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Shen C, Deng H, Sun T, Cai J, Li D, Li L, He L, Zhang B, Li D, Wang L, Niu Y. Use of Fresh Scalp Allografts From Living Relatives for Extensive Deep Burns in Children: A Clinical Study Over 7 Years. J Burn Care Res 2021; 42:323-330. [PMID: 32960969 DOI: 10.1093/jbcr/iraa155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Conventionally, pediatric patients with major burns need frozen cadaveric allografts to save their lives. However, these allografts are insufficient in many burn units because of cultural and local governmental laws in China. This paper reported 22 pediatric patients with major burns who received fresh scalp allografts from their parents, siblings, or relatives from January 2011 to December 2017. These 22 pediatric patients sustained deep partial-thickness to full-thickness burns involving 40% total body surface area (TBSA) on average. Wounds were covered with fresh scalp allografts alone or with postage stamp autografts and fresh scalp allografts post excision. Data were collected from medical files of the treated patients, including sex, age, etiology of burn injury, abbreviated burn severity index (ABSI), and TBSA. Postoperative variables included early survival rate of skin grafts, mean time to rejection, length of hospital stay (LHS), healing time of donor sites, and follow-up complications of donors. The 1-year survival rate of the 22 pediatric patients included into the study was 100%. The early survival rate of the scalp allografts was similar to the autografts. The mean time to rejection was 15.5 ± 3.60 days. The average LHS was 58 days. All donor sites healed within 7.6 days on average, without scar formation, alopecia areata, or folliculitis. Following up data of the donors revealed a full psychological sense of accomplishment and no regrets of donating the scalp to save the burned children. Therefore, the use of fresh scalp allografts is a feasible alternative to save pediatric patients with major burns when frozen allografts are unavailable.
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Affiliation(s)
- Chuanan Shen
- Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Huping Deng
- Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Tianjun Sun
- Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jianhua Cai
- Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Dongjie Li
- Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ligen Li
- Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Lixia He
- Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Bohan Zhang
- Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Dawei Li
- Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Liang Wang
- Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yuezeng Niu
- Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
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Giwa S, Lewis JK, Alvarez L, Langer R, Roth AE, Church GM, Markmann JF, Sachs DH, Chandraker A, Wertheim JA, Rothblatt M, Boyden ES, Eidbo E, Lee WPA, Pomahac B, Brandacher G, Weinstock DM, Elliott G, Nelson D, Acker JP, Uygun K, Schmalz B, Weegman BP, Tocchio A, Fahy GM, Storey KB, Rubinsky B, Bischof J, Elliott JAW, Woodruff TK, Morris GJ, Demirci U, Brockbank KGM, Woods EJ, Ben RN, Baust JG, Gao D, Fuller B, Rabin Y, Kravitz DC, Taylor MJ, Toner M. The promise of organ and tissue preservation to transform medicine. Nat Biotechnol 2017; 35:530-542. [PMID: 28591112 PMCID: PMC5724041 DOI: 10.1038/nbt.3889] [Citation(s) in RCA: 312] [Impact Index Per Article: 44.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 04/28/2017] [Indexed: 02/06/2023]
Abstract
The ability to replace organs and tissues on demand could save or improve millions of lives each year globally and create public health benefits on par with curing cancer. Unmet needs for organ and tissue preservation place enormous logistical limitations on transplantation, regenerative medicine, drug discovery, and a variety of rapidly advancing areas spanning biomedicine. A growing coalition of researchers, clinicians, advocacy organizations, academic institutions, and other stakeholders has assembled to address the unmet need for preservation advances, outlining remaining challenges and identifying areas of underinvestment and untapped opportunities. Meanwhile, recent discoveries provide proofs of principle for breakthroughs in a family of research areas surrounding biopreservation. These developments indicate that a new paradigm, integrating multiple existing preservation approaches and new technologies that have flourished in the past 10 years, could transform preservation research. Capitalizing on these opportunities will require engagement across many research areas and stakeholder groups. A coordinated effort is needed to expedite preservation advances that can transform several areas of medicine and medical science.
