Pre-transplant immune state defined by serum markers and alloreactivity predicts acute rejection after living donor kidney transplantation.

PubMed

Vondran, Florian W R; Timrott, Kai; Kollrich, Sonja; Steinhoff, Ann-Kristin; Kaltenborn, Alexander; Schrem, Harald; Klempnauer, Juergen; Lehner, Frank; Schwinzer, Reinhard

2014-09-01

Acute rejection (AR) remains a major cause for long-term kidney allograft failure. Reliable immunological parameters suitable to define the pre-transplant immune state and hence the individual risk of graft rejection are highly desired to preferably adapt the immunosuppressive regimen in advance. Donor and third party alloreactivities were determined by mixed lymphocyte cultures. Soluble forms of CD25, CD30, and CD44 were detected in patients' serum by ELISA. Various lymphocyte subpopulations were measured using flow cytometry. All patients received triple immunosuppression (tacrolimus/mycophenolate mofetil/steroids) and were grouped according to biopsy results within the first year: rejection-free (RF, n = 13), borderline (BL, n = 5), or acute rejection (AR, n = 7). Patients with AR showed the highest pre-transplant alloreactivities and serum levels (sCD25/sCD30/sCD44) according to the pattern RF < BL < AR. Relying on serum analysis only, multivariate logistic regression (logit link function) yielded a prognostic score for prediction of rejection with 75.0% sensitivity and 69.2% specificity. Patients with rejection showed markedly higher pre-transplant frequencies of CD4(+) /CD8(+) T cells lacking CD28, but lower numbers of CD8(+) CD161(bright) T cells and NK cells than RF individuals. Pre-transplant immune state defined by alloreactivity, serum markers, and particular lymphocyte subsets seems to correlate with occurrence of graft rejection after kidney transplantation. A prognostic score based on pre-transplant serum levels has shown great potential for prediction of rejection episodes and should be further evaluated. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Evaluation of pretransplant immunologic status in kidney-transplant recipients by panel reactive antibody and soluble CD30 determinations.

PubMed

Cinti, Paola; Pretagostini, Renzo; Arpino, Alessia; Tamburro, Maria Luisa; Mengasini, Sonia; Lattanzi, Roberto; De Simone, Paolo; Berloco, Pasquale; Molajoni, Elvira Renna

2005-05-15

To retrospectively compare the accuracy of pretransplant panel of reactivity antibodies (PRA) and serum level of soluble CD30 (sCD30) in predicting early (<6 months) acute rejection (AR) in living-donor and deceased-donor kidney-transplant (KT) patients. Pretransplant sera of 24 KT recipients were retrospectively tested for sCD30 and compared with PRA. Inclusion criteria were de novo graft patients on calcineurin-inhibitor-based immunosuppression, minimum follow-up of 1 year, alive with a functioning graft, and stable renal function over the last 12 months. Objective measures were incidence of biopsy-proven AR (BPAR) within 6 months of KT and sCD30 and PRA diagnostic indexes. The relative risk (RR) of BPAR for each test was also obtained. Fourteen (58.3%) patients presented at least one episode of BPAR within 6 months of KT. All rejection episodes were responsive to steroid treatment. PRA was positive in six (25%) patients, and four (66.7%) of them presented at least one episode of BPAR. sCD30 tested positive in nine (37.5%) patients, and all these later presented at least one episode of BPAR. sCD30 and PRA diagnostic indexes in predicting early (< 6months) BPAR were sensitivity 64.2% versus 28.5%; specificity 100% versus 80%; accuracy 79.1% versus 50%; positive predictive value 100% versus 66.6%; and negative predictive value 66.6% versus 44.4%. The RR of early AR was 1.4 in PRA-positive patients and extremely higher in the sCD30-positive group. Pretransplant sCD30 is a more accurate predictor of AR when compared with PRA. These results support its use in the pretransplant work-up of kidney-graft recipients.

Evaluation of pretransplant immunologic status in kidney-transplant recipients by panel reactive antibody and soluble CD30 determinations.

PubMed

Cinti, Paola; Pretagostini, Renzo; Arpino, Alessia; Tamburro, Maria Luisa; Mengasini, Sonia; Lattanzi, Roberto; De Simone, Paolo; Berloco, Pasquale; Molajoni, Elvira Renna

2005-03-15

To retrospectively compare the accuracy of pretransplant panel of reactivity antibodies (PRA) and serum level of soluble CD30 (sCD30) in predicting early (< 6 months) acute rejection (AR) in living-donor and deceased-donor kidney-transplant (KT) patients. Pretransplant sera of 24 KT recipients were retrospectively tested for sCD30 and compared with PRA. Inclusion criteria were de novo graft patients on calcineurin-inhibitor-based immunosuppression, minimum follow-up of 1 year, alive with a functioning graft, and stable renal function over the last 12 months. Objective measures were incidence of biopsy-proven AR (BPAR) within 6 months of KT and sCD30 and PRA diagnostic indexes. The relative risk (RR) of BPAR for each test was also obtained. Fourteen (58.3%) patients presented at least one episode of BPAR within 6 months of KT. All rejection episodes were responsive to steroid treatment. PRA was positive in six (25%) patients, and four (66.7%) of them presented at least one episode of BPAR. sCD30 tested positive in nine (37.5%) patients, and all these later presented at least one episode of BPAR. sCD30 and PRA diagnostic indexes in predicting early (< 6 months) BPAR were sensitivity 64.2% versus 28.5%; specificity 100% versus 80%; accuracy 79.1% versus 50%; positive predictive value 100% versus 66.6%; and negative predictive value 66.6% versus 44.4%. The RR of early AR was 1.4 in PRA-positive patients and extremely higher in the sCD30-positive group. Pretransplant sCD30 is a more accurate predictor of AR when compared with PRA. These results support its use in the pretransplant work-up of kidney-graft recipients.

High pre-transplant soluble CD30 levels are predictive of the grade of rejection.

PubMed

Rajakariar, Ravindra; Jivanji, Naina; Varagunam, Mira; Rafiq, Mohammad; Gupta, Arun; Sheaff, Michael; Sinnott, Paul; Yaqoob, M M

2005-08-01

In renal transplantation, serum soluble CD30 (sCD30) levels in graft recipients are associated with increased rejection and graft loss. We investigated whether pre-transplant sCD30 concentrations are predictive of the grade of rejection. Pre-transplant sera of 51 patients with tubulointerstitial rejection (TIR), 16 patients with vascular rejection (VR) and an age-matched control group of 41 patients with no rejection (NR) were analyzed for sCD30. The transplant biopsies were immunostained for C4d. The median sCD30 level was significantly elevated in the group with VR (248 Units (U)/mL, range: 92-802) when compared with TIR (103 U/mL, range: 36-309, p<0.001) and NR (179 U/mL, range: 70-343, p<0.03). Moreover, patients with TIR had significantly lower sCD30 levels compared to NR. Based on C4d staining, a TH2 driven process, the median sCD30 levels were significantly raised in C4d+ patients compared with C4d- group (177 U/mL vs. 120 U/mL, p<0.05). sCD30 levels measured at time of transplantation correlate with the grade of rejection. High pre-transplant levels are associated with antibody-mediated rejection which carries a poorer prognosis. sCD30 could be another tool to assess immunological risk prior to transplantation and enable a patient centered approach to immunosuppression.

Excimer UV lamp irradiation induced grafting on synthetic polymers

NASA Astrophysics Data System (ADS)

Praschak, D.; Bahners, T.; Schollmeyer, E.

Surface modifications on polyethyleneterephthalate (PET) films following excimer UV lamp irradiation induced grafting were studied. Characteristics of the modifications depending on the conditions during the irradiation were analysed using contact-angle measurements, X-ray photoelectron spectroscopy (XPS), atomic force microscopy (AFM), differential scanning calorimetry (DSC) and Fourier-transform infrared spectroscopy (FTIR). Depending on the conditions during the irradiation different surface modifications were obtained, which can generally be classified regarding the hydrophilic or hydrophobic characteristics of the resulting surface. It is shown that not every substance that meets the general demands will be grafted on synthetic polymers using excimer UV radiation. Examples of agents that can simply be grafted onto polymer surfaces and those that undergo further crosslinking, building up thin films are listed. Agents used for grafting on polymers are 1,5-hexadiene, perfluoro-4-methyl-pent-2-ene, polyethyleneglycol 200, monosilane and polyethylene. The transferability of the effects achieved to substrates such as polyparaphenylene terephthalamide or polymetaphenylene isophthalamide is shown.

Grafting of styrene into pre-irradiated fluoropolymer films: Influence of base material and irradiation temperature

NASA Astrophysics Data System (ADS)

Lappan, Uwe; Geißler, Uwe; Gohs, Uwe; Uhlmann, Steffi

2010-10-01

In this study, the influence of irradiation temperature on mechanical properties of three fluoropolymers and on grafting of styrene into the polymers by the pre-irradiation method was investigated. Electron paramagnetic resonance spectroscopy and infrared spectroscopy were used to characterize the irradiated polymers regarding trapped radical species and changes in the chemical structure, respectively. For poly(tetrafluoroethylene-co-perfluoropropyl vinyl ether) (PFA) the irradiation temperature was found to be an important factor for tensile strength and elongation at break of the pre-irradiated film. No strong effect of irradiation temperature on the mechanical properties was noticed for poly(tetrafluoroethylene-co-ethylene) (ETFE); however the yield of grafting drops at high irradiation temperatures. Finally, mechanical properties of poly(tetrafluoroethylene) (PTFE) were found to be dramatically altered, even if the film was irradiated at elevated temperature.

Risk factors for urinary tract infection after renal transplantation and its impact on graft function in children and young adults.

PubMed

Silva, Andres; Rodig, Nancy; Passerotti, Carlo P; Recabal, Pedro; Borer, Joseph G; Retik, Alan B; Nguyen, Hiep T

2010-10-01

Urinary tract infection will develop in 40% of children who undergo renal transplantation. Post-transplant urinary tract infection is associated with earlier graft loss in adults. However, the impact on graft function in the pediatric population is less well-known. Additionally the risk factors for post-transplant urinary tract infection in children have not been well elucidated. The purpose of this study was to assess the relationship between pre-transplant and post-transplant urinary tract infections on graft outcome, and the risk factors for post-transplant urinary tract infection. A total of 87 patients underwent renal transplantation between July 2001 and July 2006. Patient demographics, cause of renal failure, graft outcome, and presence of pre-transplant and post-transplant urinary tract infections were recorded. Graft outcome was based on last creatinine and nephrological assessment. Median followup was 3.12 years. Of the patients 15% had pre-transplant and 32% had post-transplant urinary tract infections. Good graft function was seen in 60% of the patients and 21% had failed function. Graft function did not correlate with a history of pre-transplant or post-transplant urinary tract infection (p >0.2). Of transplanted patients with urological causes of renal failure 57% had post-transplant urinary tract infection, compared to only 20% of those with a medical etiology of renal failure (p <0.001). In this study there was no correlation between a history of urinary tract infection (either before or after transplant) and decreased graft function. History of pre-transplant urinary tract infection was suggestive of urinary tract infection after transplant. Patients with urological causes of renal failure may be at increased risk for post-transplant urinary tract infection. Copyright © 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

THE VASCULAR PATHOPHYSIOLOGY OF AN IRRADIATED GRAFT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rubin, P.; Casarett, G.; Grise, J.W.

1960-06-01

The difference in the vascularization of grafted and normal skin forms a reasonable basis for explaining the differences in the radiation reactions of these structures. The radioisotope half time of disappearance following subcutaneous injection is an index of vascular integrity of the graft and serves as a parameter to predict its radioresponsiveness. In developing a concept of the spectrum of reactions of grafted skin to ionizing irradiation, knowledge of the radiopathologic changes in capillaries must be utilized with knowledge of the histophysiology of the vascularity of an autograft. (auth)

Preparation of vinyl acetate grafted natural rubber by irradiation method

DOE Office of Scientific and Technical Information (OSTI.GOV)

Porntrairat, A.; Pattamaprom, C.

Improvement in properties of natural rubber could be done by several methods. In this research, gamma radiation technique, which is simple, accurate, easy to control and clean, was applied to enhance the properties of natural rubber (NR) in latex state. The purpose of this research is to study the appropriate condition for preparing grafted natural rubber latex by using irradiation method. Vinyl acetate monomers (VAc) were grafted onto natural rubber latex (NR-g-PVAc) at 0-10 kGys by gamma radiation from Cobalt-60 source at room temperature. Physical properties of grafted natural rubber such as chloroform number, swelling ratio and gel content weremore » measured. The VAc content of NR-g-PVAc was investigated by titration and visualized by FTIR spectroscopy. The FTIR spectra of NR-g-PVAc prepared at 0-10 kGys showed characteristic peaks of the vinyl acetate confirming that VAc could be grafted onto natural rubber molecular chains effectively under appropriate irradiation conditions. From the result, radiation grafting was found to be a useful technique for grafting of vinyl acetate onto natural rubber.« less

Impact of pre-transplant depression on outcomes of allogeneic and autologous hematopoietic stem cell transplantation.

