New frontiers about retinal cell transplantation for retinal degenerative diseases start from the idea that acting on stem cells can help regenerate retinal layers and establish new synapses among retinal cells.Defici...New frontiers about retinal cell transplantation for retinal degenerative diseases start from the idea that acting on stem cells can help regenerate retinal layers and establish new synapses among retinal cells.Deficiency or alterations of synaptic input and neurotrophic factors result in trans-neuronal degeneration of the inner retinal cells.Thus,the disruption of photoreceptors takes place.However,even in advanced forms of retinal degeneration,a good percentage of the ganglion cells and the inner nuclear layer neurons remain intact.This phenomenon provides evidence for obtaining retinal circuitry through the transplantation of photoreceptors into the subretinal region.The eye is regarded as an optimal organ for cell transplantation because of its immunological privilege and the relatively small number of cells collaborating to carry out visual activities.The eyeball's immunological privilege,characterized by the suppression of delayed-type hypersensitivity responses in ocular tissues,is responsible for the low rate of graft rejection in transplant patients.The main discoveries highlight the capacity of embryonic stem cells(ESCs)and induced pluripotent stem cells to regenerate damaged retinal regions.Recent progress has shown significant enhancements in transplant procedures and results.The research also explores the ethical ramifications linked to the utilization of stem cells,emphasizing the ongoing issue surrounding ESCs.The analysis centers on recent breakthroughs,including the fabrication of three-dimensional retinal organoids and the innovation of scaffolding for cell transportation.Moreover,researchers are currently assessing the possibility of CRISPR and other advanced gene editing technologies to enhance the outcomes of retinal transplantation.The widespread use of universally recognized safe surgical and imaging methods enables retinal transplantation and monitoring of transplanted cell growth toward the correct location.Currently,most therapy approaches are in the first phases of development and necessitate further research,including both pre-clinical and clinical trials,to attain favorable visual results for individuals suffering from retinal degenerative illnesses.展开更多
Objective: To analyze the long term effect of primary combined tissue transplantation on hand reconstruction. Methods: The data of 8 kinds of combined tissue transplantations employed to reconstruct the severely injur...Objective: To analyze the long term effect of primary combined tissue transplantation on hand reconstruction. Methods: The data of 8 kinds of combined tissue transplantations employed to reconstruct the severely injured hands of 26 patients over the past 2 to 11 years were studied retrospectively. Among them, combined tissue transplantation taking the anterior lateral femoral flap as the main tissue unit was applied in 21 cases and taking the second toe as the main tissue unit was applied in 5 cases. Blood vessel anastomosis was performed in parallel in 16 cases, series in 6 cases and both in 4 cases. Results: Among the 60 free tissue units employed on 26 patients, 58 survived completely and the other 2 survived after dressing change because of postoperative partial necrosis. The patients were followed up for 2 11 years postoperatively, with an average of 3.5 years. According to the standard for function of reconstructed hands by Chinese Medical Association, excellent results were obtained in 10 cases, good in 12 cases, fair in 3 cases and bad in 1 case. Conclusions: Primary combined tissue transplantation, which may preserve the tissue vitality of injured hands to the maximum and thus facilitate function restoration of the hands, is a promising method in reconstructing severely injured hands.展开更多
In recent years,with the rapid development of medical research,cancer diagnosis and treatment technology have significantly improved young cancer patient’s survival rate.Anticancer therapy such as chemotherapy,radiot...In recent years,with the rapid development of medical research,cancer diagnosis and treatment technology have significantly improved young cancer patient’s survival rate.Anticancer therapy such as chemotherapy,radiotherapy,or hematopoietic stem cell transplantation can lead to premature ovarian insufficiency.The endocrine and reproductive function of the ovary is critical to women’s physical and mental health.Ovarian tissue cryopreservation and transplantation can protect not only female fertility but also preserve ovarian endocrine function.This paper interprets the guidelines for ovarian tissue cryopreservation and transplantation issued by the Chinese Society of Gynecological Endocrinology affiliated to the International Society of Gynecological Endocrinology.The purpose of this guideline’s interpretation is to promote more medical workers to understand the technology of ovarian tissue cryopreservation and transplantation,which can provide patients with more choices of fertility protection methods and improve their quality of life.展开更多
