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Gao Z, Zhou W, Lv X, Wang X. Metabolomics as a Critical Tool for Studying Clinical Surgery. Crit Rev Anal Chem 2023:1-14. [PMID: 36592066 DOI: 10.1080/10408347.2022.2162810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Metabolomics enables the analysis of metabolites within an organism, which offers the closest direct measurement of the physiological activity of the organism, and has advanced efforts to characterize metabolic states, identify biomarkers, and investigate metabolic pathways. A high degree of innovation in analytical techniques has promoted the application of metabolomics, especially in the study of clinical surgery. Metabolomics can be employed as a clinical testing method to maximize therapeutic outcomes, and has been applied in rapid diagnosis of diseases, timely postoperative monitoring, prognostic assessment, and personalized medicine. This review focuses on the use of mass spectrometry and nuclear magnetic resonance-based metabolomics in clinical surgery, including identifying metabolic changes before and after surgery, finding disease-associated biomarkers, and exploring the potential of personalized therapy. Challenges and opportunities of metabolomics in organ transplantation are also discussed, with a particular emphasis on metabolomics in donor organ evaluation and protection, prognostic outcome prediction, as well as postoperative adverse reaction monitoring. In the end, current limitations of metabolomics in clinical surgery and future research directions are presented.
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Affiliation(s)
- Zhenye Gao
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, P. R. China
| | - Wenxiu Zhou
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, P. R. China
| | - Xiaoyuan Lv
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, P. R. China
| | - Xin Wang
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, P. R. China
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Abstract
Direct peritoneal resuscitation (DPR) has been found to be a useful adjunct in the management of critically ill trauma patients. DPR is performed following damage control surgery by leaving a surgical drain in the mesentery, placing a temporary abdominal closure, and postoperatively running peritoneal dialysis solution through the surgical drain with removal through the temporary closure. In the original animal models, the peritoneal dialysate infusion was found to augment visceral microcirculatory blood flow reducing the ischemic insult that occurs following hemorrhagic shock. DPR was also found to minimize the aberrant immune response that occurs secondary to shock and contributes to multisystem organ dysfunction. In the subsequent human trials, performing DPR had significant effects in several key categories. Traumatically injured patients who received DPR had a significantly shorter time to definitive fascial closure, had a higher likelihood of achieving primary fascial closure, and experienced fewer abdominal complications. The use of DPR has been further expanded as a useful adjunct for emergency general surgery patients and in the pretransplant care of human cadaver organ donors.
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Affiliation(s)
- Samuel J Pera
- Hiram C. Polk Jr. Department of Surgery, University of Louisville, 550 South Jackson Street, Louisville, KY 40202, USA
| | - Jessica Schucht
- Hiram C. Polk Jr. Department of Surgery, University of Louisville, 550 South Jackson Street, Louisville, KY 40202, USA
| | - Jason W Smith
- Hiram C. Polk Jr. Department of Surgery, University of Louisville, 550 South Jackson Street, Louisville, KY 40202, USA.