PubMed

El-Jawahri, Areej; Chen, Yi-Bin; Brazauskas, Ruta; He, Naya; Lee, Stephanie J; Knight, Jennifer M; Majhail, Navneet; Buchbinder, David; Schears, Raquel M; Wirk, Baldeep M; Wood, William A; Ahmed, Ibrahim; Aljurf, Mahmoud; Szer, Jeff; Beattie, Sara M; Battiwalla, Minoo; Dandoy, Christopher; Diaz, Miguel-Angel; D'Souza, Anita; Freytes, Cesar O; Gajewski, James; Gergis, Usama; Hashmi, Shahrukh K; Jakubowski, Ann; Kamble, Rammurti T; Kindwall-Keller, Tamila; Lazarus, Hilard M; Malone, Adriana K; Marks, David I; Meehan, Kenneth; Savani, Bipin N; Olsson, Richard F; Rizzieri, David; Steinberg, Amir; Speckhart, Dawn; Szwajcer, David; Schoemans, Helene; Seo, Sachiko; Ustun, Celalettin; Atsuta, Yoshiko; Dalal, Jignesh; Sales-Bonfim, Carmem; Khera, Nandita; Hahn, Theresa; Saber, Wael

2017-05-15

To evaluate the impact of depression before autologous and allogeneic hematopoietic cell transplantation (HCT) on clinical outcomes post-transplantation. We analyzed data from the Center for International Blood and Marrow Transplant Research to compare outcomes after autologous (n = 3786) or allogeneic (n = 7433) HCT for adult patients with hematologic malignancies with an existing diagnosis of pre-HCT depression requiring treatment versus those without pre-HCT depression. Using Cox regression models, we compared overall survival (OS) between patients with or without depression. We compared the number of days alive and out of the hospital in the first 100 days post-HCT using Poisson models. We also compared the incidence of grade 2-4 acute and chronic graft-versus-host disease (GVHD) in allogeneic HCT. The study included 1116 (15%) patients with pre-transplant depression and 6317 (85%) without depression who underwent allogeneic HCT between 2008 and 2012. Pre-transplant depression was associated with lower OS (hazard ratio [HR], 1.13; 95% confidence interval [CI], 1.04-1.23; P = 0.004) and a higher incidence of grade 2-4 acute GVHD (HR, 1.25; 95% CI, 1.14-1.37; P < 0.0001), but similar incidence of chronic GVHD. Pre-transplant depression was associated with fewer days-alive-and-out-of-the hospital (means ratio [MR] = 0.97; 95% CI, 0.95-0.99; P = 0.004). There were 512 (13.5%) patients with Pre-transplant depression and 3274 (86.5%) without depression who underwent autologous HCT. Pre-transplant depression in autologous HCT was not associated with OS (HR, 1.15; 95% CI, 0.98-1.34; P = 0.096) but was associated with fewer days alive and out of the hospital (MR, 0.98; 95% CI, 0.97-0.99; P = 0.002). Pre-transplant depression was associated with lower OS and higher risk of acute GVHD among allogeneic HCT recipients and fewer days alive and out of the hospital during the first 100 days after autologous and allogeneic HCT. Patients with pre-transplant

Pre-Transplant Screening for Latent Adenovirus in Donors and Recipients

PubMed Central

Piatti, Gabriella

2016-01-01

Human adenoviruses are frequent cause of slight self-limiting infections in immune competent subjects, while causing life-threatening and disseminated diseases in immunocompromised patients, particularly in the subjects affected by acquired immunodeficiency syndrome and in bone marrow and organ transplant recipients. Here, infections interest lungs, liver, encephalon, heart, kidney and gastro enteric tract. To date, human adenoviruses comprise 51 serotypes grouped into seven species, among which species C especially possesses the capability to persist in infected tissues. From numerous works, it emerges that in the recipient, because of loss of immune-competence, both primary infection, via the graft or from the environment, and reactivated endogenous viruses can be responsible for transplantation related adenovirus disease. The transplants management should include the evaluation of anti-adenovirus pre-transplant screening similar to that concerning cytomegalovirus. The serological screening on cytomegalovirus immunity is currently performed to prevent viral reactivation from grafts and recipient, the viral spread and dissemination to different organs and apparatus, and potentially lethal outcome. PMID:27006724

500-Gray γ-Irradiation May Increase Adhesion Strength of Lyophilized Cadaveric Split-Thickness Skin Graft to Wound Bed.

PubMed

Wei, Lin-Gwei; Chen, Chieh-Feng; Wang, Chi-Hsien; Cheng, Ya-Chen; Li, Chun-Chang; Chiu, Wen-Kuan; Wang, Hsian-Jenn

2017-03-01

Human cadaveric skin grafts are considered as the "gold standard" for temporary wound coverage because they provide a more conductive environment for natural wound healing. Lyophilization, packing, and terminal sterilization with gamma-ray can facilitate the application of cadaveric split-thickness skin grafts, but may alter the adhesion properties of the grafts. In a pilot study, we found that 500 Gy γ-irradiation seemed not to reduce the adherence between the grafts and wound beds. We conducted this experiment to compare the adherences of lyophilized, 500-Gy γ-irradiated skin grafts to that of lyophilized, nonirradiated grafts. Pairs of wounds were created over the backs of Sprague- Dawley rats. Pairs of "lyophilized, 500-Gy γ-irradiated" and "lyophilized, nonirradiated" cadaveric split-thickness skin grafts were fixed to the wound beds. Adhesion strength between the grafts and the wound beds was measured and compared. On post-skin-graft day 7 and day 10, the adhesion strength of γ-irradiated grafts was greater than that of the nonirradiated grafts. Because lyophilized cadaveric skin grafts can be vascularized and the collagen of its dermal component can be remodeled after grafting, the superior adhesion strength of 500-Gy γ-irradiated grafts can be explained by the collagen changes from irradiation.

Pre-transplant course and risk of kidney transplant failure in IgA nephropathy patients.

PubMed

Bjørneklett, Rune; Vikse, Bjørn Egil; Smerud, Hilde Kloster; Bostad, Leif; Leivestad, Torbjørn; Hartmann, Anders; Iversen, Bjarne M

2011-01-01

There is lack of knowledge to what degree clinical/morphological presentation and course of IgA nephropathy (IgAN) prior to end-stage renal disease are risk factors for graft loss after kidney transplantation. Patients with IgAN between 1988 and 2006 (registered in the Norwegian Kidney Biopsy Registry) who later received a kidney transplant (registered in the Norwegian Renal Registry) were included. The cohort was followed up regarding death-censored graft loss throughout 2008. Graft survival with a rapid progressive (RP) vs. a slow progressive (SP) course of pre-Tx IgAN (annual GFR > or <30 mL/min/1.73 m(2) ) was studied. Among 106 included patients, there were 14 graft losses giving a graft loss rate of 1.9/100 patient years. Follow-up until the first kidney transplant was 6.9 ± 4.4 (range 0.1-19) yr. Patients with pre-Tx RP had a higher graft loss rate compared with SP patients (6.3 vs.1.3/100 patient years, p < 0.001). Graft loss rate with living-related donor (LRD) was similar to unrelated donor (UD) grafts. Most RP patients had received LRD grafts, and in SP patients, graft survival with LRD grafts was better than UD grafts (0.3 vs.2.1/100 patient years, p = 0.055). A rapid pre-transplant course is a strong risk factor for transplant failure in patients with IgAN. © 2011 John Wiley & Sons A/S.

The possible critical role of T-cell help in DSA-mediated graft loss.

PubMed

Süsal, Caner; Slavcev, Antonij; Pham, Lien; Zeier, Martin; Morath, Christian

2018-06-01

In this review, we discuss a possible central role of T-cell help in severe forms of graft damage mediated by donor-specific HLA antibodies (DSA). Some kidney transplant recipients with pretransplant DSA show a high graft failure rate, whereas in other patients DSA do not harm the transplanted kidney and in most cases, disappear shortly after transplantation. Analyzing 80 desensitized highly immunized kidney transplant recipients and another multicenter cohort of 385 patients with pretransplant HLA antibodies, we reported recently that an ongoing T-cell help from an activated immune system, as measured by an increased level of soluble CD30 in serum, might be necessary for the DSA to exert a deleterious effect. Patients positive for both pretransplant DSA and sCD30 appear to require special measures, such as the elimination of DSA from the circulation, potent immunosuppression, good HLA-matching, and intense post-transplant monitoring, whereas exclusion of DSA-positive patients from transplantation in the absence of high sCD30 may not be justified in all cases, even if the pretransplant DSA are strong and complement-activating. © 2018 Steunstichting ESOT.

Solvent effect on post-irradiation grafting of styrene onto poly(ethylene-alt-tetrafluoroethylene) (ETFE) films

NASA Astrophysics Data System (ADS)

Napoleão Geraldes, Adriana; Augusto Zen, Heloísa; Ribeiro, Geise; Fernandes Parra, Duclerc; Benévolo Lugão, Ademar

2013-03-01

Radiation-induced grafting of styrene onto ETFE films in different solvent was investigated after simultaneous irradiation (in post-irradiation condition) using a 60Co source. Grafting of styrene followed by sulfonation onto poly(ethylene-alt-tetrafluoroethylene) (ETFE) are currently studied for synthesis of ion exchange membranes. The ETFE films were immersed in styrene/toluene, styrene/methanol and styrene/isopropyl alcohol and irradiated at 20 and 100 kGy doses at room temperature. The post-irradiation time was established at 14 day and the grafting degree was evaluated. The grafted films were sulfonated using chlorosulfonic acid and 1,2-dichloroethane 20:80 (v/v) at room temperature for 5 h. The degree of grafting (DOG) was determined gravimetrically and physical or chemical changes were evaluated by differential scanning calorimeter analysis (DSC), thermogravimetric analysis (TGA) and scanning electron microscopy (SEM). The ion exchange capacity (IEC) values showed the best performance of sulfonation for ETFE membranes grafted in toluene solvent. Surface images of the grafted films by SEM technique have presented a strong effect of the solvents on the films morphology.

DIFFERENTIAL RESPONSE TO ALLOGENIC AND XENOGENIC SKIN GRAFTS BY SUBLETHALLY IRRADIATED (670 RAD) AND NON-IRRADIATED MICE SENSITIZED BY VARIOUS MEANS

DTIC Science & Technology

consecutive BALB/c or rat skin tail grafts. One week following the last injection or the rejection of the second, skin graft , the mice either were grafted...resulted in prolonged survival of subsequent allogenic skin grafts in sublethally irradiated mice. The second-set response to a xenogenic skin graft was

Determinants of graft survival in pediatric and adolescent live donor kidney transplant recipients: a single center experience.

PubMed

El-Husseini, Amr A; Foda, Mohamed A; Shokeir, Ahmed A; Shehab El-Din, Ahmed B; Sobh, Mohamed A; Ghoneim, Mohamed A

2005-12-01

To study the independent determinants of graft survival among pediatric and adolescent live donor kidney transplant recipients. Between March 1976 and March 2004, 1600 live donor kidney transplants were carried out in our center. Of them 284 were 20 yr old or younger (mean age 13.1 yr, ranging from 5 to 20 yr). Evaluation of the possible variables that may affect graft survival were carried out using univariate and multivariate analyses. Studied factors included age, gender, relation between donor and recipient, original kidney disease, ABO blood group, pretransplant blood transfusion, human leukocyte antigen (HLA) matching, pretransplant dialysis, height standard deviation score (SDS), pretransplant hypertension, cold ischemia time, number of renal arteries, ureteral anastomosis, time to diuresis, time of transplantation, occurrence of acute tubular necrosis (ATN), primary and secondary immunosuppression, total dose of steroids in the first 3 months, development of acute rejection and post-transplant hypertension. Using univariate analysis, the significant predictors for graft survival were HLA matching, type of primary urinary recontinuity, time to diuresis, ATN, acute rejection and post-transplant hypertension. The multivariate analysis restricted the significance to acute rejection and post-transplant hypertension. The independent determinants of graft survival in live-donor pediatric and adolescent renal transplant recipients are acute rejection and post-transplant hypertension.

Modification on liquid retention property of cassava starch by radiation grafting with acrylonitrile. I. Effect of γ-irradiation on grafting parameters

NASA Astrophysics Data System (ADS)

Kiatkamjornwong, S.; Chvajarernpun, J.; Nakason, C.

1993-07-01

Radiation modification on liquid retention properties of native cassava starch, gelatinized at 85°C, by graft copolymerization with acrylonitrile was carried out by mutual irradiation to gamma-rays. A thin aluminum foil was used to cover the inner wall of the reaction vessel, so that the homopolymer concentration was reduced to be less than 1.0% with a distilled water retention value of 665 g/g of the dry weight of the saponified grafted product. Confirmation of graft copolymerization and saponification reactions was made by the infrared spectrophotometric technique. The combined effect of radiation parameters in terms of an irradiation time and a dose rate to the total dose on the extent of the grafting reaction expressed in terms of grafting parameters which directly influenced liquid retention values was evaluated in conjunction with statistical analysis.

The Kidney Donor Profile Index (KDPI) of Marginal Donors Allocated by Standardized Pre-Transplant Donor Biopsy Assessment: Distribution and Association with Graft Outcomes

PubMed Central

Gandolfini, I.; Buzio, C.; Zanelli, P.; Palmisano, A.; Cremaschi, E.; Vaglio, A.; Piotti, G.; Melfa, L.; La Manna, G.; Feliciangeli, G.; Cappuccilli, M.; Scolari, M.P.; Capelli, I.; Panicali, L.; Baraldi, O.; Stefoni, S.; Buscaroli, A.; Ridolfi, L.; D'Errico, A.; Cappelli, G.; Bonucchi, D.; Rubbiani, E.; Albertazzi, A.; Mehrotra, A.; Cravedi, P.; Maggiore, U.

2015-01-01

Pre-transplant donor biopsy (PTDB)-based marginal-donor allocation systems to single or dual renal transplantation could increase the use of organs with Kidney Donor Profile Index (KDPI) in the highest range (e.g. >80 or >90), whose discard rate approximates 50% in the US. To test this hypothesis, we retrospectively calculated the KDPI and analyzed the outcomes of 442 marginal kidney transplants (340 single transplants: 278 with a PTDB Remuzzi score <4 [median KDPI:87; interquartile range(IQR):78-94] and 62 with a score =4 [median KDPI:87; IQR:76-93]; 102 dual transplants [median KDPI: 93; IQR:86-96]) and 248 single standard transplant controls [median KDPI:36; IQR:18-51]. PTDB-based allocation of marginal grafts led to a limited discard rate of 15% for kidneys with KDPI of 80-90 and of 37% for kidneys with a KDPI of 91-100. Although 1-year eGFRs were significantly lower in recipients of marginal kidneys (-9.3, -17.9, and -18.8ml/min, for dual transplants, single kidneys with PTDB score <4, and =4, respectively; P<0.001), graft survival (median follow-up 3.3 years) was similar between marginal and standard kidney transplants (hazard ratio: 1.20 [95% confidence interval: 0.80 to 1.79; P=0.38]). In conclusion, PTDB-based allocation allows the safe transplantation of kidneys with KDPI in the highest range that may otherwise be discarded. PMID:25155294

The Kidney Donor Profile Index (KDPI) of marginal donors allocated by standardized pretransplant donor biopsy assessment: distribution and association with graft outcomes.

