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Stringa P, Vecchio Dezillio LE, Talayero P, Serradilla J, Errea A, Machuca M, Papa-Gobbi R, Camps Ortega O, Pucci Molineris M, Lausada N, Andres Moreno AM, Rumbo M, Hernández Oliveros F. Experimental Assessment of Intestinal Damage in Controlled Donation After Circulatory Death for Visceral Transplantation. Transpl Int 2023; 36:10803. [PMID: 36713114 PMCID: PMC9878676 DOI: 10.3389/ti.2023.10803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 01/02/2023] [Indexed: 01/15/2023]
Abstract
There is an urgent need to address the shortage of potential multivisceral grafts in order to reduce the average time in waiting list. Since donation after circulatory death (DCD) has been successfully employed for other solid organs, a thorough evaluation of the use of intestinal grafts from DCD is warranted. Here, we have generated a model of Maastricht III DCD in rodents, focusing on the viability of intestinal and multivisceral grafts at five (DCD5) and twenty (DCD20) minutes of cardiac arrest compared to living and brain death donors. DCD groups exhibited time-dependent damage. DCD20 generated substantial intestinal mucosal injury and decreased number of Goblet cells whereas grafts from DCD5 closely resemble those of brain death and living donors groups in terms intestinal morphology, expression of tight junction proteins and number of Paneth and Globet cells. Upon transplantation, intestines from DCD5 showed increased ischemia/reperfusion damage compared to living donor grafts, however mucosal integrity was recovered 48 h after transplantation. No differences in terms of graft rejection, gene expression and absorptive function between DCD5 and living donor were observed at 7 post-transplant days. Collectively, our results highlight DCD as a possible strategy to increase multivisceral donation and transplantation procedures.
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Affiliation(s)
- Pablo Stringa
- Transplant Group, La Paz University Hospital Health Research Institute (IdiPAZ), Madrid, Spain,Department of Pediatric Surgery, La Paz University Hospital, Madrid, Spain,Institute for Immunological and Pathophysiological Studies (IIFP), School of Exact Sciences, National University of La Plata, National Council of Scientific and Technical Research (CONICET), La Plata, Argentina,Organ Transplant Laboratory, School of Medicine, National University of La Plata, La Plata, Argentina
| | - Leandro Emmanuel Vecchio Dezillio
- Institute for Immunological and Pathophysiological Studies (IIFP), School of Exact Sciences, National University of La Plata, National Council of Scientific and Technical Research (CONICET), La Plata, Argentina,Organ Transplant Laboratory, School of Medicine, National University of La Plata, La Plata, Argentina
| | - Paloma Talayero
- Immunology Department, 12 de Octubre University Hospital, Madrid, Spain
| | - Javier Serradilla
- Transplant Group, La Paz University Hospital Health Research Institute (IdiPAZ), Madrid, Spain,Department of Pediatric Surgery, La Paz University Hospital, Madrid, Spain
| | - Agustina Errea
- Institute for Immunological and Pathophysiological Studies (IIFP), School of Exact Sciences, National University of La Plata, National Council of Scientific and Technical Research (CONICET), La Plata, Argentina
| | - Mariana Machuca
- Special Pathology Laboratory, Faculty of Veterinary Sciences, National University of La Plata, La Plata, Argentina
| | - Rodrigo Papa-Gobbi
- Transplant Group, La Paz University Hospital Health Research Institute (IdiPAZ), Madrid, Spain,Department of Pediatric Surgery, La Paz University Hospital, Madrid, Spain,Institute for Immunological and Pathophysiological Studies (IIFP), School of Exact Sciences, National University of La Plata, National Council of Scientific and Technical Research (CONICET), La Plata, Argentina
| | - Onys Camps Ortega
- Transplant Group, La Paz University Hospital Health Research Institute (IdiPAZ), Madrid, Spain,Department of Pediatric Surgery, La Paz University Hospital, Madrid, Spain
| | - Melisa Pucci Molineris
- Biochemistry Research Institute of La Plata, School of Medicine, National University of La Plata, National Council of Scientific and Technical Research (CONICET), La Plata, Argentina
| | - Natalia Lausada
- Organ Transplant Laboratory, School of Medicine, National University of La Plata, La Plata, Argentina
| | - Ane Miren Andres Moreno
- Transplant Group, La Paz University Hospital Health Research Institute (IdiPAZ), Madrid, Spain,Department of Pediatric Surgery, La Paz University Hospital, Madrid, Spain
| | - Martin Rumbo