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Low JT. Understanding why advance care plans and goals of care discussions are so difficult to perform in liver transplantation – A new methodological approach from the social sciences. JOURNAL OF LIVER TRANSPLANTATION 2022. [DOI: 10.1016/j.liver.2022.100103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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4
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Kotha S, Berry P. The writing was on the wall: Decision making near the end of life in advanced liver disease. PROGRESS IN PALLIATIVE CARE 2022. [DOI: 10.1080/09699260.2022.2067702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Sreelakshmi Kotha
- Department of Gastroenterology, Guy’s and St Thomas’ Foundation Trust, London, UK
| | - Philip Berry
- Department of Gastroenterology, Guy’s and St Thomas’ Foundation Trust, London, UK
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Berkhout SG, Fritsch K, Frankel AV, Sheehan K. Obligation and the “Gift of Life”: Understanding Frictions Surrounding Advance Care Planning and Goals of Care Discussions in Liver Transplantation. JOURNAL OF LIVER TRANSPLANTATION 2022. [DOI: 10.1016/j.liver.2022.100102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Ghorbani F, Abdihaji M, Roudkenar MH, Ebrahimi A. Development of a Cell-Based Biosensor for Residual Detergent Detection in Decellularized Scaffolds. ACS Synth Biol 2021; 10:2715-2724. [PMID: 34550680 DOI: 10.1021/acssynbio.1c00321] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Ex vivo engineering of organs that uses decellularized whole organs as a scaffold with autologous stem cells is a potential alternative to traditional transplantation. However, one of the main challenges in this approach is preparing cytocompatible scaffolds. So far, high-precision and specific evaluation methods have not been developed for this purpose. Cell-based biosensors (CBBs) are promising tools to measure analytes with high sensitivity and specificity in a cost-effective and noninvasive manner. In this paper, using the NF-κB inducible promoter we developed a CBB for residual detergent detection. Proximal and core sections of the inducible promoter, containing NF-κB binding sequence, are designed and cloned upstream of the reporter gene (secreted alkaline phosphatase (SEAP)). After transfection into HEK293 cells, stable and reliable clones were selected. After confirmation of induction of this gene construct by sodium dodecyl sulfate (SDS), the stability and function of cells treated by qPCR and SEAP activity were measured. This biosensor was also used to evaluate the cytocompatibility of decellularized tissue. Results showed that the developed biosensor could detect very small amounts of SDS detergent (3.467 pM). It has the best performance 8 h after exposure to detergent, and its stability in high passage numbers was not significantly reduced. Applying this biosensor on decellularized tissues showed that SEAP activity higher than 4.36 (U/L) would lead to a viability reduction of transplanted cells below 70%. This paper presents a novel method to evaluate the cytocompatibility of decellularized tissues. The developed CBB can detect residual detergents (such as SDS) in tissues with high sensitivity and efficiency.
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Affiliation(s)
- Fatemeh Ghorbani
- Department of Medical Biotechnology, School of Paramedicine, Guilan University of Medical Sciences, 4256 Rasht, Iran
| | - Mohammadreza Abdihaji
- Center for Genomics and Bioinformatics, Indiana University, Bloomington, Indiana 47405, United States
| | - Mehryar Habibi Roudkenar
- Department of Medical Biotechnology, School of Paramedicine, Guilan University of Medical Sciences, 4256 Rasht, Iran
| | - Ammar Ebrahimi
- Department of Medical Biotechnology, School of Paramedicine, Guilan University of Medical Sciences, 4256 Rasht, Iran
- Department of Biomedical Sciences, University of Lausanne, Lausanne 1005, Switzerland
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Matiello M, Turner AC, Estrada J, Whitney CM, Kitch BT, Lee PT, Girkar U, Palacios R, Singla P, Schwamm L. Teleneurology-Enabled Determination of Death by Neurologic Criteria After Cardiac Arrest or Severe Neurologic Injury. Neurology 2021; 96:e1999-e2005. [PMID: 33637632 DOI: 10.1212/wnl.0000000000011751] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/08/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine whether providing teleneurology (TN) consultations aiding in determination of death by neurologic criteria (DNC) to a bedside intensivist is feasible and whether timely access and expert input increase the quality of the DNC examination and identification of potential organ donors, we reviewed retrospective data related to outcomes of such consultations. METHODS Between November 2017 and March 2019, TN consults were requested for sequential comatose patients in the intensive care unit (ICU). We recorded patients' demographic information, causes leading to coma or suspected DNC, and the results of TN consultations. We obtained data on the number of referrals to the organ bank and number of organ donors. RESULTS Ninety-nine consults were performed with a median time from request to start of the consult of 20.2 minutes (interquartile range 5.4-65.3 minutes). Eighty consults were requested for determination of prognosis, whereas 19 consults were requested for supervision of the DNC examination. In 1 of 80 (1.2%) prognostication consults, the patient was determined by the neurologist to require assessment of DNC and was found to meet DNC criteria; determination of DNC occurred in 11 of the 19 (57.9%) consultations for a supervised DNC examination. In a comparison of the pre-TN (94 months) and post-TN (17 months) periods, there was 2.56-fold increase in the proportion of patients meeting DNC criteria who were medically suitable for donation (pre-TN 8.9% vs post-TN 21.1%, p = 0.02) and a 2.12-fold increase in the proportion of donors (pre-TN 6.14% vs post-TN 13.1%, p = 0.14). CONCLUSIONS It is feasible to perform TN consultations for patients with severe neurologic damage and to allow expert supervision for DNC examination. Having a teleneurologist as part of the ICU assessment team helped differentiate severe neurologic deficits from DNC and was associated with increase in organ donation.
