma, and carcinoma to congenital disabilities. Every decade brings in paradigm shifts and new hope for treating challenging cases with the aid of newer devices and materials. CONCLUSION This review article outlines various technical, regulatory and quality enhancement steps involved in tissue banking. Also, it discusses the road ahead and the research avenues for developing novel allograft products with the synergy of tissue banks and clinicians. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s43465-022-00661-0.
Collapse
|
7
|
Criswell T, Swart C, Stoudemire J, Brockbank K, Floren M, Eaker S, Hunsberger J. OUP accepted manuscript. Stem Cells Transl Med 2022; 11:107-113. [PMID: 36239619 PMCID: PMC9562819 DOI: 10.1093/stcltm/szab025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 11/07/2021] [Indexed: 11/20/2022] Open
Abstract
Advances in regenerative medicine manufacturing continue to be a priority for achieving the full commercial potential of important breakthrough therapies. Equally important will be the establishment of distribution chains that support the transport of live cells and engineered tissues and organs resulting from these advanced biomanufacturing processes. The importance of a well-managed distribution chain for products requiring specialized handling procedures was highlighted during the COVID-19 pandemic and serves as a reminder of the critical role of logistics and distribution in the success of breakthrough therapies. This perspective article will provide insight into current practices and future considerations for creating global distribution chains that facilitate the successful deployment of regenerative medicine therapies to the vast number of patients that would benefit from them worldwide.
Collapse
Affiliation(s)
- Tracy Criswell
- Wake Forest Institute for Regenerative Medicine, Winston-Salem, NC, USA
- Corresponding author: Tracy Criswell, PhD, Wake Forest School of Medicine, Wake Forest Institute for Regenerative Medicine, 391 Technology Way, Winston-Salem, NC 27101, USA. Tel: 336-713-1615;
| | | | | | | | | | | | | |
Collapse
|
8
|
Baseri N, Meysamie A, Campanile F, Hamidieh AA, Jafarian A. Bacterial contamination of bone allografts in the tissue banks: a systematic review and meta-analysis. J Hosp Infect 2021; 123:156-173. [PMID: 34752801 DOI: 10.1016/j.jhin.2021.10.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 10/02/2021] [Accepted: 10/25/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Bone allografts are harvested and transplanted under sterile conditions. However, the risk of bacterial contamination of grafts during these processes is a health concern. Bioburden testing and bacterial contamination detection are conducted to ensure allograft sterility. AIM The present study aimed to determine the incidence of bacterial contamination in bone allografts based on different classifications. METHODS PROSPERO registration number was received for the study. Systematic searches were conducted in PubMed and EMBASE databases with relevant keywords from January 2000 to March 2021. After choosing related studies according to the PRISMA flow diagram, Stata software was used for data analysis. We considered I2 ˃ 50% as heterogeneity between studies. FINDINGS The overall incidence of bacterial contamination was 12.6% (95% CI 0.100, 0.152) among 19,805 bone allografts of 17 studies. The bacterial contamination rate among bone allografts was 10.8% before 2010 and 14.7% in 2010-March 2021. The contamination frequency in Asia, Europe, and Australia was 11.5%, 14.3%, and 5.2%, respectively. Bone contamination rates were higher in cadaver donors (19.9%), retrieval time sampling (13.5%), and swab samples (13.2%) compared to those in living donors (7.5%), implantation time sampling (6.9%), and bone fragments cultures (6.3%). Bacterial contamination was recovered 24.4%, 19.7%, 13.2%, and 21% from tibia, fibula, femoral, and other bones, respectively. Staphylococcus spp. was the predominant isolated bacteria from bones (63.2% of all isolated genera), followed by Propionibacterium spp. (10.6%). CONCLUSION The high contamination of bone allografts is a health concern, indicating the need for more health monitoring and improvement of standards.
Collapse
Affiliation(s)
- Neda Baseri
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging infectious diseases, Pasteur Institute of Iran, Tehran, Iran; National Reference laboratory for Plague, Tularemia and Q fever, Research Centre for Emerging and Reemerging infectious diseases, Pasteur Institute of Iran, Akanlu, Kabudar Ahang, Hamadan, Iran
| | - Alipasha Meysamie
- Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Floriana Campanile
- Department of Biomedical and Biotechnological Sciences (BIOMETEC), Medical Molecular Microbiology and Antibiotic Resistance laboratory (MMARLab), University of Catania, Catania, Italy
| | - Amir Ali Hamidieh
- Pediatric Cell and Gene Therapy Research Center, Tehran University of Medical Sciences, Tehran, Iran; Iranian Tissue Bank & Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arefeh Jafarian
- Iranian Tissue Bank & Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
9
|
Study of Cell Viability and Etiology of Contamination in Decalcified Bone Allograft: A Pilot Study. Indian J Orthop 2021; 56:16-23. [PMID: 35070138 PMCID: PMC8748563 DOI: 10.1007/s43465-021-00410-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 04/22/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Bone allografts can elicit immune responses which is correlated with the presence of Human Leukocyte Antigen (HLA) and cellular DNA. It also has risk of causing occult infection arising out of contamination during its processing and storage. The presence of immunogenic materials like cells, cellular remnants and DNA in a decalcified bone allograft during different phases of processing has never been studied. Present study was conducted to explore- the cell viability using routine Hematoxylin and Eosin, presence of DNA using Feulgen staining and etiology of contamination in decalcified bone allograft during procurement, demineralization and ethanol preservation. METHODS The harvested bones from patients undergoing hemireplacement/THR/TKR were processed to prepare decalcified bone allografts. The samples during procurement (A), HCL treatment (B) and ethanol preservation (C) were sent for histopathological analysis (number of osteocytes in the maximum density field under 40x and the cells demonstrating presence of DNA on feulgen stain) and microbiological assessment (aerobic/anaerobic/fungal cultures). RESULTS Histopathological study demonstrated the presence of osteocytes and other cells like bone marrow, adipocytes, endothelial cells in the decal bone allograft. The average number of osteocytes gradually decreased from 55.47, 9.6, 0.86 in sample A, B, C, respectively. Feulgen staining confirmed the presence of DNA in osteocytes and other cells which decreased both qualitatively and quantitatively in subsequent stages of processing. Rate of contamination demonstrated at the procurement was 6.67% (Staphylococcus aureus). After treatment with HCl (demineralisation), 7.14% of non-contaminated allografts were found contaminated (Staphylococcus epidermidis). None of the remaining 13 non-contaminated allografts showed contamination after storage in ethanol. Overall 13% of the patients had positive cultures on microbiological assessment. CONCLUSION The population of osteocytes in the harvested bone reduced significantly after processing with HCl and ethanol preservation. Presence of DNA, demonstrated by using Feulgen staining, was observed in bone marrow cells, adipocytes along with osteocytes which showed quantitative reduction on processing. Hence, antigenicity, conferred by cells and their DNA, reduced significantly after processing of decal bone. Contamination rate of banked decalcified allograft was 13%. Thus, culture and sensitivity tests should be carried out at each step of processing of decal bone allograft.
Collapse
|