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Affiliation(s)
- Sebastian Giwa
- Organ Preservation Alliance, NASA Research Park, Moffett Field, California, USA
- Sylvatica Biotech, Inc., Charleston, South Carolina, USA
- Ossium Health, San Francisco, California, USA
| | - Jedediah K Lewis
- Organ Preservation Alliance, NASA Research Park, Moffett Field, California, USA
| | - Luis Alvarez
- Regenerative Biology Research Group, Cancer and Developmental Biology Laboratory, National Cancer Institute, Bethesda, Maryland, USA
- Walter Reed National Military Medical Center, Bethesda, Maryland, USA
- Department of Chemistry and Life Science, United States Military Academy, West Point, New York, USA
| | - Robert Langer
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Alvin E Roth
- Department of Economics, Stanford University, Stanford, California, USA
| | - George M Church
- Department of Genetics, Harvard Medical School, Boston, Massachusetts, USA
| | - James F Markmann
- Division of Transplant Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - David H Sachs
- Columbia Center for Translational Immunology, Columbia University Medical Center, New York, New York, USA
| | - Anil Chandraker
- American Society of Transplantation, Mt. Laurel, New Jersey, USA
- Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jason A Wertheim
- American Society of Transplant Surgeons, Arlington Virginia, USA
- Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Edward S Boyden
- MIT Media Lab and McGovern Institute, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Elling Eidbo
- Association of Organ Procurement Organizations, Vienna, Virginia, USA
| | - W P Andrew Lee
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Bohdan Pomahac
- Department of Surgery, Division of Plastic Surgery, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Gerald Brandacher
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David M Weinstock
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Gloria Elliott
- Department of Mechanical Engineering and Engineering Science, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - David Nelson
- Department of Transplant Medicine, Nazih Zuhdi Transplant Institute, Integris Baptist Medical Center, Oklahoma City, Oklahoma, USA
| | - Jason P Acker
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
- Society for Cryobiology, Baltimore, Maryland, USA
| | - Korkut Uygun
- Department of Surgery, Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Boris Schmalz
- Organ Preservation Alliance, NASA Research Park, Moffett Field, California, USA
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Brad P Weegman
- Organ Preservation Alliance, NASA Research Park, Moffett Field, California, USA
- Sylvatica Biotech, Inc., Charleston, South Carolina, USA
| | - Alessandro Tocchio
- Organ Preservation Alliance, NASA Research Park, Moffett Field, California, USA
- Department of Radiology, Stanford School of Medicine, Stanford, California, USA
| | - Greg M Fahy
- 21st Century Medicine, Fontana, California, USA
| | - Kenneth B Storey
- Institute of Biochemistry, Carleton University, Ottawa, Ontario, Canada
| | - Boris Rubinsky
- Department of Mechanical Engineering, University of California Berkeley, Berkeley, California, USA
| | - John Bischof
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, Minnesota, USA
| | - Janet A W Elliott
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
- Department of Chemical and Materials Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Teresa K Woodruff
- Division of Obstetrics and Gynecology-Reproductive Science in Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Utkan Demirci
- Department of Radiology, Stanford School of Medicine, Stanford, California, USA
- Department of Electrical Engineering (by courtesy), Stanford, California, USA
| | | | - Erik J Woods
- Ossium Health, San Francisco, California, USA
- Society for Cryobiology, Baltimore, Maryland, USA
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Robert N Ben
- Department of Chemistry and Biomolecular Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - John G Baust
- Department of Biological Sciences, Binghamton University, State University of New York, Binghamton, New York, USA
| | - Dayong Gao
- Society for Cryobiology, Baltimore, Maryland, USA
- Department of Mechanical Engineering, University of Washington, Seattle, Washington, USA
| | - Barry Fuller
- Division of Surgery &Interventional Science, University College Medical School, Royal Free Hospital Campus, London, UK
| | - Yoed Rabin
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
| | | | - Michael J Taylor
- Sylvatica Biotech, Inc., Charleston, South Carolina, USA
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
- Department of Surgery, University of Arizona, Tucson, Arizona, USA
| | - Mehmet Toner
- Department of Surgery, Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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9
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Gaucher S, Nicco C, Jarraya M, Batteux F. Viability and Efficacy of Coverage of Cryopreserved Human Skin Allografts in Mice. INT J LOW EXTR WOUND 2010; 9:132-40. [DOI: 10.1177/1534734610380024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Human skin allografts are considered one of the best temporary biological coverages for severe burn patients. Human skin allografts can be either viable or nonviable depending on their preservation modalities. However, there is a debate about the use of viable versus nonviable skin for severe burn patients because there is no established correlation between viability and efficacy of coverage. The authors tried to correlate the viability of cryopreserved human skin allografts as assessed by the MTT assay, with efficacy of coverage, intensity of rejection at day 8, and delay of wound healing in a xenograft model using human fresh skin (FS) and cryopreserved skin (CPS) on murine recipients (n = 49). Cryopreserved grafts were less rejectable than fresh grafts, with statistically significant different delays ( P = .0008). Mice that had received grafts healed with delays; the delays, whether associated with fresh grafts or cryopreserved grafts, were not statistically significant. On day 8 after the graft, the overall damage score for the tissue’s histological architectural integrity was higher for FS. Furthermore, flow cytometry analysis showed a significant increase in the number of CD4 and CD8 T-cells ( P = .001) in the spleens of FS-grafted mice. These results confirm that the use of viable CPS does not change the potential for healing.
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Affiliation(s)
- Sonia Gaucher
- Université Paris Descartes, Faculté de Médecine, Paris, France, Service des Brûlés, AP-HP Hôpital Cochin, Paris, France,
| | - Carole Nicco
- Laboratoire d'Immunologie, IFR Alfred Jost, AP-HP Hôpital Cochin, Paris, France
| | - Mohamed Jarraya
- Banque des Tissus Humains, AP-HP Hôpital Saint Louis, Paris, France
| | - Frédéric Batteux
- Université Paris Descartes, Faculté de Médecine, Paris, France, Laboratoire d'Immunologie, IFR Alfred Jost, AP-HP Hôpital Cochin, Paris, France
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