PubMed

Gandolfini, I; Buzio, C; Zanelli, P; Palmisano, A; Cremaschi, E; Vaglio, A; Piotti, G; Melfa, L; La Manna, G; Feliciangeli, G; Cappuccilli, M; Scolari, M P; Capelli, I; Panicali, L; Baraldi, O; Stefoni, S; Buscaroli, A; Ridolfi, L; D'Errico, A; Cappelli, G; Bonucchi, D; Rubbiani, E; Albertazzi, A; Mehrotra, A; Cravedi, P; Maggiore, U

2014-11-01

Pretransplant donor biopsy (PTDB)-based marginal donor allocation systems to single or dual renal transplantation could increase the use of organs with Kidney Donor Profile Index (KDPI) in the highest range (e.g. >80 or >90), whose discard rate approximates 50% in the United States. To test this hypothesis, we retrospectively calculated the KDPI and analyzed the outcomes of 442 marginal kidney transplants (340 single transplants: 278 with a PTDB Remuzzi score<4 [median KDPI: 87; interquartile range (IQR): 78-94] and 62 with a score=4 [median KDPI: 87; IQR: 76-93]; 102 dual transplants [median KDPI: 93; IQR: 86-96]) and 248 single standard transplant controls (median KDPI: 36; IQR: 18-51). PTDB-based allocation of marginal grafts led to a limited discard rate of 15% for kidneys with KDPI of 80-90 and of 37% for kidneys with a KDPI of 91-100. Although 1-year estimated GFRs were significantly lower in recipients of marginal kidneys (-9.3, -17.9 and -18.8 mL/min, for dual transplants, single kidneys with PTDB score<4 and =4, respectively; p<0.001), graft survival (median follow-up 3.3 years) was similar between marginal and standard kidney transplants (hazard ratio: 1.20 [95% confidence interval: 0.80-1.79; p=0.38]). In conclusion, PTDB-based allocation allows the safe transplantation of kidneys with KDPI in the highest range that may otherwise be discarded. © Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.

Pre-transplant angiotensin II type 1receptor antibodies: a risk factor for decreased kidney graft function in the early post-transplant period?

PubMed

Hernández-Méndez, Erick Alejandro; Arreola-Guerra, José Manuel; Morales-Buenrostro, Luis E; Ramírez, Julia B; Calleja, Said; Castelán, Natalia; Salcedo, Isaac; Vilatobá, Mario; Contreras, Alan G; Gabilondo, Bernardo; Granados, Julio; Alberú, Josefina

2014-01-01

Angiotensin II type 1 receptor antibodies (AT1Rab) are associated to a significantly lower graft survival and a higher risk of acute rejection after kidney transplantation. This study aimed to evaluate graft function and BPAR during the 1st year post-transplant (PT) in adult kidney transplant recipients (KTR), between 03/2009 and 08/2012. Pre-KT sera were screened for AT1Rab (ELISA) and HLA-DSA (Luminex). Three groups were analyzed: AT1Rab only (n = 13); HLA-DSA only (n = 8); and no AT1Rab or HLA-DSA (n = 90). No differences were observed in clinical characteristics across groups. A higher percentage of BPAR was observed in the AT1Rab positive group, but this difference was not significant. KTR with AT1Rab had a lower mean eGFR (20 mL/min/1.73m2) when compared to KTR with no Abs at 12 months. The significant difference in eGFR was observed since the 1st month PT. Multivariate analysis showed 4 factors independently and significantly associated with eGFR at 12mos PT: BPAR (-18.7 95%, CI -28.2 to -9.26, p<0.001), AT1Rab (-10.51, CI -20.9 to -0.095, p = 0.048), donor age (-0.42, CI -0.75 to -0.103 p = 0.010), and recipient age (-0.36, CI -0.67 to -0.048, p = 0.024). In this study AT1Rab in pre-transplant sera from KTR, was an independent and significant risk factor contributing to a lower eGFR 12 months. PT. This finding deserves to be confirmed in a larger KTR population.

Synthesis of perm-selective membranes by grafting acrylic acid into air-irradiated Teflon-FEP films

NASA Astrophysics Data System (ADS)

Bozzi, Annick; Chapiro, Adolphe

Grafting acrylic acid into air-irradiated Teflon-FEP films was investigated. Pre-irradiation doses ranged from 0.5 to 10 kGy. Grafting occurred at 45 or 60°C. Homopolymerization inhibitors, ferrous ions or methylene blue, were added to the system. It was found that after completion of the reaction, within 40-100 min, membranes were obtained with very low electric resistivities. The influence of added inhibitors, pre-irradiation dose and grafting temperature was studied. From the results it is concluded that the initiating centers in air-irradiated Teflon-FEP are, on the one hand, peroxides of structure POOP', in which P is a polymeric radical and Pprime; a small fragment, and on the other trapped PO .2 radicals. The latter only react after losing their oxygen. In the presence of polymerization inhibitors, initiation involves a redox process which reduces the overall activation energy.

Free bone graft reconstruction of irradiated facial tissue: Experimental effects of basic fibroblast growth factor stimulation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Eppley, B.L.; Connolly, D.T.; Winkelmann, T.

1991-07-01

A study was undertaken to evaluate the potential utility of basic fibroblast growth factor in the induction of angiogenesis and osseous healing in bone previously exposed to high doses of irradiation. Thirty New Zealand rabbits were evaluated by introducing basic fibroblast growth factor into irradiated mandibular resection sites either prior to or simultaneous with reconstruction by corticocancellous autografts harvested from the ilium. The fate of the free bone grafts was then evaluated at 90 days postoperatively by microangiographic, histologic, and fluorochrome bone-labeling techniques. Sequestration, necrosis, and failure to heal to recipient osseous margins was observed both clinically and histologically inmore » all nontreated irradiated graft sites as well as those receiving simultaneous angiogenic stimulation at the time of graft placement. No fluorescent activity was seen in these graft groups. In the recipient sites pretreated with basic fibroblast growth factor prior to placement of the graft, healing and reestablishment of mandibular contour occurred in nearly 50 percent of the animals. Active bone formation was evident at cortical margins adjacent to the recipient sites but was absent in the more central cancellous regions of the grafts.« less

Measurement of Gamma-Irradiated Corneal Patch Graft Thickness After Aqueous Drainage Device Surgery.

PubMed

de Luna, Regina A; Moledina, Ameera; Wang, Jiangxia; Jampel, Henry D

2017-09-01

Exposure of the tube of an aqueous drainage device (ADD) through the conjunctiva is a serious complication of ADD surgery. Although placement of gamma-irradiated sterile cornea (GISC) as a patch graft over the tube is commonly performed, exposures still occur. To measure GISC patch graft thickness as a function of time after surgery, estimate the rate of graft thinning, and determine risk factors for graft thinning. Cross-sectional study of graft thickness using anterior segment optic coherence tomography (AS-OCT) was conducted at the Wilmer Eye Institute at Johns Hopkins Hospital. A total of 107 patients (120 eyes, 120 ADDs) 18 years or older who underwent ADD surgery at Johns Hopkins with GISC patch graft between July 1, 2010, and October 31, 2016, were enrolled. Implantation of ADD with placement of GISC patch graft over the tube. Graft thickness vs time after ADD surgery and risk factors for undetectable graft. Of the 107 patients included in the analysis, the mean (SD) age of the cohort was 64 (16.2) years, 49 (45.8%) were male, and 43 (40.2%) were African American. The mean time of measurement after surgery was 1.7 years (range, 1 day to 6 years). Thinner grafts were observed as the time after surgery lengthened (β regression coefficient, -60 µm per year since surgery; 95% CI, -80 µm to -40 µm). The odds ratio of undetectable grafts per year after ADD surgery was 2.1 (95% CI, 1.5-3.0; P < .001). Age, sex, race, type of ADD, quadrant of ADD placement, diagnosis of uveitis or dry eye, and prior conjunctival surgery were not correlated with the presence or absence of the graft. Gamma-irradiated sterile corneal patch grafts do not always retain their integrity after ADD surgery. Data from this cross-sectional study showed that on average, the longer the time after surgery, the thinner the graft. These findings suggest that placement of a GISC patch graft is no guarantee against tube exposure, and that better strategies are needed for preventing this

Grafting poly(vinyl alcohol) onto polybutadiene rubber latex particles by pre-irradiation

NASA Astrophysics Data System (ADS)

Tian, Bo; Dong, Wei; Liu, Yuguang

2017-06-01

Poly(vinyl alcohol) (PVA) was grafted on polybutadiene rubber latex (PBL) particles (PB-g-PVA) by pre-irradiation via emulsion grafting copolymerization. The grafting degree (G%) increased almost linearly with the reaction time and the weight ratio of PVA to the PB latex, while decreased gradually when the irradiation dose is over 30 kGy and the reaction temperature is higher than 60 °C. The grafting efficiency (GE%) has the same trend of the G% but the weight ratio of PVA to PBL, GE% decreased with increasing of PVA adding to PB latex. FTIR spectroscopy indicated that the PVA was grafted onto the PB particles. The dynamic light scattering measurement showed that the particle size of PB-g-PVA particles was larger than that of the pristine PBL particles, and it increased with increment of G%. Transmission electron microscopy images of the PB-g-PVA latex particles demonstrated that the size of PB-g-PVA particle was enlarged by the layer of grafted PVA surrounding the PBL particles. Thermal behavior exhibited the phase separation in the PB-g-PVA films, Tg1 and Tg2 related to the PB and PVA respectively, both of which shifted to a higher temperature with increasing of G%, but the Tg2 was still lower than that of the virgin PVA. The increment of the surface free energy of PB-g-PVA films was attributed to the incorporation of the polar PVA, which also resulted in improvement of the hydrophilic properties.

Post-irradiation time effects on the graft of poly(ethylene-alt-tetrafluoroethylene) (ETFE) films for ion exchange membrane application

NASA Astrophysics Data System (ADS)

Geraldes, Adriana N.; Zen, Heloísa A.; Ribeiro, Geise; Ferreira, Henrique P.; Souza, Camila P.; Parra, Duclerc F.; Santiago, Elisabete I.; Lugão, Ademar B.

2010-03-01

Grafting of styrene followed by sulfonation onto poly(ethylene-alt-tetrafluoroethylene) (ETFE) was studied for synthesis of ion exchange membranes. Radiation-induced grafting of styrene onto ETFE films was investigated after simultaneous irradiation (in post-irradiation condition) using a 60Co source. The ETFE films were irradiated at 20 kGy dose at room temperature and chemical changes were monitored after contact with styrene for grafting. The post-irradiation time was established at 14 days when the films were remained in styrene/toluene 1:1 v/v. After this period the grafting degree was evaluated in the samples. The grafted films were sulfonated using chlorosulfonic acid and 1, 2-dichloroethane 20:80 (v/v) at room temperature for 5 h. The membranes were analyzed by infrared spectroscopy (FTIR), differential scanning calorimeter (DSC), thermogravimetric measurements (TG) and degree of grafting (DOG). The ion exchange capacity (IEC) of membranes was determined by acid-base titration and the values for ETFE membranes were achieved higher than Nafion ® films. Preliminary single cell performance was made using pure H 2 and O 2 as reactants at a cell temperature of 80 °C and atmospheric gas pressure. The fuel cell performance of ETFE films was satisfactory when compared to state-of-art Nafion ® membranes.

The use of irradiated corneal patch grafts in pediatric Ahmed drainage implant surgery.

PubMed

Nolan, Kaitlyn Wallace; Lucas, Jordyn; Abbasian, Javaneh

2015-10-01

To describe the use of irradiated cornea for scleral reinforcement in Ahmed glaucoma valve drainage implant (AGV) devices in children. The medical records of patients <18 years of age who underwent AGV surgery with irradiated cornea as scleral reinforcement were reviewed retrospectively. The primary outcome measure was erosion of the drainage tube through the corneal patch graft. Secondary outcome measures included other major complications: persistent inflammation, wound dehiscence, transmission of infectious disease, endophthalmitis, and tube/plate self-explantation. A total of 25 procedures (20 patients) met inclusion criteria. Average patient age was 70 months (range, 2 months to 17 years). Mean follow-up was 24.8 months (range, 6 months to 6.2 years). One tube experienced conjunctival exposure through two separate corneal grafts (2/25 cases [8%]), sequentially in the same eye. The first event occurred at month 3.5 after primary implantation of the tube shunt; the second erosion occurred following revision of the existing implant at month 1.5 postoperatively. There were 2 cases of auto-explantation, 2 cases of wound dehiscence, and 1 case of persistent inflammation. There were no cases of endophthalmitis or other infections. To our knowledge, this is the first report describing the use of corneal patch grafts in children. Irradiated cornea improves cosmesis and enhances visualization of the tube. The risk of tube exposure was found to be low and comparable to other materials used as a patch graft. Copyright © 2015 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

Impact of pre-transplant pulmonary hypertension on survival after heart transplantation: a UNOS registry analysis.

PubMed

Vakil, Kairav; Duval, Sue; Sharma, Alok; Adabag, Selcuk; Abidi, Kashan Syed; Taimeh, Ziad; Colvin-Adams, Monica

2014-10-20

Severe pre-transplant pulmonary hypertension (PH) has been associated with adverse short-term clinical outcomes after heart transplantation in relatively small single-center studies. The impact of pre-transplant PH on long-term survival after heart transplantation has not been examined in a large, multi-center cohort. Adults (≥18 years) who underwent first time heart transplantation in the United States between 1987 and 2012 were retrospectively identified from the United Network for Organ Sharing registry. Pre-transplant PH was classified as mild, moderate, or severe based on pulmonary vascular resistance (PVR), trans-pulmonary gradient (TPG), and pulmonary artery (PA) mean pressure. Primary outcome was all-cause mortality. Data from 26,649 heart transplant recipients (mean age 52±12 years; 76% male; 76% Caucasian) were analyzed. During a mean follow-up of 5.7±4.8 years, there were 10,334 (39%) deaths. Pre-transplant PH (PVR≥2.5 WU) was a significant predictor of mortality (hazard ratio 1.10, 95% confidence interval 1.05-1.14, p<0.0001) in multivariable analysis. However, the severity of pre-transplant PH (mild/moderate vs. severe) did not affect short or long-term survival. Similarly, even in patients who were supported with either a left ventricular assist device or a total artificial heart prior to transplant, severe pre-transplant PH was not associated with worse survival when compared to patients with mild/moderate pre-transplant PH. Pre-transplant PH (PVR≥2.5 WU) is associated with a modest increase in mortality when compared to patients without pre-transplant PH. However, the severity of pre-transplant PH, assessed by PVR, TPG, or mean PA pressure, is not a discriminating factor for poor survival in patients listed for heart transplantation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Long-term use and follow-up of irradiated homologous costal cartilage grafts in the nose.