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Affiliation(s)
- Marcelo Matiello
- From the Department of Neurology (M.M., A.C.T., J.E., C.M.W., L.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Critical Care Medicine (B.T.K.), Emerson Hospital, Concord; Department of Medicine (P.T.L.), North Shore Medical Center, Salem; Institute for Medical Engineering and Science (U.G., R.P.), Massachusetts Institute of Technology, Boston; Institute for Research in Technology (R.P.), Universidad Pontificia Comillas, Madrid, Spain; and Soar Management Consulting Group (P.S.), Boston, MA.
| | - Ashby C Turner
- From the Department of Neurology (M.M., A.C.T., J.E., C.M.W., L.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Critical Care Medicine (B.T.K.), Emerson Hospital, Concord; Department of Medicine (P.T.L.), North Shore Medical Center, Salem; Institute for Medical Engineering and Science (U.G., R.P.), Massachusetts Institute of Technology, Boston; Institute for Research in Technology (R.P.), Universidad Pontificia Comillas, Madrid, Spain; and Soar Management Consulting Group (P.S.), Boston, MA
| | - Juan Estrada
- From the Department of Neurology (M.M., A.C.T., J.E., C.M.W., L.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Critical Care Medicine (B.T.K.), Emerson Hospital, Concord; Department of Medicine (P.T.L.), North Shore Medical Center, Salem; Institute for Medical Engineering and Science (U.G., R.P.), Massachusetts Institute of Technology, Boston; Institute for Research in Technology (R.P.), Universidad Pontificia Comillas, Madrid, Spain; and Soar Management Consulting Group (P.S.), Boston, MA
| | - Cynthia M Whitney
- From the Department of Neurology (M.M., A.C.T., J.E., C.M.W., L.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Critical Care Medicine (B.T.K.), Emerson Hospital, Concord; Department of Medicine (P.T.L.), North Shore Medical Center, Salem; Institute for Medical Engineering and Science (U.G., R.P.), Massachusetts Institute of Technology, Boston; Institute for Research in Technology (R.P.), Universidad Pontificia Comillas, Madrid, Spain; and Soar Management Consulting Group (P.S.), Boston, MA
| | - Barrett T Kitch
- From the Department of Neurology (M.M., A.C.T., J.E., C.M.W., L.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Critical Care Medicine (B.T.K.), Emerson Hospital, Concord; Department of Medicine (P.T.L.), North Shore Medical Center, Salem; Institute for Medical Engineering and Science (U.G., R.P.), Massachusetts Institute of Technology, Boston; Institute for Research in Technology (R.P.), Universidad Pontificia Comillas, Madrid, Spain; and Soar Management Consulting Group (P.S.), Boston, MA
| | - Patrick T Lee
- From the Department of Neurology (M.M., A.C.T., J.E., C.M.W., L.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Critical Care Medicine (B.T.K.), Emerson Hospital, Concord; Department of Medicine (P.T.L.), North Shore Medical Center, Salem; Institute for Medical Engineering and Science (U.G., R.P.), Massachusetts Institute of Technology, Boston; Institute for Research in Technology (R.P.), Universidad Pontificia Comillas, Madrid, Spain; and Soar Management Consulting Group (P.S.), Boston, MA
| | - Uma Girkar
- From the Department of Neurology (M.M., A.C.T., J.E., C.M.W., L.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Critical Care Medicine (B.T.K.), Emerson Hospital, Concord; Department of Medicine (P.T.L.), North Shore Medical Center, Salem; Institute for Medical Engineering and Science (U.G., R.P.), Massachusetts Institute of Technology, Boston; Institute for Research in Technology (R.P.), Universidad Pontificia Comillas, Madrid, Spain; and Soar Management Consulting Group (P.S.), Boston, MA
| | - Rafael Palacios
- From the Department of Neurology (M.M., A.C.T., J.E., C.M.W., L.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Critical Care Medicine (B.T.K.), Emerson Hospital, Concord; Department of Medicine (P.T.L.), North Shore Medical Center, Salem; Institute for Medical Engineering and Science (U.G., R.P.), Massachusetts Institute of Technology, Boston; Institute for Research in Technology (R.P.), Universidad Pontificia Comillas, Madrid, Spain; and Soar Management Consulting Group (P.S.), Boston, MA
| | - Pooja Singla