Objective To establish a SOI model of human renal carcinoma and a high metastatic cell subline. Methods A human renal cell line RCC-9863 has been established by inoculating a human renal tumor tissue into nude mice s....Objective To establish a SOI model of human renal carcinoma and a high metastatic cell subline. Methods A human renal cell line RCC-9863 has been established by inoculating a human renal tumor tissue into nude mice s. c.. When RCC-9863 passaged for 20 times, the tissue from the same xemotransplant tumor were used to construct SOI model. Cultured the metastatic tissue in vitro, the tumor cell suspension was then injected orthotopically, The metastatic tissue obtained underwent the same procedure again. At last, the metastatic tumor was cultured in vitro and cloned. Results 15 days later, a tumor mass sized 1. 7 cm × 0. 6 cm in the nude mouse’s renal parenchyma was grown which lobulated, rude, and with multiply blood vessels and 55 days later later the mouse became moribund and metastases in the lungs were formed. The transplanted renal tumor in the SOI model grew fast and invasively and metastasized to lungs, lymphatic node and liver. A subline, MRCC, with metastatic ability to the lung was selected.展开更多
More than 2 million human tissue transplants(bone,tendon,cartilage,skin,cornea,amniotic membrane,stem cells,heart valve,blood vessel,etc.),are performed worldwide every year.Cells and tissues are shared between countr...More than 2 million human tissue transplants(bone,tendon,cartilage,skin,cornea,amniotic membrane,stem cells,heart valve,blood vessel,etc.),are performed worldwide every year.Cells and tissues are shared between countries which have different regulations and laboratory equipment and represent a risk of hepatitis B virus(HBV)transmission that has become a global safety concern.While the risk of transfusiontransmitted HBV infection from blood donations has been estimated,the rate of HBV transmission from donors to recipients of allografts is unknown and varies between different tissues.There are various important ways of reducing the transmission risk,but donor screening and donor testing are still the main factors for preventing HBV transmission.HBV detection is included in the routine screening tests for cell and tissue donors.The standard test for preventing transplant-transmitted hepatitis B is the hepatitis B surface antigen.The implementation of methods involving nucleic acid amplification and the new generation of reactives to detect viral antibodies or antigens with an immunoassay,has increased the sensitivity and the specificity of the screening tests.The objective of our research was to review the literature and critically analyse the different steps for avoiding HBV transmission in cell and tissue donors,focusing on the screening tests performed.展开更多
We evaluated the function of the fresh and cryopresereed newborn rat testicular tissue transplanted into outbred adult castrated male rats without immunosuppression for 30 days.Testis grafts were evaluated morphologic...We evaluated the function of the fresh and cryopresereed newborn rat testicular tissue transplanted into outbred adult castrated male rats without immunosuppression for 30 days.Testis grafts were evaluated morphologically and histologically,and testosterone(T)levels of serum and homogenate of testis grafts were determined in recipients by 30 days after transplantation.The fresh tissues(GroupI)and cryopreserved tissues(Group Ⅱ),from the 2nd or 3rd day of postnatal,showed an overall increase in growth,with maintenance of architecture and minimal lymphocytic infiltration.Thirty days after implantation,mean(±s)serum T concentrations(0.986±0.028 nmol/L in group I;1.113±0.201 nmol/L in group Ⅱ)were significantly higher than that prior to transplantation(<0.347 nmol/L,respectively;P<0.01 and P<0.01).After transplantation,however,mean serum T levels between two groups were not significantly different(P<0.05),and their grafting homogenate T levels(0.944±0.164 nmol/g in group I;1.019±0.172 nmol/g in group Ⅱ) were also not significantly different between two groups(P>0.05).Our data suggest that the testicular tissue of newborn rats can not only survive,grow and differentiate,but also can produce enough T detectable in vivo after transplantation and no significant differences were found between fresh tissue and frozen tissue transplanted.展开更多
BACKGROUND： In 2011, a pilot program for deceased organ donation was initiated in China. We describe the first successful series of liver transplants in the pilot program.METHODS： From July 2011 to August 2012, our ...BACKGROUND： In 2011, a pilot program for deceased organ donation was initiated in China. We describe the first successful series of liver transplants in the pilot program.METHODS： From July 2011 to August 2012, our center performed 26 liver transplants from a pool of 29 deceased donors. All organ donation and allograft procurement were conducted according to the national protocol. The clinical data of donors and recipients were collected and summarized retrospectively.RESULTS： Among the 29 donors, 24 were China Category II donors（organ donation after cardiac death）, and five were China Category III donors（organ donation after brain death followed by cardiac death）. The recipients were mainly the patients with hepatocellular carcinoma. The one-year patient survival rate was 80.8% with a median follow-up of 422（2-696） days. Among the five mortalities during the follow-up,three died of tumor recurrence. In terms of post-transplant complications, 9 recipients（34.6%） experienced early allograft dysfunction, 1（3.8%） had non-anastomotic biliary stricture,and 1（3.8%） was complicated with hepatic arterial thrombosis.None of these complications resulted in patient death. Notably,primary non-function was not observed in any of the grafts.CONCLUSION： With careful donor selection, liver transplant from deceased donors can be performed safely and plays acritical role in overcoming the extreme organ shortage in China.展开更多