PubMed

Kridel, Russell W H; Ashoori, Faramarz; Liu, Edmund S; Hart, Carol G

2009-01-01

In 1993, Kridel and Konior published a preliminary report (in the Archives of Otolaryngology-Head and Neck Surgery) on the use of irradiated homologous costal cartilage (IHCC) or homograft cartilage in the nose. This is a follow-up study to share our experience in answering fundamental questions: (1) What are the major long-term complications of IHCC, and are they any greater than with the use of the patient's own cartilage? (2) Is IHCC a reliable and safe implant? (3) Does IHCC resorb over time? (4) What measures are implemented in our practice to minimize the sequelae? We performed a retrospective review of patient medical charts in a university-affiliated private practice setting. A total of 357 patients underwent primary or revision rhinoplasty using IHCC grafts with postoperative follow-up duration ranging from 4 days to 24 years (mean [SD], 13.45 [2.83] years). A total of 1025 IHCC grafts and 373 other grafts (including 218 autogenous cartilage [AC] grafts) were used. A total of 201 grafts were dorsal onlay grafts, and 74 of them have been further followed up since the previous report. The grafts were evaluated for warping, infection, infective resorption, noninfective resorption, mobility, and extrusion. Patient satisfaction evaluation was performed in 42 patients. The total complication rate related to IHCC grafts was 3.25%, which included 10 warped grafts of 941 palpable or superficial IHCC grafts (1.06%), 9 infections of 1025 IHCC grafts (0.87%), 5 cases of infective resorption of 1025 IHCC grafts (0.48%), 5 noninfective resorptions of 943 palpable IHCC grafts (0.53%), and 3 cases of graft mobility of 941 palpable grafts (0.31%). Nine cases of local infection were treated and could have arisen from any of the 1025 IHCC grafts as well as from the 373 other grafts. Among the 9 cases of infection, in 2 patients IHCC grafts were used alone, and in 7 patients IHCC grafts were used in combination with other types of graft materials; therefore, the actual

Nomograms for predicting graft function and survival in living donor kidney transplantation based on the UNOS Registry.

PubMed

Tiong, H Y; Goldfarb, D A; Kattan, M W; Alster, J M; Thuita, L; Yu, C; Wee, A; Poggio, E D

2009-03-01

We developed nomograms that predict transplant renal function at 1 year (Modification of Diet in Renal Disease equation [estimated glomerular filtration rate]) and 5-year graft survival after living donor kidney transplantation. Data for living donor renal transplants were obtained from the United Network for Organ Sharing registry for 2000 to 2003. Nomograms were designed using linear or Cox regression models to predict 1-year estimated glomerular filtration rate and 5-year graft survival based on pretransplant information including demographic factors, immunosuppressive therapy, immunological factors and organ procurement technique. A third nomogram was constructed to predict 5-year graft survival using additional information available by 6 months after transplantation. These data included delayed graft function, any treated rejection episodes and the 6-month estimated glomerular filtration rate. The nomograms were internally validated using 10-fold cross-validation. The renal function nomogram had an r-square value of 0.13. It worked best when predicting estimated glomerular filtration rate values between 50 and 70 ml per minute per 1.73 m(2). The 5-year graft survival nomograms had a concordance index of 0.71 for the pretransplant nomogram and 0.78 for the 6-month posttransplant nomogram. Calibration was adequate for all nomograms. Nomograms based on data from the United Network for Organ Sharing registry have been validated to predict the 1-year estimated glomerular filtration rate and 5-year graft survival. These nomograms may facilitate individualized patient care in living donor kidney transplantation.

Audit of the Douglas Hocking Research Institute bone bank: ten years of non-irradiated bone graft.

PubMed

Love, David; Pritchard, Michael; Burgess, Tanya; Van Der Meer, Gavin; Page, Richard; Williams, Simon

2009-01-01

An audit performed in the use of non-irradiated femoral head bone graft at the Geelong Hospital over a 10-year period. While it is thought the non-irradiated bone graft provides a better structural construct there is theoretical increased risk of infection transmission. We performed a retrospective review of prospectively collected data in the use of non-irradiated bone allograft used from the Geelong Hospital Douglas Hocking Research Institute bone bank over a 10-year period. The review was performed using data collected from the bone bank and correlating it with the patient's medical record. All complications, including infections, related to the use of the allograft were recorded. We found that over the 10 years to 2004 that 811 femoral heads were donated, with 555 being used over 362 procedures in 316 patients. We identified a total of nine deep infections, of which seven were in joint replacements. Overall this was a 2.5% deep infection rate, which was lowered to 1.4% if the previously infected joints that were operated on were excluded. The use of non-irradiated femoral head bone graft was safe in a regional setting.

Study on pre-irradiation grafting of BSA⧸NASI conjugates on agarose and its application

NASA Astrophysics Data System (ADS)

Min, Yi; Baolin, Zhang; Hongfei, Ha

1993-10-01

In this work we used N-acryloxysuccinimide (NASI) with a function group as the intermediate to graft the Bovine Serum Albumin (BSA), passthrough BSA / NASI conjugates, onto agarose which has been pre-irradiated in Co-60 γ-source. Preparation of BSA / NASI conjugates was carried out at 37°C for 2h, the molar ratio of BSA and NASI in reaction is 1:6. Pre-irradiation of agarose sample was carried out at room temperature in air and grafting was performed below 37°C for 5h under bubbling nitrogen. The total dose used was lower than 7 kGy. This technique is applicable to immobilize BSA and other proteins or separate the tryptophans enantiomer as well.

Irradiation grafting of natural rubber latex with maleic anhydride and its compatibilization of poly(lactic acid)/natural rubber blends

NASA Astrophysics Data System (ADS)

Pongsathit, Siriwan; Pattamaprom, Cattaleeya

2018-03-01

Maleic anhydride (MA) is an interesting monomer to be grafted onto natural rubber(NR) due to its potential as a compatibilizer of hydrophobic rubbers and polymers with higher polarity. So far, radiation grafting of MA onto NR in latex state has not been reported. In this study, the grafting of NR with MA in latex state was investigated by exposing the latex to cobalt-60 gamma irradiation at a fixed MA content of 9% and a varied absorbed doses from 2 to 10 kGy. The FTIR spectrometer, 1H NMR spectrometer and gel content analysis have confirmed successful grafting of MA onto NR after irradiation. The grafted NRs were then used to increase the compatibility and the impact property of PLA/NR blends. It was found that the highest impact strength of the blends was achieved when the grafting was carried out at the absorbed dose of 4 kGy.

Improvement of pesticide adsorption capacity of cellulose fibre by high-energy irradiation-initiated grafting of glycidyl methacrylate

NASA Astrophysics Data System (ADS)

Takács, Erzsébet; Wojnárovits, László; Koczog Horváth, Éva; Fekete, Tamás; Borsa, Judit

2012-09-01

Cellulose as a renewable raw material was used for preparation of adsorbent of organic impurities in wastewater treatment. Hydrophobic surface of cellulose substrate was developed by grafting glycidyl methacrylate in simultaneous grafting using gamma irradiation initiation. Water uptake of cellulose significantly decreased while adsorption of phenol and a pesticide molecule (2,4-dichlorophenoxyacetic acid: 2,4-D) increased upon grafting. Adsorption equilibrium data fitted the Freundlich isotherm for both solutes.

Preparation and characterization of poly(methyl methacrylate) and poly(maleic anhydride-co-diallyl phthalate) grafted carbon black through γ-ray irradiation

NASA Astrophysics Data System (ADS)

Bo, Yang; Cui, Jiayang; Cai, Yangben; Xu, Shiai

2016-02-01

In this study, the grafting polymerization of methyl methacrylate (MMA) monomer and maleic anhydride/diallyl phthalate (MAH/DAP) co-monomer onto the surface of carbon black (CB) were carried out at room temperature and normal pressure by γ-ray irradiation. The surface chemistry of grafted CBs were characterized by infrared spectroscopy (IR), thermo-gravimetric analysis (TGA) and X-ray photoelectron spectroscopy (XPS). The results show that there are some remanent polymers on the surface of modified CBs after extract for 48 h, indicating that poly(methyl methacrylate) (PMMA) and poly(MAH-co-DAP) have been successfully grafted onto the surface of CB without using initiator due to the high energy of γ-ray irradiation. Dynamic light scattering (DLS), scanning electron microscopy (SEM) and transmission electron microscopy (TEM) reveal that the grafted CBs have smaller average aggregate size and better dispersibility than that of CB in absolute ethanol. In addition, it was found that the amount of oxygen groups and the irradiation doses/dose rates have little effect on the grafting degree of CB.

Age-Dependent Association Between Pre-transplant Blood Transfusion and Outcomes of Pediatric Heart Transplantation.

PubMed

McKee, C; Tumin, D; Alevriadou, B R; Nicol, K K; Yates, A R; Hayes, D; Tobias, J D

2018-04-01

Avoidance of red blood cell (RBC) transfusions in patients awaiting heart transplantation (HTx) has been suggested to minimize the risk of allosensitization. Although recent studies have suggested that an immature immune system in younger HTx recipients may reduce risks associated with RBC transfusion, the role of age in moderating the influence of transfusion on HTx outcomes remains unclear. We used available data from a national transplant registry to explore whether the association between pre-transplant transfusions and outcomes of pediatric HTx varies by patient age. De-identified data were obtained from the United Network for Organ Sharing registry, including first-time recipients of isolated HTx performed at age 0-17 years in 1995-2015. The primary exposure was receiving blood transfusions within 2 weeks prior to HTx. Patient survival after HTx was evaluated using multivariable Cox proportional hazards, where age at transplant was interacted with exposure to pre-transplant transfusion. Age-specific hazard ratios (HRs) of pre-transplant transfusion were plotted across ages at transplant. There were 4883 patients meeting inclusion criteria, of whom 1258 died during follow-up (mean follow-up duration 6 ± 5 years). Patients receiving pre-transplant transfusions were distinguished by younger age, higher prevalence of prior cardiac surgery, greater likelihood of being in the intensive care unit, and greater use of left ventricular assist device bridge to transplant. In multivariable analysis, pre-transplant transfusions were associated with increased mortality hazard among infants < 1 year of age (HR = 1.46; 95% CI 1.23, 1.74; p < 0.001). For each additional year of age, the excess hazard associated with pre-transplant transfusions decreased by 3% (interaction HR = 0.97; 95% CI 0.98, 0.99; p = 0.003). By age 8, the association between pre-transplant transfusions and post-transplant mortality was no longer statistically significant (HR�

Graft polymerization of guar gum with acryl amide irradiated by microwaves for colonic drug delivery.

PubMed

Shahid, Muhammad; Bukhari, Shazia Anwer; Gul, Yousra; Munir, Hira; Anjum, Fozia; Zuber, Mohammad; Jamil, Tahir; Zia, Khalid Mahmood

2013-11-01

This article is aimed to discuss the modification of guar gum through microwave irradiation by varying the time of irradiation. The characterization of the modified products was carried out using FTIR spectroscopic analysis. The FT-IR spectrum of the pure guar gum (GG) sample showed a broad peak at 3298 cm(-1) while the modified GG sample displayed a peak at 1541 cm(-1) which was absent in the crude sample. The X-ray diffraction (XRD) analysis confirmed the increase in crystallinity due to grafting of the sample with polyacrylamide (GG-g-PAM). Scanning electron microscope (SEM) images revealed that granular form of guar gum was changed into fibrillar structure after grafting. Thermo-gravimetric analysis of the modified samples was also carried out and discussed. The role of guar gum as a matrix for controlled release of drug triamcinolone was evaluated. The GG-acrylamide grafted samples presented a correlation between drug release and time of microwave exposure. The results revealed that such modified product has potential applications in colonic drug delivery system. Copyright © 2013 Elsevier B.V. All rights reserved.

Low pretransplant IgA level is associated with early post-lung transplant seromucous infection.

PubMed

Murthy, Sudish C; Avery, Robin K; Budev, Marie; Gupta, Sandeep; Pettersson, Gösta B; Nowicki, Edward R; Mehta, Atul; Chapman, Jeffrey T; Rajeswaran, Jeevanantham; Blackstone, Eugene H

2018-04-13

Infection is an important cause of morbidity and mortality after lung transplantation. Immunoglobulins are part of both seromucous (IgA) and serum (IgG) infection defense mechanisms. We therefore hypothesized that lower pretransplant IgA levels would be associated with more early post-lung transplant seromucous infections and greater mortality independent of IgG. From January 2000 to July 2010, 538 patients undergoing primary lung transplantation had pretransplant IgA (n = 429) and IgG (n = 488) measured as a clinical routine. Median IgA was 200 mg·dL -1 (2% < 70 mg·dL -1 , lower limit of normal); median IgG was 970 mg·dL -1 (5% < 600 mg·dL -1 ). Intensive microbiology review was used to categorize infections and their causative organisms within the first posttransplant year. In total, 397 seromucous infections were observed in 247 patients, most bacterial. Although IgA and IgG were moderately correlated (r = 0.5, P < .0001), low pretransplant IgA was a strong risk factor (P = .01) for seromucous infections, but pretransplant IgG was not (P ≥ .6). As pretransplant IgA levels fell below 200 mg·dL -1 , the risk of these posttransplant infections rose nearly linearly. Lower pretransplant levels of IgA were associated with greater posttransplant mortality to end of follow-up (P = .004), but pretransplant IgG was not (P ≥ .3). Low levels of preoperative IgA, an important immunoglobulin involved in mucosal immunologic defense, but not IgG, are associated with seromucous infections in the year after lung transplantation and increased follow-up mortality. It would appear prudent to identify patients with relative IgA deficiency at listing and to increase vigilance of monitoring for, and prophylaxis against, seromucous infection in this high-risk population. Copyright © 2018. Published by Elsevier Inc.

Fabrication of thermo-responsive PNIPAAm-g-ETFE for cell culture dishes by pre-irradiation grafting

NASA Astrophysics Data System (ADS)

Yamahara, Yumi; Nagasawa, Naotsugu; Taguchi, Mitsumasa; Oshima, Akihiro; Washio, Masakazu

2018-01-01

Thermo-responsive templates for the cell cultivation based on Poly(tetrafluoroethylene-co-ethylene) (ETFE) were fabricated by pre-irradiation grafting of N-isoproplyacrylamide (NIPAAm) monomer by electron beam (EB) irradiation under nitrogen gas atmosphere at room temperature, and their characteristic properties were studied. The detachment of cultured HeLa cells from fabricated thermo-responsive templates were attempted. Furthermore, the reaction mechanism is proposed using ESR spectroscopy and FT-IR spectroscopy. It is confirmed that the cultured HeLa cells were detached from fabricated thermo-responsive templates at 20 °C. Water contact angle analysis indicated that obtained templates had thermo-response around 30 °C. It is suggested that the grafted polymer chains would mainly react with peroxy radicals (-CF2-CF(OO･)-) on tetrafluoroethylene unit in ETFE.