- Institute for Immunological and Pathophysiological Studies (IIFP), School of Exact Sciences, National University of La Plata, National Council of Scientific and Technical Research (CONICET), La Plata, Argentina
| | - Francisco Hernández Oliveros
- Transplant Group, La Paz University Hospital Health Research Institute (IdiPAZ), Madrid, Spain,Department of Pediatric Surgery, La Paz University Hospital, Madrid, Spain,Executive Operational Committee, ERN TransplantChild, Madrid, Spain,*Correspondence: Francisco Hernández Oliveros,
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Papa-Gobbi R, Bueno A, Serradilla J, Talayero P, Stringa P, Pascual-Miguel B, Alcolea-Sánchez A, González-Sacristan R, Andrés AM, López-Santamaría M, Rumbo M, Ramos-Boluda E, Hernández-Oliveros F. Novel coronavirus (SARS-CoV-2) infection in a patient with multivisceral transplant. Transpl Infect Dis 2020; 23:e13430. [PMID: 32741047 PMCID: PMC7435537 DOI: 10.1111/tid.13430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/17/2020] [Accepted: 07/20/2020] [Indexed: 01/19/2023]
Affiliation(s)
- Rodrigo Papa-Gobbi
- Transplant Group, La Paz University Hospital Health Research Institute (IdiPAZ), Madrid, Spain
| | - Alba Bueno
- Transplant Group, La Paz University Hospital Health Research Institute (IdiPAZ), Madrid, Spain.,Department of Pediatric Surgery, La Paz University Hospital, Madrid, Spain
| | - Javier Serradilla
- Transplant Group, La Paz University Hospital Health Research Institute (IdiPAZ), Madrid, Spain.,Department of Pediatric Surgery, La Paz University Hospital, Madrid, Spain
| | - Paloma Talayero
- Department of Immunology, 12 de Octubre University Hospital, Madrid, Spain
| | - Pablo Stringa
- Institute for Immunological and Pathophysiological Studies (IIFP), School of Exact Sciences, National University of La Plata, National Council of Scientific and Technical Research (CONICET), La Plata, Argentine
| | - Bárbara Pascual-Miguel
- Translational Research in Pediatric Oncology, Hematopoietic Transplantation & Cell Therapy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | | | | | - Ane M Andrés
- Transplant Group, La Paz University Hospital Health Research Institute (IdiPAZ), Madrid, Spain.,Department of Pediatric Surgery, La Paz University Hospital, Madrid, Spain
| | | | - Martín Rumbo
- Institute for Immunological and Pathophysiological Studies (IIFP), School of Exact Sciences, National University of La Plata, National Council of Scientific and Technical Research (CONICET), La Plata, Argentine
| | | | - Francisco Hernández-Oliveros
- Transplant Group, La Paz University Hospital Health Research Institute (IdiPAZ), Madrid, Spain.,Department of Pediatric Surgery, La Paz University Hospital, Madrid, Spain
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Vela M, Stringa P, González-Navarro P, Machuca M, Pascual-Miguel B, Mestre C, Arreola NM, Papa-Gobbi R, Navarro-Zapata A, Pires-Lobo SC, Andrés AM, Hernández-Oliveros F, Pérez-Martínez A. Donor's graft ex vivo T-cell depletion with fludarabine reduces graft-versus-host disease signs and improves survival after intestinal transplantation - an experimental study. Transpl Int 2020; 33:1302-1311. [PMID: 32526809 DOI: 10.1111/tri.13672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 03/31/2020] [Accepted: 06/05/2020] [Indexed: 11/26/2022]
Abstract
Intestinal passenger T leukocytes are responsible for graft-versus-host disease (GvHD) in intestinal transplantation (ITx). We hypothesized that ex vivo fludarabine treatment of the bowel graft would diminish the risk of GvHD and improve overall survival post-transplant. We performed isolated heterotopic small bowel transplantations from Lewis (LEW) to Brown Norway (BN) rat strains, which generated GvHD signs from the fourth day post-transplant. These symptoms included rash, weight loss, piloerection, and diarrhea. The grafts of one of the experimental groups were immersed and sealed in cold Celsior preservation solution with 1000 µm fludarabine for 1 h, prior to its implantation into recipient animals. No histological signs of intestinal tissue alterations were observed after fludarabine treatment. Fludarabine-treated bowel recipients showed significantly later and milder clinical signs of GvHD and reduced total donor cell chimerism, as determined by flow cytometry using strain-specific anti-HLA antibodies. Additionally, fludarabine treatment prolonged recipients' overall survival (13.5 days ± 0.3 days vs. 9.2 days ± 0.5). We conclude that active modification of the intestinal leukocyte composition is advantageous in our ITx animal model. Immunosuppression with fludarabine during the surgical procedure, which could be translated directly to the clinic, protects bowel recipients from GvHD and improves overall post-transplant survival.