Plasticity changes of uninjured nerves can result in a novel neural circuit after spinal cord injury, which can restore sensory and motor functions to different degrees. Although processes of neural plasticity have be...Plasticity changes of uninjured nerves can result in a novel neural circuit after spinal cord injury, which can restore sensory and motor functions to different degrees. Although processes of neural plasticity have been studied, the mechanism and treatment to effectively improve neural plasticity changes remain controversial. The present study reviewed studies regarding plasticity of the central nervous system and methods for promoting plasticity to improve repair of injured central nerves. The results showed that synaptic reorganization, axonal sprouting, and neurogenesis are critical factors for neural circuit reconstruction. Directed functional exercise, neurotrophic factor and transplantation of nerve-derived and non-nerve-derived tissues and cells can effectively ameliorate functional disturbances caused by spinal cord injury and improve quality of life for patients.展开更多
This review addresses the accumulating evidence that live(not decellularized)allogeneic peripheral nerves are functionally and immunologically peculiar in comparison with many other transplanted allogeneic tissues.Thi...This review addresses the accumulating evidence that live(not decellularized)allogeneic peripheral nerves are functionally and immunologically peculiar in comparison with many other transplanted allogeneic tissues.This is relevant because live peripheral nerve allografts are very effective at promoting recovery after segmental peripheral nerve injury via axonal regeneration and axon fusion.Understanding the immunological peculiarities of peripheral nerve allografts may also be of interest to the field of transplantation in general.Three topics are addressed:The first discusses peripheral nerve injury and the potential utility of peripheral nerve allografts for bridging segmental peripheral nerve defects via axon fusion and axon regeneration.The second reviews evidence that peripheral nerve allografts elicit a more gradual and less severe host immune response allowing for prolonged survival and function of allogeneic peripheral nerve cells and structures.Lastly,potential mechanisms that may account for the immunological differences of peripheral nerve allografts are discussed.展开更多
Vascularized composite tissue allotransplantation(VCA)offers treatment options of complex functional deficiencies that cannot be repaired with conventional reconstructive methods.VCAs consist of blocks of functional u...Vascularized composite tissue allotransplantation(VCA)offers treatment options of complex functional deficiencies that cannot be repaired with conventional reconstructive methods.VCAs consist of blocks of functional units comprising different tissue types such as skin,bone,muscle,nerves,blood vessels,tendons,ligaments and others,and are thus substantially different from the composition of organ transplants.The field of VCA has made fascinating progresses in the recent past.Among other VCAs,numerous successful hand,face and limb transplants have been performed in the world.At the same time,specific questions in regard to innate and adaptive immunity,consequences of ischemia/reperfusion injury,immunosuppression,preservation,and regenerative capacity remain.In spite of this,the field is poised to make significant advances in the near future.展开更多
It is today widely acknowledged that nerve repair is now more than a matter of perfect microsurgical reconstruction only and that, to further improve clinical outcome, the involvement of different scientific disciplin...It is today widely acknowledged that nerve repair is now more than a matter of perfect microsurgical reconstruction only and that, to further improve clinical outcome, the involvement of different scientific disciplines is required. This evolving reconstructive/regenerative approach is based on the interdisciplinary and integrated pillars of tissue engineering such as reconstructive microsurgery, transplantation and biomaterials. In this paper, some of the most promising innovations for the tissue engineering of nerves, emerging from basic science investigation, are critically overviewed with special focus on those approaches that appear today to be more suitable for clinical translation.展开更多