Grafting of neural stem and progenitor cells to the hippocampus of young, irradiated mice causes gliosis and disrupts the granule cell layer

PubMed Central

Sato, Y; Shinjyo, N; Sato, M; Osato, K; Zhu, C; Pekna, M; Kuhn, H G; Blomgren, K

2013-01-01

Ionizing radiation persistently reduces the pool of neural stem and progenitor cells (NSPCs) in the dentate gyrus (DG) of the hippocampus, which may explain some of the learning deficits observed in patients treated with radiotherapy, particularly pediatric patients. A single dose of 8 Gy irradiation (IR) was administered to the brains of postnatal day 14 (P14) C57BL/6 mice and 1.0 × 105 bromodeoxyuridine-labeled, syngeneic NSPCs were injected into the hippocampus 1 day, 1 week or 6 weeks after IR. Cell survival and phenotype were evaluated 5 weeks after grafting. When grafted 1 day post-IR, survival and neuronal differentiation of the transplanted NSPCs were lower in irradiated brains, whereas the survival and cell fate of grafted cells were not significantly different between irradiated and control brains when transplantation was performed 1 or 6 weeks after IR. A young recipient brain favored neuronal development of grafted cells, whereas the older recipient brains displayed an increasing number of cells developing into astrocytes or unidentified cells. Injection of NSPCs, but not vehicle, induced astrogliosis and reduced thickness of the dorsal blade of the GCL after 5 months. In summary, we demonstrate that age and interval between IR and grafting can affect survival and differentiation of grafted NSPCs. The observed long-term gliosis and degeneration warrant caution in the context of NSPC grafting for therapeutical purposes. PMID:23598403

Survival of dental implants in native and grafted bone in irradiated head and neck cancer patients: a retrospective analysis.

PubMed

Buddula, Aravind; Assad, Daniel A; Salinas, Thomas J; Garces, Yolanda I

2011-01-01

To study the long-term survival of dental implants placed in native or grafted bone in irradiated bone in subjects who had received radiation for head and neck cancer. A retrospective chart review was conducted for all patients who received dental implants following radiation treatment for head and neck cancer between May 1, 1987 and July 1, 2008. Only patients irradiated with a radiation dose of 50 Gy or greater and those who received dental implants in the irradiated field after head and neck radiation were included in the study. The associations between implant survival and patient/implant characteristics were estimated by fitting univariate marginal Cox proportional hazards models. A total of 48 patients who had prior head and neck radiation had 271 dental implants placed during May 1987-July 2008. There was no statistically significant difference between implant failure in native and grafted bone (P=0.76). Survival of implants in grafted bone was 82.3% and 98.1% in maxilla and mandible, respectively, after 3 years. Survival of implants in native bone in maxilla and mandible was 79.8% and 100%, respectively, after 3 years. For implants placed in the native bone, there was a higher likelihood of failure in the maxilla compared to the mandible and there was also a tendency for implants placed in the posterior region to fail compared to those placed in the anterior region. There was no significant difference in survival when implants were placed in native or grafted bone in irradiated head and neck cancer patients. For implants placed in native bone, survival was significantly influenced by the location of the implant (maxilla or mandible, anterior or posterior).

EFFECT OF HYPOTHYROIDISM AND THYROID GRAFTS ON LYMPHOID TUMOR DEVELOPMENT IN IRRADIATED C57BL MICE

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nagareda, C.S.; Kaplan, H.S.

1959-04-01

Studies on the effect of radiothyroidectomy and thyroid grafts on the incidence of thymic implant lymphomas in thymectomized-irradiated CS7BL mice are reported. Hypothyroidism significantly inhibited thymic implant tumor development in females. A similar reduction of lymphoma incidence in hypothyroid males was not statistically significant. When thyroid activity was restored by grafting normal thyroids to radiothyroidectomized animals, lymphoma incidence returned to the level seen in euthyroid animals. I/sup 131/ uptake measurements were made on a representative number of thyroids and thyroid grafts. There was no significant uptake by the I/sup 131/-treated thyroids. Thyroid grafts were just as active as thyroids frommore » control animals. Body weight decreased significantiy in hypothyroid animals and was restored to control euthyroid levels in radiothyroidectomized animals by thyroid grafts. The possible influence of secondary nutritional and endocrine disturbances on leukemogenesis are discussed; it seems likely that the observed inhibition is attributable to hypothyroidism per se, rather than to secondary influences on nutrition or other endocrine imbalances. Incidental observations on pituitary tumor development in lymphoma- free radiothyroldectomized animals are also reported. Pituitary tumor development was completely prevented by thyroid grafts after radiothyroidectomy. (auth)« less

Clinical Impact of Pretransplant Multidrug-Resistant Gram-Negative Colonization in Autologous and Allogeneic Hematopoietic Stem Cell Transplantation.

PubMed

Forcina, Alessandra; Lorentino, Francesca; Marasco, Vincenzo; Oltolini, Chiara; Marcatti, Magda; Greco, Raffaella; Lupo-Stanghellini, Maria Teresa; Carrabba, Matteo; Bernardi, Massimo; Peccatori, Jacopo; Corti, Consuelo; Ciceri, Fabio

2018-03-02

Multidrug-resistant Gram-negative bacteria (MDR-GNB) are an emerging cause of morbidity and mortality after hematopoietic stem cell transplantation (HSCT). Three-hundred forty-eight consecutive patients transplanted at our hospital from July 2012 to January 2016 were screened for a pretransplant MDR-GNB colonization and evaluated for clinical outcomes. A pretransplant MDR-GNB colonization was found in 16.9% of allo-HSCT and in 9.6% of auto-HSCT recipients. Both in auto- and in allo-HSCT, carriers of a MDR-GNB showed no significant differences in overall survival (OS), transplant-related mortality (TRM), or infection-related mortality (IRM) compared with noncarriers. OS at 2 years for carriers compared with noncarriers was 85% versus 81% (P = .262) in auto-HSCT and 50% versus 43% (P = .091) in allo-HSCT. TRM at 2 years was 14% versus 5% (P = .405) in auto-HSCT and 31% versus 25% (P = .301) in allo-HSCT. IRM at 2 years was 14% versus 2% (P = .142) in auto-HSCT and 23% versus 14% (P = .304) in allo-HSCT. In multivariate analysis, only grade III to IV acute graft-versus-host disease was an independent factor for reduced OS (P < .001) and increased TRM (P < .001) and IRM (P < .001). During the first year after transplant, we collected 73 GNB bloodstream infectious (BSI) episodes in 54 patients, 42.4% of which sustained by a MDR-GNB. Rectal swabs positivity associated with the pathogen causing subsequent MDR-GNB BSI episodes in 13 of 31 (41.9%). Overall, OS at 4 months from MDR-GNB BSI episode onset was of 67.9%, with a 14-day attributed mortality of 12.9%, not being significantly different between carriers and noncarriers (P = .207). We conclude that in this extended single-center experience, a pretransplant MDR-GNB colonization did not significantly influence OS, TRM, and IRM both in auto- and allo-HSCT settings and that MDR-GNB attributed mortality can be controlled in carriers when an early pre-emptive antimicrobial therapy is

Intestinal microbiota-related effects on graft-versus-host disease.

PubMed

Shono, Yusuke; Docampo, Melissa D; Peled, Jonathan U; Perobelli, Suelen M; Jenq, Robert R

2015-05-01

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an increasingly important treatment for conditions including hematopoietic malignancies and inherited hematopoietic disorders, and is considered to be the most effective form of tumor immunotherapy available to date. However, graft-versus-host disease (GVHD) remains a major source of morbidity and mortality following allo-HSCT, and understanding the mechanisms of GVHD has been highlighted as a key research priority. During development of GVHD, activation of various immune cells, especially donor T cells, leads to damage of target organs including skin, liver, hematopoietic system, and of particular clinical importance, gut. In addition to histocompatibility complex differences between the donor and recipient, pretransplant conditioning with chemotherapy and irradiation also contributes to GVHD by damaging the gut, resulting in systemic exposure to microbial products normally confined to the intestinal lumen. The intestinal microbiota is a modulator of gastrointestinal immune homeostasis. It also promotes the maintenance of epithelial cells. Recent reports provide growing evidence of the impact of intestinal microbiota on GVHD pathophysiology. This review summarizes current knowledge of changes and effects of intestinal microbiota in the setting of allo-HSCT. We will also discuss potential future strategies of intestinal microbiota manipulation that might be advantageous in decreasing allo-HSCT-related morbidity and mortality.

Intestinal microbiota-related effects on graft-versus-host disease

PubMed Central

Shono, Yusuke; Docampo, Melissa D.; Peled, Jonathan U.; Perobelli, Suelen M.; Jenq, Robert R.

2016-01-01

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an increasingly important treatment for conditions including hematopoietic malignancies and inherited hematopoietic disorders, and is considered to be the most effective form of tumor immunotherapy available to date. However, graft-versus-host disease (GVHD) remains a major source of morbidity and mortality following allo-HSCT, and understanding the mechanisms of GVHD has been highlighted as a key research priority. During development of GVHD, activation of various immune cells, especially donor T cells, leads to damage of target organs including skin, liver, hematopoietic system, and of particular clinical importance, gut. In addition to histocompatibility complex differences between the donor and recipient, pre-transplant conditioning with chemotherapy and irradiation also contributes to GVHD by damaging the gut, resulting in systemic exposure to microbial products normally confined to the intestinal lumen. The intestinal microbiota is a modulator of gastrointestinal immune homeostasis. It also promotes the maintenance of epithelial cells. Recent reports provide growing evidence of the impact of intestinal microbiota on GVHD pathophysiology. This review summarizes current knowledge of changes and effects of intestinal microbiota in the setting of allo-HSCT. We will also discuss potential future strategies of intestinal-microbiota manipulation that might be advantageous in decreasing allo-HSCT related morbidity and mortality. PMID:25812838

Pre-transplant donor HLA-specific antibodies: characteristics causing detrimental effects on survival after lung transplantation.

PubMed

Smith, John D; Ibrahim, Mohamed W; Newell, Helen; Danskine, Anna J; Soresi, Simona; Burke, Margaret M; Rose, Marlene L; Carby, Martin

2014-10-01

The impact of Luminex-detected HLA antibodies on outcomes after lung transplantation is unclear. Herein we have undertaken a retrospective study of pre-transplant sera from 425 lung transplants performed between 1991 and 2003. Pre-transplant sera, originally screened by complement-dependent cytotoxicity (CDC) assays, were retrospectively tested for the presence of HLA-specific antibodies using HLA-coated Luminex beads and C4d deposition on Luminex beads. The results were correlated with graft survival at 1 year. Twenty-seven patients were retrospectively identified as having been transplanted against donor-specific HLA antibodies (DSA) and 36 patients against non-donor-specific HLA antibodies (NDSA). DSA-positive patients had 1-year survival of 51.9% compared with 77.8% for NDSA and 71.8% for antibody-negative patients (p = 0.029). One-year survival of patients with complement-fixing DSA was 12.5% compared with 62.5% for non-complement-fixing DSA, 75.8% for non-complement-fixing NDSA and 71.8% for antibody-negative patients (p < 0.0001). DSA-positive patients with mean fluorescence intensity (MFI) >5,000 had 1-year survival of 33.3% compared with 71.4% for MFI 2,000 to 5000 and 62.5% for MFI <2,000 (p = 0.0046). Multivariable analysis revealed DSA to be an independent predictor of poor patient survival within 1 year (p = 0.0010, hazard ratio [HR] = 3.569) as well as complement-fixing DSA (p < 0.0001, HR = 11.083) and DSA with MFI >5,000 (p = 0.0001, HR = 5.512). Pre-formed DSA, particularly complement-fixing DSA, and high MFI are associated with poor survival within the first year after lung transplantation. Risk stratification according to complement fixation or MFI levels may allow for increased transplantation in sensitized patients. Copyright © 2014 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Effect of pretransplant diabetes on short-term outcomes after liver transplantation: a national cohort study.

PubMed

Hoehn, Richard S; Singhal, Ashish; Wima, Koffi; Sutton, Jeffrey M; Paterno, Flavio; Steve Woodle, E; Hohmann, Sam; Abbott, Daniel E; Shah, Shimul A

2015-07-01

We sought to analyse the effect of pretransplant diabetes on post-operative outcomes and resource utilization following liver transplantation. A retrospective cohort study was designed using a linkage between the University HealthSystem Consortium and Scientific Registry of Transplant Recipients databases. We identified 12 442 patients who underwent liver transplantation at 63 centres from 2007-2011 and separated cohorts of patients with diabetes (n = 2971; 24%) and without (n = 9471; 76%) at the time of transplant. We analysed transplant related outcomes and short-term survival. Diabetic recipients were more likely to be male (70% vs 67%), non-white (32% vs 26%), older (age ≥60; 41% vs 28%), and have a higher BMI (29 vs 27; P < 0.001). More diabetic patients were on haemodialysis (10% vs 7%), had cirrhosis caused by NASH (24% vs 9%; P < 0.001), and received liver allografts from older donors (≥ 60 years; 19% vs 15%) with a higher donor risk index (>1.49; 46% vs 42%; P < 0.001). Post-transplant, diabetic recipients had longer hospital length of stay (10 vs 9 days), higher peri-transplant mortality (5% vs 4%) and 30-day readmission rates (41% vs 37%), were less often discharged to home (83% vs 87%; P < 0.05), and had inferior graft and patient survival. Liver transplant was more expensive for type 1 vs type 2 diabetics ($105 078 vs $100 624, P < 0.001). Poorly controlled diabetic recipients were less likely discharged home following transplant (75% vs 82%, P < 0.01). This national study indicates that pretransplant diabetes is associated with inferior post-operative outcomes and increased resource utilization after liver transplantation. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The Impact of pre-transplant depression on the outcomes of allogeneic and autologous hematopoietic stem cell transplantation

PubMed Central

El-Jawahri, Areej; Chen, Yi-Bin; Brazauskas, Ruta; He, Naya; Lee, Stephanie J.; Knight, Jennifer; Majhail, Navneet; Buchbinder, David; Schears, Raquel M.; Wirk, Baldeep M.; Wood, William A.; Ahmed, Ibrahim; Aljurf, Mahmoud; Szer, Jeff; Beattie, Sara M.; Battiwalla, Minoo; Dandoy, Christopher; Diaz, Miguel-Angel; D’Souza, Anita; Freytes, Cesar O.; Gajewski, James; Gergis, Usama; Hashmi, Shahrukh K.; Jakubowski, Ann; Kamble, Rammurti T.; Kindwall-Keller, Tamila; Lazarus, Hilard M.; Malone, Adriana K.; Marks, David I.; Meehan, Kenneth; Savani, Bipin N.; Olsson, Richard F.; Rizzieri, David; Steinberg, Amir; Speckhart, Dawn; Szwajcer, David; Schoemans, Helene; Seo, Sachiko; Ustun, Celalettin; Atsuta, Yoshiko; Dalal, Jignesh; Sales-Bonfim, Carmem; Khera, Nandita; Hahn, Theresa; Saber, Wael

2017-01-01

Background To evaluate the impact of depression prior to autologous and allogeneic HCT on clinical outcomes post-transplant. Methods We analyzed data from the Center for International Blood and Marrow Transplant Research to compare outcomes after autologous (n=3786) or allogeneic (n=7433) HCT for adult patients with hematologic malignancies with an existing diagnosis of pre-HCT depression requiring treatment vs. those without pre-HCT depression. Using Cox regression models, we compared OS between patients with or without depression. We compared the number of days-alive-and-out-of-the-hospital in the first 100 days post-HCT using Poisson models. We also compared the incidence of grade II-IV acute and chronic GVHD in allogeneic HCT. Results 1116 (15%) patients with pre-transplant depression and 6317 (85%) without depression underwent allogeneic HCT in 2008-2012 were included. Pre-transplant depression was associated with lower OS (HR=1.13, 95%CI1.04-1.23, P=0.004) and higher incidence of grade II-IV acute GVHD (HR=1.25, 95%CI 1.14-1.37, P<0.0001), but similar incidence of chronic GVHD. Pre-transplant depression was associated with fewer days alive and out-of-the hospital (Means-Ratio (MR)=0.97, 95%CI0.95-0.99, P=0.004). There were 512 (13.5%) patients with pre-transplant depression and 3274 (86.5%) without depression who underwent autologous HCT. Pre-transplant depression in autologous HCT was not associated with OS (HR=1.15, 95%CI0.98-1.34, P=0.096), but was associated with fewer days-alive-and-out-of-the-hospital (MR=0.98, 95%CI0.97-0.99, P=0.002). Conclusions Pre-transplant depression was associated with lower OS and higher risk of acute GVHD among allogeneic HCT recipients, and fewer days-alive-and-out-of-the-hospital during the first 100 days after autologous and allogeneic HCT. Patients with pre-transplant depression represent a vulnerable population at risk for post-transplant complications. PMID:28102896

Donor-specific antibodies require preactivated immune system to harm renal transplant.

