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Galvao FHF, Grinberg M. Bioethics and xenotransplantation from pig to human. Clinics (Sao Paulo) 2023; 78:100170. [PMID: 36738646 PMCID: PMC9932344 DOI: 10.1016/j.clinsp.2023.100170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/05/2023] [Indexed: 02/05/2023] Open
Affiliation(s)
- Flavio Henrique Ferreira Galvao
- Departamento de Gastroenterologia, Disciplina de Transplanre de Órgãos do Aparelho Digestivo, Laboratório de Investigação Medical (LIM) 37, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil; Bioethical Committee from Hospital das Clínicas, Faculdade de Medicina, Universidade de Sao Paulo (USP), São Paulo, SP, Brazil.
| | - Max Grinberg
- Departamento de Gastroenterologia, Disciplina de Transplanre de Órgãos do Aparelho Digestivo, Laboratório de Investigação Medical (LIM) 37, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil; Departamento de Cardiologia, Instituto do Coração Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil; Bioethical Committee from Hospital das Clínicas, Faculdade de Medicina, Universidade de Sao Paulo (USP), São Paulo, SP, Brazil
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Schlör S, Pflaum M, Höffler K, Kühn C, Haverich A, Wiegmann B. Towards Biohybrid Lung Development: Establishment of a Porcine In Vitro Model. MEMBRANES 2022; 12:membranes12070687. [PMID: 35877890 PMCID: PMC9325277 DOI: 10.3390/membranes12070687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/29/2022] [Accepted: 07/01/2022] [Indexed: 02/04/2023]
Abstract
Lung transplantation (LTx) is the only curative therapy option for patients with end-stage lung diseases, though only available for chosen patients. To provide an alternative treatment option to LTx, we aim for the development of an implantable biohybrid lung (BHL) based on hollow fiber membrane (HFM) technology used in extracorporeal membrane oxygenators. Crucial for long-lasting BHL durability is complete hemocompatibility of all blood contacting surfaces, which can be achieved by their endothelialization. In continuation to successful in vitro investigations using human endothelial cells (ECs), indicating general feasibility, the appropriate porcine in vivo model needs to be prepared and established to fill the translational data gap prior to patient’s application. Therefore, isolation of porcine ECs from carotid arteries (pCECs) was established. Following, pCECs were used for HFM endothelialization and examined under static and dynamic conditions using cell medium or heparinized blood, to assess their proliferation capacity, flow resistance and activation state, especially under clinically relevant conditions. Additionally, comparative hemocompatibility tests between native and endothelialized HFMs were performed. Overall, pure pCECs formed a viable and confluent monolayer, which resisted applied flow conditions, in particular due to physiological extracellular matrix synthesis. Additionally, pCECs remained the non-inflammatory and anti-thrombogenic status, significantly improving the hemocompatibility of endothelialized HFMs. Finally, as relevant for reliable porcine to human translation, pCECs behaved in the same way as human ECs. Concluding, generated in vitro data justify further steps towards pre-clinical BHL examination, in particular BHL application to porcine lung injury models, reflecting the clinical scenario with end-stage lung-diseased patients.
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Affiliation(s)
- Simon Schlör
- Department for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; (S.S.); (M.P.); (K.H.); (C.K.); (A.H.)
- Lower Saxony Center for Biomedical Engineering, Implant Research and Development (NIFE), Stadtfelddamm 34, 30625 Hannover, Germany
| | - Michael Pflaum
- Department for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; (S.S.); (M.P.); (K.H.); (C.K.); (A.H.)
- Lower Saxony Center for Biomedical Engineering, Implant Research and Development (NIFE), Stadtfelddamm 34, 30625 Hannover, Germany
| | - Klaus Höffler
- Department for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; (S.S.); (M.P.); (K.H.); (C.K.); (A.H.)
- Lower Saxony Center for Biomedical Engineering, Implant Research and Development (NIFE), Stadtfelddamm 34, 30625 Hannover, Germany
| | - Christian Kühn
- Department for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; (S.S.); (M.P.); (K.H.); (C.K.); (A.H.)
- Lower Saxony Center for Biomedical Engineering, Implant Research and Development (NIFE), Stadtfelddamm 34, 30625 Hannover, Germany
- German Center for Lung Research (DZL), Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Axel Haverich
- Department for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; (S.S.); (M.P.); (K.H.); (C.K.); (A.H.)