Transplantation of adult spinal cord tissue(aSCT)is a promising treatment for spinal cord injury(SCI)basing on various types of neural cells and matrix components inside aSCT.However,long-term systemic administration ...Transplantation of adult spinal cord tissue(aSCT)is a promising treatment for spinal cord injury(SCI)basing on various types of neural cells and matrix components inside aSCT.However,long-term systemic administration of immunosuppressors(e.g.tacrolimus,TAC)is required for the survival of allogeneic tissue,which often associated with severe side effects such as infection,liver damageand renal failure.In this study,a triglycerol monostearate(TGM)-based TAC delivery system(e.g.TAC@TGM)with high drug loading concentration was developed,which possessed injectable properties as well as sustainable and immune-responsive drug release behaviors.In complete transected SCI model,locally injected TAC@TGM could reduce the infiltration of inflammation cells,enhance the survival of transplanted aSCT(e.g.Tuj-1^(+)and NF^(+)neurons)and promote the recovery of locomotor function.Moreover,controlled release of TAC by TAC@TGM attenuated side effects of TAC on liver and kidneys compared with traditional systemic administration.More importantly,the developed TAC@TGM system provided a facile single dose of long-term immunosuppressive effect not just for aSCT transplantation,but also for other tissue/organ and cell transplantations.展开更多
Nowadays, fat transfer is an accepted technique that has been popularized in clinical practice, during which large volumes of fat are strategically relocated to increase and improve the contour of the body. In the pre...Nowadays, fat transfer is an accepted technique that has been popularized in clinical practice, during which large volumes of fat are strategically relocated to increase and improve the contour of the body. In the present study, we investigated the histological and morphometric changes after large volumes of fat were grafted within the subcutaneous cellular tissue. An experimental study was designed using four 3-month-old male pigs. One hundred cc of decanted fat tissue was transferred into the right leg. Volume augmentation achieved by auto lipo-injecting within the subcutaneous cellular tissue persisted up to two months. Although there is a reduction in cell number and size, an increased amount of extracellular matrix and the presence of oily cysts and microcalcifications were observed. <strong>Conclusion:</strong> The volume augmentation, which is achieved by autologous fat transfer in large quantities in subcutaneous cellular tissue, can remain for months.展开更多
Face transplant(FT)has evolved enormously in the last 10 years since the successful completion of the first facial transplant.This procedure has become a new reconstructive option for complex facial deformities to res...Face transplant(FT)has evolved enormously in the last 10 years since the successful completion of the first facial transplant.This procedure has become a new reconstructive option for complex facial deformities to restore the anatomy of patients with severely disfigured faces.The authors review the literature and discuss the main surgical,immunological,and ethical aspects as well as the results described in patients undergoing FT.To date there have been more than thirty FT worldwide.The main indication was post-traumatic deformity.In all cases a standard immunosuppression was performed with three drugs,although acute rejection episodes were observed,that could be controlled with conventional immunosuppressive regimen.Overall,functional and aesthetic results have been excellent at short-term and high satisfaction rate exceeded initial expectations,although long-term data are still scarce.Major complications were opportunistic infections.Five deaths that occurred have reopened the ethical debate about the potential complications and concerns of providing informed consent to recipients.Continuous progresses in microsurgical techniques and preoperative planning have promoted the evolution from partial to full FT.All these are on the basis of accurate and careful selection of well-motivated candidates.The next challenge will be getting new immunosuppressive treatment strategies.Although clinical experience has demonstrated the FT viability,it is still considered an experimental procedure in which we have much to learn to define its true role in the current reconstructive surgery and resolve major technical,medical and ethical problems involved.展开更多
Vascularized lymph node transfers(VLNT)are useful options for the surgical treatment of lymphedema.Conventional VLNT does not include the reconstruction of physiological lymphatic outflow,which may pose a risk of post...Vascularized lymph node transfers(VLNT)are useful options for the surgical treatment of lymphedema.Conventional VLNT does not include the reconstruction of physiological lymphatic outflow,which may pose a risk of postoperative lymphatic vessel obstruction and lymph node sclerosis.We report a case of lymph flow bypass reconstruction using a superficial circumflex Iliac artery perforator(SCIP)flap,including VLNT with efferent lymphatico-lymphatic anastomosis.A 63-year-old female with severe right upper extremity lymphedema after mastectomy was reconstructed using a SCIP free flap,which included a vascularized lymph node elevated from the left groin area and transferred to the right axilla area.The SCIP vessels were anastomosed to the medial intercostal artery perforator vessels and the efferent lymphatic vessel from the vascularized lymph node was anastomosed to the internal mammary lymphatic vessels using supermicrosurgical technique.Indocyanine green lymphography showed the reconstructed lymphatic flow from the right hand to the right internal mammary lymphatics through the transferred flap.Postoperatively,lymphedema improved and there was no lymphedema at the donor site with a 2-year follow-up.Lymphatic flow bypass reconstruction using VLNT with efferent lymphatico-lymphatic anastomosis may provide a useful option for the treatment of severe lymphedema.展开更多