PubMed

Süsal, Caner; Döhler, Bernd; Ruhenstroth, Andrea; Morath, Christian; Slavcev, Antonij; Fehr, Thomas; Wagner, Eric; Krüger, Bernd; Rees, Margaret; Balen, Sanja; Živčić-Ćosić, Stela; Norman, Douglas J; Kuypers, Dirk; Emonds, Marie-Paule; Pisarski, Przemyslaw; Bösmüller, Claudia; Weimer, Rolf; Mytilineos, Joannis; Scherer, Sabine; Tran, Thuong H; Gombos, Petra; Schemmer, Peter; Zeier, Martin; Opelz, Gerhard

2016-07-01

It is an unresolved issue why some kidney transplant recipients with pretransplant donor-specific HLA antibodies (DSA) show a high transplant failure rate, whereas in other patients DSA do not harm the graft. We investigated whether help from preactivated T-cells might be necessary for DSA to exert a deleterious effect. The impact of pretransplant DSA and immune activation marker soluble CD30 (sCD30) on 3-year graft survival was analyzed in 385 presensitized kidney transplant recipients. A deleterious influence of pretransplant DSA on graft survival was evident only in patients who were positive for the immune activation marker sCD30. In the absence of sCD30 positivity, 3-year graft survival was virtually identical in patients with or without DSA (83.1±3.9% and 84.3±2.8%, P=0.81). A strikingly lower 3-year graft survival rate of 62.1±6.4% was observed in patients who were both sCD30 and DSA positive (HR 2.92, P<0.001). Even in the presence of strong DSA with ≥5000 MFI, the 3-year graft survival rate was high if the recipients were sCD30 negative. Pretransplant DSA have a significantly deleterious impact on graft survival only in the presence of high pretransplant levels of the activation marker sCD30. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Effects of pretransplant sarcopenia and sequential changes in sarcopenic parameters after living donor liver transplantation.

PubMed

Kaido, Toshimi; Tamai, Yumiko; Hamaguchi, Yuhei; Okumura, Shinya; Kobayashi, Atsushi; Shirai, Hisaya; Yagi, Shintaro; Kamo, Naoko; Hammad, Ahmed; Inagaki, Nobuya; Uemoto, Shinji

2017-01-01

Sarcopenia is characterized by muscle mass depletion and decrease in muscle power or physical activity. We previously reported that low skeletal muscle mass (SMM) is closely involved with posttransplant mortality in patients undergoing living donor liver transplantation (LDLT). The aim of this study was to prospectively investigate the effects of pretransplant sarcopenia on survival and examine sequential changes in sarcopenic parameters after LDLT. Sarcopenia was defined by measuring SMM using a multifrequency body composition analyzer and assessing grip strength (GS) in 72 adults who underwent LDLT at Kyoto University Hospital between January 2013 and October 2015. The effects of pretransplant sarcopenia on short-term survival and sequential changes in SMM and GS were prospectively analyzed. Of 72 patients, 10 (14%) were defined as having pretransplant sarcopenia. Overall survival rates were significantly lower in patients with sarcopenia (n = 10) than those without sarcopenia (n = 62; P < 0.001). SMM worsened after LDLT and did not return to preoperative levels until 1 y after LDLT. In contrast, GS returned to preoperative levels at 6 mo after LDLT, following sharp decrease at 1 mo after LDLT. This prospective study confirmed that pretransplant sarcopenia is closely associated with short-term survival after LDLT and that GS recovers before SMM. Copyright © 2016 Elsevier Inc. All rights reserved.

THE RESPONSE OF X-IRRADIATED LIMBS OF ADULT URODELES TO NORMAL TISSUE GRAFTS. I. EFFECTS OF AUTOGRAFTS OF SIXTY-DAY FOREARM REGENERATES

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stinson, B.D.

1963-06-01

Results are reported of autoplastic transplantation of parts of nonirradiated, regenerated forelimb to the contralateral x-irradiated forelimb in adult Triturus viridescens. The right forelimbs were exposed to various doses of localized irradiation (1000 to 5000 r) followed by amputation of both left and right forelimbs through the mid forearm. Left limbs regenerated normally, but irradiated right limbs failed to exhibit any significant degree of regenerative activity over a 3-month period. Both forelimbs were reamputated through the distal humerus and observed for an additional two months. Left limbs produced normal regenerates, but irradiated right limbs gave no gross evidence of regenerationmore » at any of the radiation dose levels. Normal left regenerates were reamputated immediately distal to the elbow on the 60th day after the second amputation; the severed forearm was trimmed with scissors along anterior and posterior borders and denuded of skin over its proximal half, leaving an essentially complete forearm region as a normal autograft. This was implanted into the irradiated right upper arm stump, after ablation of the distal half of its humerus, with normal proximodistal polarity in all cases. The irradiated stump was reamputated through the distal portion of the implanted normal autograft two weeks after implantation, and was observed for four months. Periodic gross observations showed that over 90% of irradiated upper arms formed regenerates at a rate which paralleled that of nonirradiated controls. However, regenerates formed on irradiated upper arms exhibited a restriction of morphogenetic capacity, only 60% attaining 3- and 4-digit stages. Most of the morphologically more complex regenerates which developed on the irradiated upper arm stumps manifested left limb asymmetry despite their formation on right irradiated stumps, suggesting a relation between the asymmetry of the normal graft and that of the resulting regenerate. All regenerates which

Relative reductions in soluble CD30 levels post-transplant predict acute graft function in islet allograft recipients receiving three different immunosuppression protocols.

PubMed

Hire, Kelly; Hering, Bernhard; Bansal-Pakala, Pratima

2010-08-01

Despite advances in islet transplantation, challenges remain in monitoring for anti-islet immune responses. Soluble CD30 (sCD30) has been investigated as a predictor of acute rejection in kidney, lung, and heart transplantation as well as in a single study in human islet cell recipients. In this study, sCD30 levels were retrospectively assessed in 19 allograft recipients treated with three different immunosuppression induction therapies. Soluble CD30 levels were assessed at pre-transplant; early post-transplant (day 4-day 7); one-month post-transplant; and late post-transplant (day 90-day 120) and then correlated with eventual graft outcomes at 1-year follow-up. Results showed no correlation between mean serum sCD30 levels at any point in time pre- or post-transplant and graft function at 1-year follow-up. However, analysis demonstrated that mean sCD30 levels at day 28 or day 90-day 120 decreased from pre-transplant levels in recipients with long-term islet allograft function compared to recipients with partial or non-graft function (a decrease of 43.6+/-25.6% compared to 16.7+/-35.2%, p<0.05). In another finding, immunosuppression with the ATG protocol led to a greater reduction in sCD30 levels post-transplant overall. A larger reduction post-transplant correlated with full graft function. The results demonstrate that a relative reduction in sCD30 levels post-transplant may be applicable as a biomarker to monitor graft function in islet allograft recipients. Additionally, knowledge of the impact of various immunosuppression protocols on the timing and extent of changes in post-transplant sCD30 levels could aid in patient-specific tailoring of immunosuppression. Copyright © 2010 Elsevier B.V. All rights reserved.

Intraoperative extracorporeal autogenous irradiated tendon grafts for functional limb salvage surgery of soft tissue sarcomas of the wrist and hand.

PubMed

Omori, Shinsuke; Hamada, Kenichiro; Outani, Hidetatsu; Oshima, Kazuya; Joyama, Susumu; Tomita, Yasuhiko; Naka, Norifumi; Araki, Nobuhito; Yoshikawa, Hideki

2015-05-12

In patients with soft tissue sarcoma of the wrist and hand, limb salvage operation is extremely challenging for surgeons in attempting a complete tumor resection with negative surgical margins. In this study, we report four patients with soft tissue sarcoma of the wrist and hand treated by limb salvage operation with intraoperative extracorporeal autogenous irradiated tendon grafts. The patients were all male, and the mean age at the time of surgery was 45 years. Histological diagnoses included clear cell sarcoma in two patients, synovial sarcoma in one, and angiosarcoma in one. All four patients had high grade tumors, wherein three had American Joint Committee on Cancer (AJCC) stage III disease and one with AJCC stage IV disease. The tumors were resected en bloc with involved tendons. The tendons were isolated from the resected tissues, irradiated ex vivo, and re-implanted into the host tendons. In one patient, the bone was resected additionally because of tumor invasion to the bone. Hand function was evaluated using Musculoskeletal Tumor Society (MSTS) rating system. Of the four patients, three died of distant metastatic disease. The remaining patient lives and remains disease-free. The mean follow-up period was 33 months. One patient had local recurrence outside the irradiated graft at 20 months after surgery. The functional rating was 22. Lower scores were seen in patients with reconstruction of flexor tendons than extensor tendons. Limb salvage operation with intraoperative extracorporeal autogenous irradiated tendon grafts is an acceptable method in selected patients with soft tissue sarcoma of the wrist and hand.

Preparation of starch-poly-glutamic acid graft copolymers by microwave irradiation and the characterization of their properties

USDA-ARS?s Scientific Manuscript database

Graft copolymers of waxy maize starch and poly-y-glutamic acid (PGA) were produced in an aqueous solution using microwave irradiation. The microwave reaction conditions were optimized with regard to temperature and pH. The temperature of 180 deg C and pH 7.0 were the best reaction conditions resulti...

Donor brain death predisposes human kidney grafts to a proinflammatory reaction after transplantation.

PubMed

de Vries, D K; Lindeman, J H N; Ringers, J; Reinders, M E J; Rabelink, T J; Schaapherder, A F M

2011-05-01

Donor brain death has profound effects on post-transplantation graft function and survival. We hypothesized that changes initiated in the donor influence the graft's response to ischemia and reperfusion. In this study, human brain dead donor kidney grafts were compared to living and cardiac dead donor kidney grafts. Pretransplant biopsies of brain dead donor kidneys contained notably more infiltrating T lymphocytes and macrophages. To assess whether the different donor conditions result in a different response to reperfusion, local cytokine release from the reperfused kidney was studied by measurement of paired arterial and renal venous blood samples. Reperfusion of kidneys from brain dead donors was associated with the instantaneous release of inflammatory cytokines, such as G-CSF, IL-6, IL-9, IL-16 and MCP-1. In contrast, kidneys from living and cardiac dead donors showed a more modest cytokine response with release of IL-6 and small amounts of MCP-1. In conclusion, this study shows that donor brain death initiates an inflammatory state of the graft with T lymphocyte and macrophage infiltration and massive inflammatory cytokine release upon reperfusion. These observations suggest that brain dead donors require a novel approach for donor pretreatment aimed at preventing this inflammatory response to increase graft survival. ©2011 The Authors Journal compilation©2011 The American Society of Transplantation and the American Society of Transplant Surgeons.

Relation between pretransplant serum levels of soluble CD30 and acute rejection during the first 6 months after a kidney transplant.

PubMed

Shooshtarizadeh, Tina; Mohammadali, Ali; Ossareh, Shahrzad; Ataipour, Yousef

2013-06-01

The immunologic status of kidney allograft recipients affects transplant outcome. High levels of pretransplant serum soluble CD30 correlate with an increased risk of acute rejection. Studies show conflicting results. We evaluated the relation between pretransplant serum sCD30 levels with the risk of posttransplant acute kidney rejection in renal transplant recipients. This prospective cohort study was performed between March 2010 and March 2011 on 77 kidney transplant recipients (53 men [68.8%], 24 women [31.2%]; mean age, 41 ± 14 y). Serum samples were collected 24 hours before transplant and analyzed for soluble CD30 levels by enzyme-linked immunosorbent assay. Patients were followed for 6 months after transplant. Acute biopsy-proven rejection episodes were recorded, serum creatinine levels were measured, and glomerular filtration rates were calculated at the first and sixth months after transplant. Preoperative serum soluble CD30 levels were compared in patients with and without rejection. The mean pretransplant serum soluble CD30 level was 92.1 ± 47.3 ng/mL. At 6 months' follow-up, 10 patients experienced acute rejection. Mean pretransplant soluble CD30 levels were 128.5 ± 84 ng/mL versus 86.7 ± 37 ng/mL in patients with and without acute rejection episodes (P = .008). At 100 ng/mL, the sensitivity, specificity, and positive and negative predictive values of pretransplant serum soluble CD30 level to predict acute rejection were 70%, 73.6%, 29.1%, and 94.3%. We showed a significant relation between pretransplant serum soluble CD30 levels and acute allograft rejection. High pretransplant levels of serum soluble CD30 can be a risk factor for kidney transplant rejection, and its high negative predictive value at various cutoffs make it useful to find candidates with a low risk of acute rejection after transplant.