- Lower Saxony Center for Biomedical Engineering, Implant Research and Development (NIFE), Stadtfelddamm 34, 30625 Hannover, Germany
- German Center for Lung Research (DZL), Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Bettina Wiegmann
- Department for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; (S.S.); (M.P.); (K.H.); (C.K.); (A.H.)
- Lower Saxony Center for Biomedical Engineering, Implant Research and Development (NIFE), Stadtfelddamm 34, 30625 Hannover, Germany
- German Center for Lung Research (DZL), Carl-Neuberg-Str. 1, 30625 Hannover, Germany
- Correspondence:
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Morgaz J, Navarrete R, Granados MDM, Gómez-Villamandos RJ. Swine model in transplant research: Review of anaesthesia and perioperative management. World J Anesthesiol 2015; 4:73-82. [DOI: 10.5313/wja.v4.i3.73] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 08/05/2015] [Accepted: 10/19/2015] [Indexed: 02/06/2023] Open
Abstract
Pigs are one of most common animal species to be used in biomedical models due to their many anatomical visceral similarities with humans, particularly with regards to transplantation. Despite this use, in many of the researches in which pigs are selected for transplantation, the anaesthesia used is an adaptation of human anaesthesia and presents some limitations such as a reduced analgesia a limited control in perioperative period. In this review we show some of the most important conditions in the preanaesthetic management and of swine as well as we review of anaesthetic protocols for the most common types of swine model of transplantation.
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Galvao FHF, Soler W, Pompeu E, Waisberg DR, Mello ESD, Costa ACL, Teodoro W, Velosa AP, Capelozzi VL, Antonangelo L, Catanozi S, Martins A, Malbouisson LMS, Cruz RJ, Figueira ER, Filho JAR, Chaib E, D'Albuquerque LAC. Immunoglobulin G profile in hyperacute rejection after multivisceral xenotransplantation. Xenotransplantation 2012; 19:298-304. [PMID: 22957972 DOI: 10.1111/xen.12002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Xenotransplantation is a potential solution for the high mortality of patients on the waiting list for multivisceral transplantation; nevertheless, hyperacute rejection (HAR) hampers this practice and motivates innovative research. In this report, we describe a model of multivisceral xenotransplantation in which we observed immunoglobulin G (IgG) involvement in HAR. METHODS We recovered en bloc multivisceral grafts (distal esophagus, stomach, small intestine, colon, liver, pancreas, and kidneys) from rabbits (n = 20) and implanted them in the swine (n = 15) or rabbits (n = 5, control). Three hours after graft reperfusion, we collected samples from all graft organs for histological study and to assess IgG fixation by immunofluorescence. Histopathologic findings were graded according to previously described methods. RESULTS No histopathological features of rejection were seen in the rabbit allografts. In the swine-to-rabbit grafts, features of HAR were moderate in the liver and severe in esophagus, stomach, intestines, spleen, pancreas, and kidney. Xenograft vessels were the central target of HAR. The main lesions included edema, hemorrhage, thrombosis, myosites, fibrinoid degeneration, and necrosis. IgG deposition was intense on cell membranes, mainly in the vascular endothelium. CONCLUSIONS Rabbit-to-swine multivisceral xenotransplants undergo moderate HAR in the liver and severe HAR in the other organs. Moderate HAR in the liver suggests a degree of resistance to the humoral immune response in this organ. Strong IgG fixation in cell membranes, including vascular endothelium, confirms HAR characterized by a primary humoral immune response. This model allows appraisal of HAR in multiple organs and investigation of the liver's relative resistance to this immune response.
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Affiliation(s)
- Flavio H F Galvao
- Department of Gastroenterology (LIM 37), University of São Paulo School of Medicine, Sao Paulo, Brazil.
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Galvão FHF, Farias AQ, Pompeu E, Waisberg DR, Teixeira ARF, de Mello ES, Lino Costa AC, de Castro Galvão R, Santos VR, Chaib E, Carrilho FJ, D’Albuquerque LAC. Endoscopic features in a model of multivisceral xenotransplantation. Xenotransplantation 2010; 17:423-8. [PMID: 21192494 DOI: 10.1111/j.1399-3089.2010.00609.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Filho JAR, Nani RS, Carmona MJC, Ballesteros MV, D'Albuquerque LAC. Anestesia para trasplante hepático en hepatitis fulminante. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2009. [DOI: 10.1016/s0120-3347(09)74010-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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