文摘New frontiers about retinal cell transplantation for retinal degenerative diseases start from the idea that acting on stem cells can help regenerate retinal layers and establish new synapses among retinal cells.Deficiency or alterations of synaptic input and neurotrophic factors result in trans-neuronal degeneration of the inner retinal cells.Thus,the disruption of photoreceptors takes place.However,even in advanced forms of retinal degeneration,a good percentage of the ganglion cells and the inner nuclear layer neurons remain intact.This phenomenon provides evidence for obtaining retinal circuitry through the transplantation of photoreceptors into the subretinal region.The eye is regarded as an optimal organ for cell transplantation because of its immunological privilege and the relatively small number of cells collaborating to carry out visual activities.The eyeball's immunological privilege,characterized by the suppression of delayed-type hypersensitivity responses in ocular tissues,is responsible for the low rate of graft rejection in transplant patients.The main discoveries highlight the capacity of embryonic stem cells(ESCs)and induced pluripotent stem cells to regenerate damaged retinal regions.Recent progress has shown significant enhancements in transplant procedures and results.The research also explores the ethical ramifications linked to the utilization of stem cells,emphasizing the ongoing issue surrounding ESCs.The analysis centers on recent breakthroughs,including the fabrication of three-dimensional retinal organoids and the innovation of scaffolding for cell transportation.Moreover,researchers are currently assessing the possibility of CRISPR and other advanced gene editing technologies to enhance the outcomes of retinal transplantation.The widespread use of universally recognized safe surgical and imaging methods enables retinal transplantation and monitoring of transplanted cell growth toward the correct location.Currently,most therapy approaches are in the first phases of development and necessitate further research,including both pre-clinical and clinical trials,to attain favorable visual results for individuals suffering from retinal degenerative illnesses.
文摘Objective: To analyze the long term effect of primary combined tissue transplantation on hand reconstruction. Methods: The data of 8 kinds of combined tissue transplantations employed to reconstruct the severely injured hands of 26 patients over the past 2 to 11 years were studied retrospectively. Among them, combined tissue transplantation taking the anterior lateral femoral flap as the main tissue unit was applied in 21 cases and taking the second toe as the main tissue unit was applied in 5 cases. Blood vessel anastomosis was performed in parallel in 16 cases, series in 6 cases and both in 4 cases. Results: Among the 60 free tissue units employed on 26 patients, 58 survived completely and the other 2 survived after dressing change because of postoperative partial necrosis. The patients were followed up for 2 11 years postoperatively, with an average of 3.5 years. According to the standard for function of reconstructed hands by Chinese Medical Association, excellent results were obtained in 10 cases, good in 12 cases, fair in 3 cases and bad in 1 case. Conclusions: Primary combined tissue transplantation, which may preserve the tissue vitality of injured hands to the maximum and thus facilitate function restoration of the hands, is a promising method in reconstructing severely injured hands.
基金supported by Capital's Funds for Health Improvement and Research of China(Grant No.2020-2-2112)Beijing Municipal Administration of Hospitals’Ascent Plan of China(Grant No.DFL20181401)the Beijing Natural Science Foundation of China(Grant No.7202047),References。
文摘In recent years,with the rapid development of medical research,cancer diagnosis and treatment technology have significantly improved young cancer patient’s survival rate.Anticancer therapy such as chemotherapy,radiotherapy,or hematopoietic stem cell transplantation can lead to premature ovarian insufficiency.The endocrine and reproductive function of the ovary is critical to women’s physical and mental health.Ovarian tissue cryopreservation and transplantation can protect not only female fertility but also preserve ovarian endocrine function.This paper interprets the guidelines for ovarian tissue cryopreservation and transplantation issued by the Chinese Society of Gynecological Endocrinology affiliated to the International Society of Gynecological Endocrinology.The purpose of this guideline’s interpretation is to promote more medical workers to understand the technology of ovarian tissue cryopreservation and transplantation,which can provide patients with more choices of fertility protection methods and improve their quality of life.