The effect of pre-transplant pain and chronic disease self-efficacy on quality of life domains in the year following hematopoietic stem cell transplantation.

PubMed

O'Sullivan, Madeline L; Shelby, Rebecca A; Dorfman, Caroline S; Kelleher, Sarah A; Fisher, Hannah M; Rowe Nichols, Krista A; Keefe, Francis J; Sung, Anthony D; Somers, Tamara J

2018-04-01

Pain is common for hematopoietic stem cell transplant (HSCT) patients and may be experienced pre-transplant, acutely post-transplant, and for months or years following transplant. HSCT patients with persistent pain may be at risk for poor quality of life following transplant; however, the impact of pre-transplant pain on quality of life post-transplant is not well understood. Self-efficacy for chronic disease management is associated with quality of life among cancer patients and may impact quality of life for HSCT patients. The primary aim was to examine the effect of pre-transplant pain and self-efficacy on quality of life domains in the year following transplant. One hundred sixty-six HSCT patients completed questionnaires providing information on pain, self-efficacy, and quality of life prior to transplant, at discharge, and 3-, 6-, and 12-months post-transplant as part of a longitudinal, observational study. Linear mixed modeling examined the trajectories of these variables and the effect of pre-transplant pain and self-efficacy on post-transplant quality of life. Pain and social and emotional quality of life remained stable in the year following transplant while self-efficacy and physical and functional quality of life improved. Pre-transplant pain was significantly related to lower physical well-being post-transplant. Lower pre-transplant self-efficacy was related to lower quality of life across all domains post-transplant. Above and beyond the effect of pre-transplant pain, self-efficacy for managing chronic disease is important in understanding quality of life following transplant. Identifying patients with pain and/or low self-efficacy pre-transplant may allow for early intervention with self-management strategies.

Preparation, properties and biological application of pH-sensitive poly(ethylene oxide) (PEO) hydrogels grafted with acrylic acid(AAc) using gamma-ray irradiation

NASA Astrophysics Data System (ADS)

Nho, Young Chang; Mook Lim, Youn; Moo Lee, Young

2004-09-01

pH-sensitive hydrogels were studied as a drug carrier for the protection of insulin from the acidic environment of the stomach before releasing it in the small intestine. In this study, hydrogels based on poly(ethylene oxide) (PEO) networks grafted with acrylic acid (AAc) were prepared via a two-step process. PEO hydrogels were prepared by γ-ray irradiation, and then grafting by AAc monomer onto the PEO hydrogels with the subsequent irradiation (radiation dose: 5-20 kGy, dose rate: 2.15 kGy/h). These grafted hydrogels showed a pH-sensitive swelling behavior. The grafted hydrogels were used as a carrier for the drug delivery systems for the controlled release of insulin. The in vitro drug release behaviors of these hydrogels were examined by quantification analysis with a UV/VIS spectrophotometer. Insulin was loaded into freeze-dried hydrogels (7 mm×3 mm×2.5 mm) and administrated orally to healthy and diabetic Wistar rats. The oral administration of insulin-loaded hydrogels to Wistar rats decreased the blood glucose levels obviously for at least 4 h due to the absorption of insulin in the gastrointestinal tract.

[Organ transplantation and blood transfusion].

PubMed

Matignon, M; Bonnefoy, F; Lang, P; Grimbert, P

2011-04-01

Pretransplant blood transfusion remains a controversial subject and its history can summarize the last 40 years of transplantation. Until 1971, transfusions were widely used in patients awaiting transplantation, especially due to the anemia induced by the chronic renal dysfunction. Then, a noxious effect of preformed anti-HLA antibodies on renal grafts survival was reported and pretransplant transfusions were stopped. Between 1972 and 1977, improvement of renal graft survival in patients who received pretransplant transfusions was noted. Therefore, from 1978 on, a systematic policy of pretransplant transfusions was adopted by almost all centres of transplantation. During the eighties, it was again abandoned for several reasons: absence of graft survival improvement in patients treated by cyclosporine, HLA immunization leading to an increased incidence of acute graft rejection, risk of viral diseases transmission and human recombinant erythropoietin development. The lack of improvement in graft survival for ten years has been leading the transplant community to look for antigen-specific immunosuppressive strategies to achieve transplantation tolerance. Donor-specific transfusion may have clinical benefits, as long-term grafts survival improvement, through modulation of the recipient's cellular immune system and has been recently reconsidered, especially before living donor transplantation. The immunological mechanisms inducing a tolerance-gaining effect of transfusions are still misunderstood, but the recent discovery of immunomodulatory effects of the apoptotic cells present in cellular products could enlighten our comprehension of pretransplant transfusions benefits and could help to develop specific tolerance induction strategies in solid organ transplantation. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Pre-transplant weight loss predicts inferior outcome after allogeneic stem cell transplantation in patients with myelodysplastic syndrome.

PubMed

Radujkovic, Aleksandar; Becker, Natalia; Benner, Axel; Penack, Olaf; Platzbecker, Uwe; Stölzel, Friedrich; Bornhäuser, Martin; Hegenbart, Ute; Ho, Anthony D; Dreger, Peter; Luft, Thomas

2015-10-27

Allogeneic stem cell transplantation (alloSCT) represents a curative therapeutic option for patients with myelodysplastic syndrome (MDS), but relapse and non-relapse mortality (NRM) limit treatment efficacy. Based on our previous observation in acute myeloid leukemia we investigated the impact of pre-transplant weight loss on post-transplant outcome in MDS patients. A total of 111 patients diagnosed with MDS according to WHO criteria transplanted between 2000 and 2012 in three different transplant centers were included into the analysis. Data on weight loss were collected from medical records prior to conditioning therapy and 3-6 months earlier. Patient, disease and transplant characteristics did not differ between patients with weight loss (2-5%, n = 17; > 5%, n = 17) and those without (n = 77). In a mixed effect model, weight loss was associated with higher risk MDS (p = 0.046). In multivariable analyses, pre-transplant weight loss exceeding 5% was associated with a higher incidence of relapse (p < 0.001) and NRM (p = 0.007). Pre-transplant weight loss of 2-5% and > 5% were independent predictors of worse disease-free (p = 0.023 and p < 0.001, respectively) and overall survival (p = 0.043 and p < 0.001, respectively). Our retrospective study suggests that MDS patients losing weight prior to alloSCT have an inferior outcome after transplantation. Prospective studies addressing pre-transplant nutritional interventions are highly warranted.

Pre-transplant weight loss predicts inferior outcome after allogeneic stem cell transplantation in patients with myelodysplastic syndrome

PubMed Central

Radujkovic, Aleksandar; Becker, Natalia; Benner, Axel; Penack, Olaf; Platzbecker, Uwe; Stölzel, Friedrich; Bornhäuser, Martin; Hegenbart, Ute; Ho, Anthony D.; Dreger, Peter; Luft, Thomas

2015-01-01

Allogeneic stem cell transplantation (alloSCT) represents a curative therapeutic option for patients with myelodysplastic syndrome (MDS), but relapse and non-relapse mortality (NRM) limit treatment efficacy. Based on our previous observation in acute myeloid leukemia we investigated the impact of pre-transplant weight loss on post-transplant outcome in MDS patients. A total of 111 patients diagnosed with MDS according to WHO criteria transplanted between 2000 and 2012 in three different transplant centers were included into the analysis. Data on weight loss were collected from medical records prior to conditioning therapy and 3–6 months earlier. Patient, disease and transplant characteristics did not differ between patients with weight loss (2–5%, n = 17; > 5%, n = 17) and those without (n = 77). In a mixed effect model, weight loss was associated with higher risk MDS (p = 0.046). In multivariable analyses, pre-transplant weight loss exceeding 5% was associated with a higher incidence of relapse (p < 0.001) and NRM (p = 0.007). Pre-transplant weight loss of 2–5% and > 5% were independent predictors of worse disease-free (p = 0.023 and p < 0.001, respectively) and overall survival (p = 0.043 and p < 0.001, respectively). Our retrospective study suggests that MDS patients losing weight prior to alloSCT have an inferior outcome after transplantation. Prospective studies addressing pre-transplant nutritional interventions are highly warranted. PMID:26360778

New-onset diabetes mellitus after living-donor liver transplantation: association with graft synthetic function.

PubMed

Yagi, Shintaro; Kaido, Toshimi; Iida, Taku; Yoshizawa, Atsushi; Okajima, Hideaki; Uemoto, Shinji

2017-06-01

It is now known that post-transplant graft function after deceased-donor liver transplantation and living-donor liver transplantation (LDLT) differ; however, there is no report assessing the relationship between graft function and the development of new-onset diabetes mellitus after transplantation (NODAT). We conducted this study to identify the predictive risk factors for NODAT, including graft function after LDLT. The subjects of this study were 175 adult recipients who underwent LDLT at Kyoto University Hospital between 2006 and 2010, and survived for more than 3 months (median observation period, 1046 days). The 1-, 2-, and 3-year incidences of NODAT after LDLT were 26.1, 32.0, and 33.4%, respectively. Pre-transplant diabetes was associated with poor survival (p = 0.0048), whereas NODAT was not associated with patient survival. In the multivariate analysis, recipient age ≥40, a tacrolimus trough level ≥8 ng/mL 3 months after LDLT, and cholinesterase (ChE) <185 IU/L 3 months after LDLT were the independent risk factors for NODAT. Poor graft synthetic function 3 months after LDLT as well as older age of the recipient and a higher tacrolimus concentration were strongly associated with NODAT development after LDLT.

The UK National Registry of ABO and HLA Antibody Incompatible Renal Transplantation: Pretransplant Factors Associated With Outcome in 879 Transplants

PubMed Central

Pankhurst, Laura; Hudson, Alex; Mumford, Lisa; Willicombe, Michelle; Galliford, Jack; Shaw, Olivia; Thuraisingham, Raj; Puliatti, Carmelo; Talbot, David; Griffin, Sian; Torpey, Nicholas; Ball, Simon; Clark, Brendan; Briggs, David; Fuggle, Susan V.; Higgins, Robert M.

2017-01-01

Background ABO and HLA antibody incompatible (HLAi) renal transplants (AIT) now comprise around 10% of living donor kidney transplants. However, the relationship between pretransplant factors and medium-term outcomes are not fully understood, especially in relation to factors that may vary between centers. Methods The comprehensive national registry of AIT in the United Kingdom was investigated to describe the donor, recipient and transplant characteristics of AIT. Kaplan-Meier analysis was used to compare survival of AIT to all other compatible kidney transplants performed in the United Kingdom. Cox proportional hazards regression modeling was used to determine which pretransplant factors were associated with transplant survival in HLAi and ABOi separately. The primary outcome was transplant survival, taking account of death and graft failure. Results For 522 HLAi and 357 ABO incompatible (ABOi) transplants, 5-year transplant survival rates were 71% (95% confidence interval [CI], 66-75%) for HLAi and 83% (95% CI, 78-87%) for ABOi, compared with 88% (95% CI, 87-89%) for 7290 standard living donor transplants, and 78% (95% CI, 77-79%) for 15 322 standard deceased donor transplants (P < 0.0001). Increased chance of transplant loss in HLAi was associated with increasing number of donor specific HLA antibodies, center performing the transplant, antibody level at the time of transplant, and an interaction between donor age and dialysis status. In ABOi, transplant loss was associated with no use of IVIg, cytomegalovirus seronegative recipient, 000 HLA donor-recipient mismatch; and increasing recipient age. Conclusions Results of AIT were acceptable, certainly in the context of a choice between living donor AIT and an antibody compatible deceased donor transplant. Several factors were associated with increased chance of transplant loss, and these can lead to testable hypotheses for further improving therapy. PMID:28706984

Pretransplant diabetes, not donor age, predicts long-term outcomes in cardiac transplantation.

PubMed

Meyer, Steven R; Modry, Dennis L; Norris, Colleen M; Pearson, Glen J; Bentley, Michael J; Koshal, Arvind; Mullen, John C; Rebeyka, Ivan M; Ross, David B; Wang, Shaohua

2006-01-01

Accepting donors of advanced age may increase the number of hearts available for transplantation. Objectives were to review the outcomes of using cardiac donors 50 years of age and older and to identify predictors of outcome at a single institution. A retrospective analysis of all adult cardiac transplants (n = 338) performed at our institution between 1988 and 2002 was conducted. Of these, 284 patients received hearts from donors <50 years old and 54 received hearts from donors > or =50 years old. Recipients of hearts from older donors had a greater frequency of pretransplant diabetes (19% vs 33%), renal failure (16% vs 30%), and dialysis (3% vs 9%). There were no differences in ICU or postoperative length of stay, days ventilated, or early rejection episodes. Recipients of older donor hearts, however, had increased perioperative mortality (7% vs 17%; p = 0.03). Multivariate analysis identified older donors (OR 2.599; p = 0.03) and donor ischemia time (OR 1.006; p = 0.002) as significant predictors of perioperative mortality. Actuarial survival at 1 (87% vs 74%), 5 (76% vs 69%), and 10 (59% vs 58%) years was similar (p = 0.08) for the two groups. Separate multivariate analyses identified pretransplant diabetes as the sole predictor of long-term survival (HR 1.659; p = 0.02) and transplant coronary disease (HR 2.486; p = 0.003). Despite increased perioperative mortality, donors > or =50 years old may be used with long-term outcomes similar to those of younger donor hearts. This has potential to expand the donor pool. Pretransplant diabetes has a significant impact on long-term outcomes in cardiac transplantation and requires further investigation.

TEMPO addition into pre-irradiated fluoropolymers and living-radical graft polymerization of styrene for preparation of polymer electrolyte membranes

NASA Astrophysics Data System (ADS)

Sawada, Shin-ichi; Suzuki, Akihiro; Terai, Takayuki; Maekawa, Yasunari

2010-04-01

We prepared proton exchange membranes (PEMs) by 2,2,6,6-tetramethylpiperidinyl-1-oxy (TEMPO)-mediated living-radical graft polymerization (LRGP) of styrene into fluoropolymer films and subsequent sulfonation. Poly(vinylidene fluoride) (PVDF) and poly(ethylene- co-tetrafluoroethylene) (ETFE) films were first irradiated and then treated with TEMPO solutions in various solvents. TEMPO addition was confirmed by the test of styrene grafting into TEMPO-treated films at 60 °C, at which the LRGP never proceeds. This test enabled us to differentiate the LRGP from the conventional graft polymerization. In order to gain a deep insight about TEMPO-addition reaction, the TEMPO-penetration behavior into the base polymer films was examined by a permeation experiment and computer simulation. Xylene and dioxane were appropriate solvents for the complete introduction of TEMPO into PVDF and ETFE films, respectively. Then, the LRGP of styrene was performed based on the fully TEMPO-capped films at 125 °C with various solvents. By using an alcoholic solvent, the degree of grafting was enhanced and it reached a maximum of 38%. This grafted film was sulfonated to prepare a PEM showing an ion exchange capacity of 2.2 meq/g and proton conductivity of 1.6×10 -1 S/cm.

