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Transplantation Technologies & Research

ISSN: 2161-0991

Open Access

Article in Press

Volume 10, Issue 3 (2020)

    Editorial Pages: 1 - 2

    Collapsing Glomerulopathy in Transplanted Kidneys: Only a Tip of the Iceberg?

    Muhammed Mubarak

    Renal transplantation is the treatment of choice for patients with end-stage renal disease (ESRD) from a variety of causes. Although the short term results of renal transplantation have improved remarkably during the recent past, the long term outcomes have not improved to the same extent [1]. The long term success is marred by the occurrence of gradual onset of the often irreversible graft parenchymal scarring process, previously called as chronic allograft nephropathy (CAN), and now replaced by the term interstitial fibrosis/tubular atrophy (IF/TA) by the Banff group [2]. The later complication is multifactorial in origin and is the final common pathway resulting from both immune and non-immune mechanisms of graft injury [1,2]. Among the non-immune causes, the occurrence of recurrent or de novo renal diseases, especially the glomerulopathies, is of particular concern, as the frequency of this complication tends to rise with increasing post transplantation duration and is one of the major causes of IF/TA in the long run.

    Research Article Pages: 1 - 4

    Human T-Cell Lymphoma Virus-Positive Allograft Used For Effective Orthotopic Liver Transplantation: A Case Report and Review of the Literature

    TR Harring, NT Nguyen, JA Goss and CA O’Mahony

    Introduction: The human T-cell lymphoma virus was screened for previously in organ donors secondary to concern for progressive disease in an immunocompromised host. However, due to the low prevalence of the virus, a shortage of suitable allografts, and the lack of a time-effective test, this practice has been abandoned in the United States. The human T-cell lymphoma virus type-I may cause progression to several diseases, including human T-cell lymphoma virus-associated myelopathy, and adult T-cell lymphoma/leukemia. Moreover, there is an overall lack of data relating to the safety profile in the medical literature with use of human T-cell lymphoma virus-positive allografts.

    Aim: To determine the safety of human T-cell lymphoma virus-positive allografts in orthotopic liver transplantation.

    Materials and Methods: Our database was queried for recipients of known human T-cell lymphoma virus-positive allografts at time of transplantation. We present one patient case report followed by a review of the medical literature.

    Results: The patient was transplanted secondary to cirrhosis due to alcohol and hepatitis-C virus infection with hepatocellular carcinoma. When a suitable allograft became available, the patient was advised that it was human T-cell lymphoma virus type I-positive. The risks and benefits were discussed thoroughly with the patient and he elected to proceed with the operation. His operation and post-operative course were unremarkable. He continues to do well during on follow-up of over 777 days, and currently he has no symptoms of any human T-cell lymphoma virusassociated disease. Review of the medical literature demonstrates few reports on human T-cell lymphoma virusrelated complications after orthotopic liver transplantation; however, there are theories that immunosuppresion may cause progressive disease in these patients.

    Conclusions: Human T-cell lymphoma virus type I-positive donors can be life-saving sources of allografts. Our center supports the use of these allografts in patients that otherwise continue to be on the waiting list.

    Volume 11, Issue 1 (2021)

      Research Article Pages: 1 - 5

      24-Hour Rat Hind Limb Preservation Using a 3D-Printed Subnormothermic Portable Machine Perfusion Device

      Rafael J Veraza, Jaclyn Merlo, Jerry Gelineau and Leonid Bunegin*

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      Background: Currently, severed limbs after combat or traumatic injuries are preserved with cold ischemic storage. However, this method maintains limb viability for no more than 12 hours. In this study, a new device, referred to as the Universal Limb Stasis System for Extended Storage (ULiSSES™), was used to maintain rodent skeletal muscle viability for 24 hours, after 4 hours of ambient temperature ischemia.

      Methods: Hind-limbs from 5 Sprague Dawley rats were recovered and allowed to lie on a counter for approximately 4 hours at room temperature (19-24oC) to simulate delayed limb recovery. Limbs were then perfused for 24 hours using room temperature Krebs Henseleit solution. Arterial and venous pressure, flow, PaO2, PvO2, perfusate pH, and temperature were recorded hourly.

      Results: Ambient ischemia time was 3.4 ± 0.5 hours. Perfusion pressure was 8.2 ± 2.0 mmHg with a mean flow to the limbs of 9.5 ± 5.0 ml/min. The pH and temperature of the KH perfusate were stable throughout preservation at 7.38 ± 0.05 and 23.7 ± 0.5ºC, respectively. Oxygen consumption reached a plateau of 0.28 ± 0.04 ml O2/min/100 g by 17 hours with vascular resistance hovering around 1.0 ± 0.2 mmHg/ml/min initially, then declining by about 50% after 18 hours. Mean limb weight gain was 37.7 ± 31.8%.

      Conclusions: ULiSSES™ appears to open the potential for stabilization and preservation of avulsed limbs for 24 hours or longer, leading to the feasibility of costeffective transport from any recovery site to any re-plantation site with minimal tissue deterioration. 

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