文摘Objective To establish a SOI model of human renal carcinoma and a high metastatic cell subline. Methods A human renal cell line RCC-9863 has been established by inoculating a human renal tumor tissue into nude mice s. c.. When RCC-9863 passaged for 20 times, the tissue from the same xemotransplant tumor were used to construct SOI model. Cultured the metastatic tissue in vitro, the tumor cell suspension was then injected orthotopically, The metastatic tissue obtained underwent the same procedure again. At last, the metastatic tumor was cultured in vitro and cloned. Results 15 days later, a tumor mass sized 1. 7 cm × 0. 6 cm in the nude mouse’s renal parenchyma was grown which lobulated, rude, and with multiply blood vessels and 55 days later later the mouse became moribund and metastases in the lungs were formed. The transplanted renal tumor in the SOI model grew fast and invasively and metastasized to lungs, lymphatic node and liver. A subline, MRCC, with metastatic ability to the lung was selected.
文摘More than 2 million human tissue transplants(bone,tendon,cartilage,skin,cornea,amniotic membrane,stem cells,heart valve,blood vessel,etc.),are performed worldwide every year.Cells and tissues are shared between countries which have different regulations and laboratory equipment and represent a risk of hepatitis B virus(HBV)transmission that has become a global safety concern.While the risk of transfusiontransmitted HBV infection from blood donations has been estimated,the rate of HBV transmission from donors to recipients of allografts is unknown and varies between different tissues.There are various important ways of reducing the transmission risk,but donor screening and donor testing are still the main factors for preventing HBV transmission.HBV detection is included in the routine screening tests for cell and tissue donors.The standard test for preventing transplant-transmitted hepatitis B is the hepatitis B surface antigen.The implementation of methods involving nucleic acid amplification and the new generation of reactives to detect viral antibodies or antigens with an immunoassay,has increased the sensitivity and the specificity of the screening tests.The objective of our research was to review the literature and critically analyse the different steps for avoiding HBV transmission in cell and tissue donors,focusing on the screening tests performed.
文摘We evaluated the function of the fresh and cryopresereed newborn rat testicular tissue transplanted into outbred adult castrated male rats without immunosuppression for 30 days.Testis grafts were evaluated morphologically and histologically,and testosterone(T)levels of serum and homogenate of testis grafts were determined in recipients by 30 days after transplantation.The fresh tissues(GroupI)and cryopreserved tissues(Group Ⅱ),from the 2nd or 3rd day of postnatal,showed an overall increase in growth,with maintenance of architecture and minimal lymphocytic infiltration.Thirty days after implantation,mean(±s)serum T concentrations(0.986±0.028 nmol/L in group I;1.113±0.201 nmol/L in group Ⅱ)were significantly higher than that prior to transplantation(<0.347 nmol/L,respectively;P<0.01 and P<0.01).After transplantation,however,mean serum T levels between two groups were not significantly different(P<0.05),and their grafting homogenate T levels(0.944±0.164 nmol/g in group I;1.019±0.172 nmol/g in group Ⅱ) were also not significantly different between two groups(P>0.05).Our data suggest that the testicular tissue of newborn rats can not only survive,grow and differentiate,but also can produce enough T detectable in vivo after transplantation and no significant differences were found between fresh tissue and frozen tissue transplanted.
基金supported by grants from the National High Technology Research and Development Program of China(863 Program)(2012AA021008)the Special Fund for Science Research by Ministry of Health(201302009)
文摘BACKGROUND： In 2011, a pilot program for deceased organ donation was initiated in China. We describe the first successful series of liver transplants in the pilot program.METHODS： From July 2011 to August 2012, our center performed 26 liver transplants from a pool of 29 deceased donors. All organ donation and allograft procurement were conducted according to the national protocol. The clinical data of donors and recipients were collected and summarized retrospectively.RESULTS： Among the 29 donors, 24 were China Category II donors（organ donation after cardiac death）, and five were China Category III donors（organ donation after brain death followed by cardiac death）. The recipients were mainly the patients with hepatocellular carcinoma. The one-year patient survival rate was 80.8% with a median follow-up of 422（2-696） days. Among the five mortalities during the follow-up,three died of tumor recurrence. In terms of post-transplant complications, 9 recipients（34.6%） experienced early allograft dysfunction, 1（3.8%） had non-anastomotic biliary stricture,and 1（3.8%） was complicated with hepatic arterial thrombosis.None of these complications resulted in patient death. Notably,primary non-function was not observed in any of the grafts.CONCLUSION： With careful donor selection, liver transplant from deceased donors can be performed safely and plays acritical role in overcoming the extreme organ shortage in China.