- From the Department of Neurology (M.M., A.C.T., J.E., C.M.W., L.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Critical Care Medicine (B.T.K.), Emerson Hospital, Concord; Department of Medicine (P.T.L.), North Shore Medical Center, Salem; Institute for Medical Engineering and Science (U.G., R.P.), Massachusetts Institute of Technology, Boston; Institute for Research in Technology (R.P.), Universidad Pontificia Comillas, Madrid, Spain; and Soar Management Consulting Group (P.S.), Boston, MA
| | - Lee Schwamm
- From the Department of Neurology (M.M., A.C.T., J.E., C.M.W., L.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Critical Care Medicine (B.T.K.), Emerson Hospital, Concord; Department of Medicine (P.T.L.), North Shore Medical Center, Salem; Institute for Medical Engineering and Science (U.G., R.P.), Massachusetts Institute of Technology, Boston; Institute for Research in Technology (R.P.), Universidad Pontificia Comillas, Madrid, Spain; and Soar Management Consulting Group (P.S.), Boston, MA
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Zhu M, Bian Y, Jiang J, Lei T, Shu K. Rapid screening for safety of donation from donors with central nervous system malignancies. Medicine (Baltimore) 2020; 99:e22808. [PMID: 33285676 PMCID: PMC7717844 DOI: 10.1097/md.0000000000022808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
With the increasing demand on organ transplants, it has become a common practice to include patients with primary central nervous system (CNS) malignancies as donors given the suggested low probability metastatic spread outside of the CNS. However, an extra-CNS spread of the disease cannot be excluded raising potential risks of cancer transmission from those donors. In order to balance between the risk of donor-derived disease transmission and the curative benefit for the recipient, a careful donor and organ selection is important. We performed a literature research and summarized all reported studies of organ transplants from donors suffered from primary CNS malignancies and determined the risk of tumor transmission to recipients. There were 22 cases of transplant-transmitted CNS tumors onto recipients since 1976. The association risks of cancer transmission were attributed to donor tumor histology, disruption of the blood-brain barrier, cerebrospinal fluid extra-CNS, and false diagnosis of primary intracranial tumor as well as the molecular properties of the primary tumor such as the existence of EGFR-amplification. The association risks and features of CNS tumors transmission recipients indicated that we need to reassess our thresholds for the potential fatal consequences of these donors.
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Affiliation(s)
| | | | - Jipin Jiang
- Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, People's Republic of China
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Pawlow PC, Blumenthal NP, Christie JD, Matura LA, Courtright KR, Aryal S, Ersek M. The palliative care needs of lung transplant candidates. Clin Transplant 2020; 34:e14092. [PMID: 32978822 DOI: 10.1111/ctr.14092] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/19/2020] [Accepted: 09/02/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Little is known about the palliative care needs of patients awaiting lung transplantation. The aim of this study was to describe these needs in patients undergoing evaluation for or awaiting lung transplantation. METHODS Cross-sectional survey using an adapted version of the Needs at the End-of-life Screening Tool (NEST-13) at a US-based transplant program. RESULTS Among the 111 participants, 83.5% were White, 60.0% were female, and almost three-quarters had either restrictive or obstructive lung disease. The greatest palliative care needs included difficulty being physically active (mean: 7.9/10; SD: 2.6; median: 9.0), physical symptoms (mean: 7.4/10; SD: 2.6; median: 8.0), missing work due to illness (mean: 6.2/10; SD: 4.0; median: 8.0), and concerns that life might end (mean: 5.1/10; SD: 3.6; median: 5.0). Participants reported that religious/spiritual beliefs contribute to their sense of purpose (mean: 4.1/10; SD: 3.9) but had few unmet needs in this area (mean: 0.9/10; median: 0.0). Only 6.4% reported seeing a palliative care specialist, and 48.2% were unsure what a palliative care specialist is. CONCLUSION There are substantial palliative care needs among lung transplant candidates, particularly physical symptoms and end-of-life concerns. These findings support integrating palliative care and end-of-life discussions in the management of lung transplant candidates.