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Affiliation(s)
- Maria Vela
- Translational Research in Paediatric Oncology, Hematopoietic Transplantation & Cell Therapy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Pablo Stringa
- Institute for Immunological and Physiopathological Studies (IIFP-CONICET-UNLP), National University of La Plata, Buenos Aires, Argentine
| | - Pablo González-Navarro
- Translational Research in Paediatric Oncology, Hematopoietic Transplantation & Cell Therapy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Mariana Machuca
- Veterinary Pathology Laboratory, Veterinary Sciences Department, National University of La Plata, Buenos Aires, Argentine
| | - Bárbara Pascual-Miguel
- Translational Research in Paediatric Oncology, Hematopoietic Transplantation & Cell Therapy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Carmen Mestre
- Translational Research in Paediatric Oncology, Hematopoietic Transplantation & Cell Therapy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Nidia M Arreola
- Transplant Group - Experimental Surgery, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Rodrigo Papa-Gobbi
- Transplant Group - Experimental Surgery, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Alfonso Navarro-Zapata
- Translational Research in Paediatric Oncology, Hematopoietic Transplantation & Cell Therapy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Sara C Pires-Lobo
- Transplant Group - Experimental Surgery, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,Paediatric Surgery Department, La Paz University Hospital, Madrid, Spain
| | - Ane M Andrés
- Transplant Group - Experimental Surgery, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,Paediatric Surgery Department, La Paz University Hospital, Madrid, Spain
| | - Francisco Hernández-Oliveros
- Transplant Group - Experimental Surgery, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,Paediatric Surgery Department, La Paz University Hospital, Madrid, Spain
| | - Antonio Pérez-Martínez
- Translational Research in Paediatric Oncology, Hematopoietic Transplantation & Cell Therapy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,Paediatric Hemato-Oncology Department, La Paz University Hospital, Madrid, Spain
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Stringa P, Toledano V, Papa-Gobbi R, Arreola M, Largo C, Machuca M, Aguirre LA, Rumbo M, López-Collazo E, Hernández Oliveros F. Galactomannan as a Potential Modulator of Intestinal Ischemia-Reperfusion Injury. J Surg Res 2019; 249:232-240. [PMID: 31796217 DOI: 10.1016/j.jss.2019.10.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/30/2019] [Accepted: 10/20/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND Galactomannan (GAL), a polysaccharide present on the cell wall of several fungi, has shown an ability to modulate inflammatory responses through the dectin-1 receptor in human macrophages. However, studies evaluating the modulatory properties of this polysaccharide in in vivo inflammatory scenarios are scarce. We hypothesized that GAL pretreatment would modulate local and remote damage related to intestinal reperfusion after an ischemic insult. MATERIALS AND METHODS Adult male Balb/c mice were subjected to intestinal ischemia-reperfusion injury by reversible occlusion of the superior mesenteric artery, consisting of 45 min of ischemia followed by 3 or 24 h of reperfusion. Intragastric GAL (70 mg/kg) was administered 12 h before ischemia, and saline solution was used in the control animals. Jejunum, lung, and blood samples were taken for the analysis of histology, gene expression, plasma cytokine levels, and nitrosative stress. RESULTS Intestinal and lung histologic alterations were attenuated by GAL pretreatment, showing significant differences compared with nontreated animals. Interleukin 1β, monocyte chemoattractant protein 1, and IL-6 messenger RNA expression were considerably downregulated in the small intestine of the GAL group. In addition, GAL treatment significantly prevented plasma interleukin 6 and monocyte chemoattractant protein 1 upregulation and diminished nitrate and nitrite levels after 3 h of intestinal reperfusion. CONCLUSIONS GAL pretreatment constitutes a novel and promising therapy to reduce local and remote damage triggered by intestinal ischemia-reperfusion injury. Further in vivo and in vitro studies to understand GAL's modulatory effects are warranted.
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Affiliation(s)
- Pablo Stringa
- Transplant Group, Experimental Surgery, IdiPAZ, La Paz University Hospital, Madrid, Spain; Tumor Immunology Laboratory, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Victor Toledano
- Tumor Immunology Laboratory, IdiPAZ, La Paz University Hospital, Madrid, Spain; Innate Immunity Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Rodrigo Papa-Gobbi
- Transplant Group, Experimental Surgery, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Miguel Arreola
- Transplant Group, Experimental Surgery, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Carlota Largo
- Transplant Group, Experimental Surgery, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Mariana Machuca
- Special Pathology Laboratory, Faculty of Veterinary Sciences, National University of La Plata, La Plata, Buenos Aires, Argentina
| | - Luis A Aguirre
- Tumor Immunology Laboratory, IdiPAZ, La Paz University Hospital, Madrid, Spain; Innate Immunity Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Martin Rumbo
- Institute for Immunological and Physiopathological Studies (IIFP-CONICET-UNLP), National University of La Plata, La Plata, Buenos Aires, Argentina
| | - Eduardo López-Collazo
- Tumor Immunology Laboratory, IdiPAZ, La Paz University Hospital, Madrid, Spain; Innate Immunity Group, IdiPAZ, La Paz University Hospital, Madrid, Spain.
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