基金supported by the National Natural Science Foundation of China (Goat model of ischemic injury in corticospinal tract projection path and axonal guidance of MPA-1B migration in the spinal cord), No. 30972153the National Natural Science Foundation of China (Spinal cord ischemia/reperfusion injury and proteomics), No. 30872609
文摘Plasticity changes of uninjured nerves can result in a novel neural circuit after spinal cord injury, which can restore sensory and motor functions to different degrees. Although processes of neural plasticity have been studied, the mechanism and treatment to effectively improve neural plasticity changes remain controversial. The present study reviewed studies regarding plasticity of the central nervous system and methods for promoting plasticity to improve repair of injured central nerves. The results showed that synaptic reorganization, axonal sprouting, and neurogenesis are critical factors for neural circuit reconstruction. Directed functional exercise, neurotrophic factor and transplantation of nerve-derived and non-nerve-derived tissues and cells can effectively ameliorate functional disturbances caused by spinal cord injury and improve quality of life for patients.
基金supported by University of Wyoming Startup Funds,United States Department of Defense,grant No.W81XWH-17-1-0402the University of Wyoming Sensory Biology COBRE under National Institutes of Health(NIH),award number 5P20GM121310-02+2 种基金the National Institute of General Medical Sciences of the NIH under Award Number P20GM103432(to JSB)the Lone Star Paralysis Foundation,NIH R01NS081063Department of Defense award W81XWH-19-2-0054 to GDB。
文摘This review addresses the accumulating evidence that live(not decellularized)allogeneic peripheral nerves are functionally and immunologically peculiar in comparison with many other transplanted allogeneic tissues.This is relevant because live peripheral nerve allografts are very effective at promoting recovery after segmental peripheral nerve injury via axonal regeneration and axon fusion.Understanding the immunological peculiarities of peripheral nerve allografts may also be of interest to the field of transplantation in general.Three topics are addressed:The first discusses peripheral nerve injury and the potential utility of peripheral nerve allografts for bridging segmental peripheral nerve defects via axon fusion and axon regeneration.The second reviews evidence that peripheral nerve allografts elicit a more gradual and less severe host immune response allowing for prolonged survival and function of allogeneic peripheral nerve cells and structures.Lastly,potential mechanisms that may account for the immunological differences of peripheral nerve allografts are discussed.
基金grants from the NIH(RO1AG039449)the Carlos Slim Foundation de la Salud(all to SGT)supported by DFG grant KFO 243/1.
文摘Vascularized composite tissue allotransplantation(VCA)offers treatment options of complex functional deficiencies that cannot be repaired with conventional reconstructive methods.VCAs consist of blocks of functional units comprising different tissue types such as skin,bone,muscle,nerves,blood vessels,tendons,ligaments and others,and are thus substantially different from the composition of organ transplants.The field of VCA has made fascinating progresses in the recent past.Among other VCAs,numerous successful hand,face and limb transplants have been performed in the world.At the same time,specific questions in regard to innate and adaptive immunity,consequences of ischemia/reperfusion injury,immunosuppression,preservation,and regenerative capacity remain.In spite of this,the field is poised to make significant advances in the near future.
基金supported by San Paolo Bank Foundation and Piemonte Region
文摘It is today widely acknowledged that nerve repair is now more than a matter of perfect microsurgical reconstruction only and that, to further improve clinical outcome, the involvement of different scientific disciplines is required. This evolving reconstructive/regenerative approach is based on the interdisciplinary and integrated pillars of tissue engineering such as reconstructive microsurgery, transplantation and biomaterials. In this paper, some of the most promising innovations for the tissue engineering of nerves, emerging from basic science investigation, are critically overviewed with special focus on those approaches that appear today to be more suitable for clinical translation.
基金supported by the Key Research and Development Program of Hunan Province(Grant Number 2021DK2003)the National Natural Science Foundation of China(Grant Number 81891000)+1 种基金Fundamental Research Funds of the Central Universities(Grant Number 521119200010)Strategic Priority Research Program of the Chinese Academy of Sciences(Grant Numbers XDA16040601,XDA16040704).