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Affiliation(s)
- Patricia C Pawlow
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Nancy P Blumenthal
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Jason D Christie
- Pulmonary, Allergy and Critical Care Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lea Ann Matura
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Katherine R Courtright
- Pulmonary, Allergy and Critical Care Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Palliative and Advanced Illness Research (PAIR) Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Subhash Aryal
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Mary Ersek
- Department of Veterans Affairs, Corporal Michael J. Crescenz VA Medical Center - Philadelphia, University of Pennsylvania School of Nursing, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Pawlow PC, Doherty CL, Blumenthal NP, Matura LA, Christie JD, Ersek M. An Integrative Review of the Role of Palliative Care in Lung Transplantation. Prog Transplant 2020; 30:147-154. [DOI: 10.1177/1526924820913512] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Lung transplant patients experience significant physical symptoms and psychological stress that affect their quality of life. Palliative care is an interdisciplinary specialty associated with improved symptom management and enhanced quality of life. Little, however, is known about the palliative care needs of lung transplant patients and the role it plays in their care. Aim: The aim of this integrative review was to synthesize the literature describing the palliative care needs, the current role, and factors influencing the integration of palliative care in the care of lung transplant patients. Design/Data Sources: We searched PubMed, Scopus, CINAHL, and Embase to identify English-language, primary studies focused on palliative care in adult lung transplantation. Study quality was evaluated using Strengthening the Report of Observational studies in Epidemiology and Consolidated Criteria for Reporting Qualitative Research criteria. Results: Seven articles were included in the review. Most were single-center, descriptive studies. Two studies used qualitative and 5 used quantitative methodologies. Collectively, these studies suggest that palliative care is typically consulted for physical and psychological symptom management, although consultation is uncommon and often occurs late in the lung transplant process. We found no studies that systematically assessed palliative needs. Misperceptions about palliative care, communication challenges, and unrealistic patient/family expectations are identified barriers to the integration. While limited, evidence suggests that palliative care can be successfully integrated into lung transplant patient management. Conclusions: Empirical literature about palliative care in lung transplantation is sparse. Further research is needed to define the needs and opportunities for integration into the care of these patients.
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Affiliation(s)
| | | | | | - Lea Ann Matura
- University of Pennsylvania School of Nursing Philadelphia, PA, USA
| | - Jason D. Christie
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mary Ersek
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Veterans Affairs, Corporal Michael J. Crescenz VA Medical Center, PA, USA
- School of Nursing, Perelman School of Medicine, University of Pennsylvania, PA, USA
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Structure and Function of Porcine Arteries Are Preserved for up to 6 Days Using the HypoRP Cold-storage Solution. Transplantation 2020; 104:e125-e134. [PMID: 32000259 DOI: 10.1097/tp.0000000000003141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Maintaining functional vessels during preservation of vascularized composite allografts (VCAs) remains a major challenge. The University of Wisconsin (UW) solution has demonstrated significant short-term benefits (4-6 h). Here we determined whether the new hypothermic resuscitation and preservation solution HypoRP improves both structure, survival, and function of pig arteries during storage for up to 6 days. METHODS Using porcine swine mesenteric arteries, the effects of up to 6-day incubation in a saline (PBS), UW, or HypoRP solution on the structure, cell viability, metabolism, and function were determined. RESULTS After incubation at 4°C, for up to 6 days, the structures of the arteries were significantly disrupted, especially the tunica media, following incubation in PBS, in contrast with incubation in the HypoRP solution and to a lesser extent, in UW solution. Those disruptions were associated with increased active caspase 3 indicative of apoptosis. Additionally, while incubation in PBS led to a significant decrease in the metabolic activity, UW and HypoRP solutions allowed a stable to increased metabolic activity following 6 days of cold storage. Functional responsiveness to phenylephrine (PE) and sodium nitroprusside (SNP) decreased over time for artery rings stored in PBS and UW solution but not for those stored in HypoRP solution. Moreover, artery rings cold-stored in HypoRP solution were more sensitive to ATP. CONCLUSIONS The HypoRP solution improved long-term cold storage of porcine arteries by limiting structural alterations, including the collagen matrix, reducing apoptosis, and maintaining artery contraction-relaxation functions for up to 6 days.