文摘Transplantation of adult spinal cord tissue(aSCT)is a promising treatment for spinal cord injury(SCI)basing on various types of neural cells and matrix components inside aSCT.However,long-term systemic administration of immunosuppressors(e.g.tacrolimus,TAC)is required for the survival of allogeneic tissue,which often associated with severe side effects such as infection,liver damageand renal failure.In this study,a triglycerol monostearate(TGM)-based TAC delivery system(e.g.TAC@TGM)with high drug loading concentration was developed,which possessed injectable properties as well as sustainable and immune-responsive drug release behaviors.In complete transected SCI model,locally injected TAC@TGM could reduce the infiltration of inflammation cells,enhance the survival of transplanted aSCT(e.g.Tuj-1^(+)and NF^(+)neurons)and promote the recovery of locomotor function.Moreover,controlled release of TAC by TAC@TGM attenuated side effects of TAC on liver and kidneys compared with traditional systemic administration.More importantly,the developed TAC@TGM system provided a facile single dose of long-term immunosuppressive effect not just for aSCT transplantation,but also for other tissue/organ and cell transplantations.
文摘Nowadays, fat transfer is an accepted technique that has been popularized in clinical practice, during which large volumes of fat are strategically relocated to increase and improve the contour of the body. In the present study, we investigated the histological and morphometric changes after large volumes of fat were grafted within the subcutaneous cellular tissue. An experimental study was designed using four 3-month-old male pigs. One hundred cc of decanted fat tissue was transferred into the right leg. Volume augmentation achieved by auto lipo-injecting within the subcutaneous cellular tissue persisted up to two months. Although there is a reduction in cell number and size, an increased amount of extracellular matrix and the presence of oily cysts and microcalcifications were observed. <strong>Conclusion:</strong> The volume augmentation, which is achieved by autologous fat transfer in large quantities in subcutaneous cellular tissue, can remain for months.
文摘Face transplant(FT)has evolved enormously in the last 10 years since the successful completion of the first facial transplant.This procedure has become a new reconstructive option for complex facial deformities to restore the anatomy of patients with severely disfigured faces.The authors review the literature and discuss the main surgical,immunological,and ethical aspects as well as the results described in patients undergoing FT.To date there have been more than thirty FT worldwide.The main indication was post-traumatic deformity.In all cases a standard immunosuppression was performed with three drugs,although acute rejection episodes were observed,that could be controlled with conventional immunosuppressive regimen.Overall,functional and aesthetic results have been excellent at short-term and high satisfaction rate exceeded initial expectations,although long-term data are still scarce.Major complications were opportunistic infections.Five deaths that occurred have reopened the ethical debate about the potential complications and concerns of providing informed consent to recipients.Continuous progresses in microsurgical techniques and preoperative planning have promoted the evolution from partial to full FT.All these are on the basis of accurate and careful selection of well-motivated candidates.The next challenge will be getting new immunosuppressive treatment strategies.Although clinical experience has demonstrated the FT viability,it is still considered an experimental procedure in which we have much to learn to define its true role in the current reconstructive surgery and resolve major technical,medical and ethical problems involved.
文摘Vascularized lymph node transfers(VLNT)are useful options for the surgical treatment of lymphedema.Conventional VLNT does not include the reconstruction of physiological lymphatic outflow,which may pose a risk of postoperative lymphatic vessel obstruction and lymph node sclerosis.We report a case of lymph flow bypass reconstruction using a superficial circumflex Iliac artery perforator(SCIP)flap,including VLNT with efferent lymphatico-lymphatic anastomosis.A 63-year-old female with severe right upper extremity lymphedema after mastectomy was reconstructed using a SCIP free flap,which included a vascularized lymph node elevated from the left groin area and transferred to the right axilla area.The SCIP vessels were anastomosed to the medial intercostal artery perforator vessels and the efferent lymphatic vessel from the vascularized lymph node was anastomosed to the internal mammary lymphatic vessels using supermicrosurgical technique.Indocyanine green lymphography showed the reconstructed lymphatic flow from the right hand to the right internal mammary lymphatics through the transferred flap.Postoperatively,lymphedema improved and there was no lymphedema at the donor site with a 2-year follow-up.Lymphatic flow bypass reconstruction using VLNT with efferent lymphatico-lymphatic anastomosis may provide a useful option for the treatment of severe lymphedema.