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Mir TA, Iwanaga S, Kurooka T, Toda H, Sakai S, Nakamura M. Biofabrication offers future hope for tackling various obstacles and challenges in tissue engineering and regenerative medicine: A Perspective. Int J Bioprint 2018; 5:153. [PMID: 32596529 PMCID: PMC7294687 DOI: 10.18063/ijb.v5i1.153] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 07/02/2018] [Indexed: 12/26/2022] Open
Abstract
Biofabrication is an emerging multidisciplinary field that makes a revolutionary impact on the researches on life science, biomedical engineering, and both basic and clinical medicine, has progressed tremendously over the past few years. Recently, there has been a big boom in three-dimensional (3D) printing or additive manufacturing (AM) research worldwide, and there is a significant increase not only in the number of researchers turning their attention to AM but also publications demonstrating the potential applications of 3D printing techniques in multiple fields. Biofabrication and bioprinting hold great promise for the innovation of engineering-based organ replacing medicine. In this mini review, various challenges in the field of tissue engineering are focused from the point of view of the biofabrication - strategies to bridge the gap between organ shortage and mission of medical innovation research seek to achieve organ-specific treatments or regenerative therapies. Four major challenges are discussed including (i) challenge of producing organs by AM, (ii) digitalization of tissue engineering and regenerative medicine, (iii) rapid production of organs beyond the biological natural course, and (iv) extracorporeal organ engineering.
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Affiliation(s)
- Tanveer Ahmad Mir
- Graduate School of Science and Engineering for Research (Engineering), University of Toyama, Toyama 930-8555, Japan
- Toyama Nanotechnology Manufacturing Cluster, Toyama, Japan
- Laboratory of Biosensors, BioMEMS and Bionanotechnology, Alfaisal University Riyadh 11533, Kingdom of Saudi Arabia
| | - Shintaroh Iwanaga
- Graduate School of Science and Engineering for Research (Engineering), University of Toyama, Toyama 930-8555, Japan
| | - Taketoshi Kurooka
- Graduate School of Science and Engineering for Research (Engineering), University of Toyama, Toyama 930-8555, Japan
| | - Hideki Toda
- Graduate School of Science and Engineering for Research (Engineering), University of Toyama, Toyama 930-8555, Japan
| | - Shinji Sakai
- Graduate School of Engineering Science, Osaka University, 1-3, Machikaneyama-Cho, Toyonaka City, Osaka 560-8531, Japan
| | - Makoto Nakamura
- Graduate School of Science and Engineering for Research (Engineering), University of Toyama, Toyama 930-8555, Japan
- Toyama Nanotechnology Manufacturing Cluster, Toyama, Japan
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13
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Attitudes Toward Penile Transplantation Among Urologists and Health Professionals. Sex Med 2018; 6:316-323. [PMID: 30057121 PMCID: PMC6302119 DOI: 10.1016/j.esxm.2018.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 05/31/2018] [Accepted: 06/07/2018] [Indexed: 12/02/2022] Open
Abstract
Introduction Penile transplantation, in its infancy, has the potential to reestablish functional outcomes for men with penile loss and disfigurement. However, significant bioethical considerations are pertinent, and systematic discussions are necessary to safely progress implementation. Aim To determine the attitude of health practitioners toward the penile transplant and identify the key aspects of concern pertinent to the operation and clinical care. Methods Health care professionals from the United States responded to either email invitation, web link, or social media post on Facebook to complete a questionnaire investigating perceptions and attitudes toward penile transplantation. Main Outcome Measures Respondents' attitude toward penile transplantation, their own perceived important functions of the penis, and concerns about performing a penile transplantation. Respondents' previous exposure to visceral transplants, to penile disfigurement, and information about penile transplants were used as independent factors in analysis. Results Among 412 health care professionals who responded to the questionnaire, 95.9% were in favor of visceral organ transplant, but only 64.3% were in favor of penile transplantation. The results showed that 61.3% of respondents first learned about the penile transplant from mass media, whereas only 37.5% had been exposed through a scientific journal, formal lecture, or a professional colleague. Younger health professionals and those exposed through professional forums surrounding penile transplantation were more likely to be in favor of the procedure (P < .001). The most important functions of the penis were identified by respondents as being sexual function (role in sexual activity) and gender identity (being a man) with rates of 86.4% and 85.3%, respectively (P < .001). Barriers identified by respondents included the use of immunosuppression and the potential subsequent effect on healthcare resource utilization. Reading an excerpt about penile trauma in war during the questionnaire improved acceptance of penile transplantation (P = .05). Conclusion Penile transplantation is accepted by most health professionals surveyed. Younger respondents and those informed through professional outlets are more favorable toward penile transplantation. Anticipated limitations include the risk of immunosuppression, lack of available donors, and the effect on healthcare utilization. Najari B, Flannigan R, Hobgood J, et al. Attitudes Toward Penile Transplantation Among Urologists and Health Professionals. Sex Med 2018;6:316–323.
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Mazzarelli C, Prentice WM, Heneghan MA, Belli LS, Agarwal K, Cannon MD. Palliative care in end-stage liver disease: Time to do better? Liver Transpl 2018; 24:961-968. [PMID: 29729119 DOI: 10.1002/lt.25193] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 03/28/2018] [Accepted: 04/08/2018] [Indexed: 12/12/2022]
Abstract
Optimal involvement of palliative care (PC) services in the management of patients with decompensated cirrhosis and end-stage liver disease (ESLD) is limited. This may result from both ignorance and the failure to recognize the spectrum and unpredictability of the underlying liver condition. Palliative care is a branch of medicine that focuses on quality of life (QoL) by optimizing symptom management and providing psychosocial, spiritual, and practical support for both patients and their caregivers. Historically, palliative care has been underutilized for patients with decompensated liver disease. This review provides an evidence-based analysis of the benefits of the integration of palliative care into the management of patients with ESLD. Liver Transplantation 24 961-968 2018 AASLD.
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Affiliation(s)
- Chiara Mazzarelli
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, United Kingdom.,Hepatology and Gastroenterology Unit, ASST Ospedale Niguarda, Milan, Italy
| | - Wendy M Prentice
- Cicely Saunders Institute, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Michael A Heneghan
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Luca S Belli
- Hepatology and Gastroenterology Unit, ASST Ospedale Niguarda, Milan, Italy
| | - Kosh Agarwal
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Mary D Cannon
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, United Kingdom
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15
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Proceedings of the signature series event of the international society for cellular therapy: "Advancements in cellular therapies and regenerative medicine in digestive diseases," London, United Kingdom, May 3, 2017. Cytotherapy 2018; 20:461-476. [PMID: 29398624 DOI: 10.1016/j.jcyt.2017.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Accepted: 12/01/2017] [Indexed: 12/18/2022]
Abstract
A summary of the First Signature Series Event, "Advancements in Cellular Therapies and Regenerative Medicine for Digestive Diseases," held on May 3, 2017, in London, United Kingdom, is presented. Twelve speakers from three continents covered major topics in the areas of cellular therapy and regenerative medicine applied to liver and gastrointestinal medicine as well as to diabetes mellitus. Highlights from their presentations, together with an overview of the global impact of digestive diseases and a proposal for a shared online collection and data-monitoring platform tool, are included in this proceedings. Although growing evidence demonstrate the feasibility and safety of exploiting cell-based technologies for the treatment of digestive diseases, regulatory and methodological obstacles will need to be overcome before the successful implementation in the clinic of these novel attractive therapeutic strategies.
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