Microstructured polymer films by X-ray lithographic exposure and grafting

NASA Astrophysics Data System (ADS)

Gürsel, Selmiye A.; Padeste, Celestino; Solak, Harun H.; Scherer, Günther G.

2005-07-01

Recently we reported on a new technique to generate micro- and nanostructured polymer materials by the combination of selective irradiation of polymer substrates with X-rays and subsequent grafting of a second polymer. Here we focus on the spatially defined grafting throughout the thickness of poly(ethylene-alt-tetrafluoroethylene) (ETFE) and poly (tetrafluoroethylene-co-hexafluoropropylene) (FEP) films using X-ray irradiation through a metal mask, followed by grafting with styrene. Calculations of the transmission of X-rays through the polymer as a function of the wavelength have revealed that energy deposition within the substrate material, which should control the density of created radicals, can be selected in a wide range. Depending on the used wavelength the radicals are created either near the surface or in the bulk of the sample. First experiments demonstrated spatially defined grafting through a 100 μm thick ETFE film and 25 μm thick FEP film. The achieved graft level depends on the irradiation dose as well as on the grafting parameters such as concentration, temperature and time. The precision of structure definition within the film depends on the properties of the X-ray source, the metal mask and the grafting process. The presented process allows controlled grafting through fluoropolymer films with micrometer resolution and local modification of the properties of the films, such as ion conductivity, diffusion of specific molecules or optical properties.

Current status of grafts and implants in rhinoplasty: Part II. Homologous grafts and allogenic implants.

PubMed

Sajjadian, Ali; Naghshineh, Nima; Rubinstein, Roee

2010-03-01

After reading this article, the participant should be able to: 1. Understand the challenges in restoring volume and structural integrity in rhinoplasty. 2. Identify the appropriate uses of various homologous grafts and allogenic implants in reconstruction, including: (a) freeze-dried acellular allogenic cadaveric dermis grafts, (b) irradiated cartilage grafts, (c) hydroxyapatite mineral matrix, (d) silicone implants, (e) high-density polyethylene implants, (f) polytetrafluoroethylene implants, and (g) injectable filler materials. 3. Identify the advantages and disadvantages of each of these biomaterials. 4. Understand the specific techniques that may aid in the use these grafts or implants. This review specifically addresses the use of homologous grafts and allogenic implants in rhinoplasty. It is important to stress that autologous materials remain the preferred graft material for use in rhinoplasty, owing to their high biocompatibility and low risk of infection and extrusion. However, concerns of donor-site morbidity, graft availability, and graft resorption have motivated the development and use of homologous and allogenic implants.

Patient-reported immunosuppression nonadherence 6 to 24 months after liver transplant: association with pretransplant psychosocial factors and perceptions of health status change

PubMed Central

Rodrigue, James R.; Nelson, David R.; Hanto, Douglas W.; Reed, Alan I.; Curry, Michael P.

2014-01-01

Context Knowing the prevalence and risk factors of immunosuppression nonadherence after liver transplant may help guide intervention development. Objective To examine whether sociodemographic and psychosocial variables before liver transplant are predictive of nonadherence after liver transplant. Design Structured telephone interviews were used to collect self-report immunosuppression adherence and health status information. Medical record reviews were then completed to retrospectively examine the relationship between immunosuppression adherence and pretransplant variables, including sociodemographic and medical characteristics and the presence or absence of 6 hypothesized psychosocial risk factors. Setting and Participants A nonprobability sample of 236 adults 6 to 24 months after liver transplant at 2 centers completed structured telephone interviews. Main Outcome Measure Immunosuppressant medication nonadherence, categorized as missed-dose and altered-dose “adherent” or “nonadherent” during the past 6 months; immunosuppression medication holidays. Results Eighty-two patients (35%) were missed-dose nonadherent and 34 patients (14%) were altered-dose nonadherent. Seventy-one patients (30%) reported 1 or more 24-hour immunosuppression holidays in the past 6 months. Missed-dose nonadherence was predicted by male sex (odds ratio, 2.46; P = .01), longer time since liver transplant (odds ratio, 1.08; P = .01), pretransplant mood disorder (odds ratio, 2.52; P = .004), and pretransplant social support instability (odds ratio, 2.25; P = .03). Altered-dose nonadherence was predicted by pretransplant mood disorder (odds ratio, 2.15; P = .04) and pretransplant social support instability (odds ratio, 1.89; P = .03). Conclusion Rates of immunosuppressant nonadherence and drug holidays in the first 2 years after liver transplant are unacceptably high. Pretransplant mood disorder and social support instability increase the risk of nonadherence, and interventions should

Dialysis Vintage and Outcomes after Kidney Transplantation: A Retrospective Cohort Study

PubMed Central

Haller, Maria C.; Kainz, Alexander; Baer, Heather

2017-01-01

Background and objectives Historically, length of pretransplant dialysis was associated with premature graft loss and mortality after kidney transplantation, but with recent advancements in RRT it is unclear whether this negative association still exists. Design, setting, participants, &measurements This is a retrospective cohort study evaluating 6979 first kidney allograft recipients from the Austrian Registry transplanted between 1990 and 2013. Duration of pretransplant dialysis treatment was used as categoric predictor classified by tertiles of the distribution of time on dialysis. A separate category for pre-emptive transplantation was added and defined as kidney transplantation without any dialysis preceding the transplant. Outcomes were death-censored graft loss, all-cause mortality, and the composite of both. Results Median duration of follow-up was 8.2 years, and 1866 graft losses and 2407 deaths occurred during the study period. Pre-emptive transplantation was associated with a lower risk of graft loss (hazard ratio, 0.76; 95% confidence interval, 0.59 to 0.98), but not in subgroup analyses excluding living transplants and transplants performed since 2000. The association between dialysis duration and graft loss did not depend on the year of transplantation (P=0.40) or donor source (P=0.92). Longer waiting time on dialysis was not associated with a higher rate of graft loss, but the rate of death was higher in patients on pretransplant dialysis for >1.5 years (hazard ratio, 1.62; 95% confidence interval, 1.43 to 1.83) compared with pretransplant dialysis for <1.5 years. Conclusions Our findings support the evidence that pre-emptive transplantation is associated with superior graft survival compared with pretransplant dialysis, although this association was weaker in transplants performed since 2000. However, our analysis shows that length of dialysis was no longer associated with a higher rate of graft loss, although longer waiting times on dialysis were

Di-(2-ethylhexyl)-phthalate migration from irradiated poly(vinyl chloride) blood bags for graft-vs-host disease prevention.

PubMed

Ferri, Marcella; Marcella, Ferri; Chiellini, Federica; Federica, Chiellini; Pili, Giorgio; Giorgio, Pili; Grimaldi, Luca; Luca, Grimaldi; Florio, Elena Tiziana; Pili, Stefania; Stefania, Pili; Cucci, Francesco; Francesco, Cucci; Latini, Giuseppe; Giuseppe, Latini

2012-07-01

Irradiation with 20-25 kGy is a process commonly used for sterilizing poly(vinyl chloride) (PVC) medical devices. Moreover, whole blood and blood components undergo additional irradiation with 25-50 Gy to inhibit the proliferative capacity of lymphocytes and reduce the risk of transfusion-associated graft-vs-host disease (GVHD). Di-(2-ethylhexyl)-phthalate (DEHP) plasticized PVC is extensively used for the production of flexible medical devices including blood bags, but since DEHP is not covalently bound to PVC, it tends to migrate and leach out of the medical device, with harmful consequences for the patients. In this study, the effects of different doses of gamma irradiation on DEHP migration from PVC blood bags was investigated using differential scanning calorimetry (DSC) analysis. Our findings indicate that irradiation with 25-100 Gy reduces the ability of DEHP to migrate from the blood bags, and in the case of a primary container a correlation between the doses of gamma ray irradiation was also observed. In particular, a decrease in DEHP leachability was obtained by increasing the dose of gamma ray irradiation. Copyright © 2012 Elsevier B.V. All rights reserved.

Kinetics and characterization of radiation-induced grafting of styrene on fluoropolymers

NASA Astrophysics Data System (ADS)

Guilmeau, I.; Esnouf, S.; Betz, N.; Le Moël, A.

1997-08-01

Grafting of styrene solution onto poly(ethylene-co-tetrafluoroethylene) (ETFE) was carried out by the pre-irradiation method. ETFE films were irradiated by 1.5 MeV electron beams in air. The influence of grafting temperature (50 to 80°C) has been investigated. It was found that the saturation grafting yield and the initial rate follow an Arrhenius law. The volume grafting yields were measured by FTIR spectroscopy in transmission and by weighing and the 'surface' grafting yields by FTIR-ATR. The results showed that grafting reaction is not monomer diffusion controlled in 30 μm film, nevertheless heterogeneities are revealed. By in-situ ESR, the decay of peroxy radicals was recorded under various heating and grafting conditions. These experiments suggest that the peroxy radicals react rapidly with monomer, but do not initiate the grafting process. The propagating radicals were not detectable, which may indicate that polystyrene chains are very long.

Pretransplant Aspergillus colonization of cystic fibrosis patients and the incidence of post-lung transplant invasive aspergillosis.

PubMed

Luong, Me-Linh; Chaparro, Cecilia; Stephenson, Anne; Rotstein, Coleman; Singer, Lianne G; Waters, Valerie; Azad, Sassan; Keshavjee, Shaf; Tullis, Elizabeth; Husain, Shahid

2014-02-15

Invasive aspergillosis (IA) is an important cause of morbidity and mortality among patients undergoing lung transplant. Cystic fibrosis-lung transplant recipients (CF-LTRs) may be at greater risk of IA following lung transplantation because of the presence of Aspergillus in their airways before transplantation. This study evaluated the impact of pretransplant Aspergillus colonization on the risk for IA among CF-LTRs. A single-center retrospective cohort study of CF-LTRs was conducted between 2006 and 2010. Respiratory tract cultures before transplantation were reviewed to identify patients with pretransplant Aspergillus colonization. Patients with positive Aspergillus sputum culture or positive bronchoalvelolar lavage (BAL) galactomannan after transplantation were classified as having colonization or disease according to the International Society of Heart and Lung Transplantation criteria. A total of 93 CF patients underwent lung transplantation. Seventy percent (65/93) of CF-LTRs had pretransplant Aspergillus colonization. Thirty-six patients had positive intraoperative Aspergillus culture from the native lung BAL. Overall, 22.5% (20/93) of CF-LTRs developed IA. Median time to IA was 42 days following transplantation. Positive intraoperative Aspergillus culture (OR 4.36, 95% CI 1.35-14.05, P=0.01) and treatment for acute cellular rejection within 90 days after transplantation (OR 3.53, 95% CI 1.03-12.15, P=0.05) were independent risk factors for IA. Antifungal prophylaxis was administered to 61% (57/93) of CF-LTRs. One-year mortality rate was 16% (15/93). IA was not associated with increased risk of death (OR 2.10, 95% CI 0.62-7.06, P=0.23). Pretransplant Aspergillus colonization is frequent among CF-LTRs and a positive intraoperative Aspergillus culture produced a fourfold higher risk of developing IA.

Revision Risk After Allograft Anterior Cruciate Ligament Reconstruction: Association With Graft Processing Techniques, Patient Characteristics, and Graft Type.

PubMed

Tejwani, Samir G; Chen, Jason; Funahashi, Tadashi T; Love, Rebecca; Maletis, Gregory B

2015-11-01

Allograft tissue is a common graft choice for anterior cruciate ligament reconstruction (ACLR). Allograft sterilization methods vary widely across numerous commercial tissue vendors. Multiple studies, despite being limited in sample size, have suggested a higher rate of clinical failure associated with the use of allograft tissue in ACLR when compared with autograft. To examine the association of graft processing techniques, patient characteristics, and graft type with risk of revision surgery after allograft ACLR. Cohort study; Level of evidence, 3. A retrospective cohort study was conducted that used an integrated United States health care system's ACLR registry to identify primary unilateral cases in which allografts were used. Aseptic revision was the endpoint of the study. Allograft type, processing methods (irradiation dose, AlloWash, AlloTrue, BioCleanse), and graft donor age were assessed as potential risk factors for revision, with adjustment for patient age, sex, and body mass index (BMI) by use of survival analysis. Hazard ratios (HR) and 95% confidence intervals (CIs) were calculated. A total of 5968 primary ACLR cases with allograft were included in the study, of which 3688 (61.8%) were male patients. The median age of the cohort at the time of surgery was 34.1 years (interquartile range, 24.1-42.9 years). The mean time to follow-up (±SD) was 2.1 ± 1.5 years. There were 3751 (62.9%) allograft ACLRs using soft tissue, 1188 (19.9%) with Achilles tendon, and 1029 (17.2%) with bone-patellar tendon-bone (BPTB). Graft processing groups included BioCleanse (n = 367), AlloTrue or AlloWash (n = 2278), irradiation greater than 1.8 Mrad (n = 1146), irradiation up to 1.8 Mrad (n = 3637), and no irradiation (n = 1185). There were 156 (2.6%) aseptic revisions. After adjustment for patient age, sex, and BMI, the use of BioCleanse (HR = 2.45; 95% CI, 1.36-4.40) and irradiation greater than 1.8 Mrad (HR = 1.64; 95% CI, 1.08-2.49) were associated with a higher risk of

Ventricular assist device elicits serum natural IgG that correlates with the development of primary graft dysfunction following heart transplantation.

PubMed

See, Sarah B; Clerkin, Kevin J; Kennel, Peter J; Zhang, Feifan; Weber, Matthew P; Rogers, Kortney J; Chatterjee, Debanjana; Vasilescu, Elena R; Vlad, George; Naka, Yoshifumi; Restaino, Susan W; Farr, Maryjane A; Topkara, Veli K; Colombo, Paolo C; Mancini, Donna M; Schulze, P Christian; Levin, Bruce; Zorn, Emmanuel

2017-08-01

Pre-transplant sensitization is a limiting factor in solid-organ transplantation. In heart transplants, ventricular assist device (VAD) implantation has been associated with sensitization to human leukocyte antigens (HLA). The effect of VAD on non-HLA antibodies is unclear. We have previously shown that polyreactive natural antibodies (Nabs) contribute to pre-sensitization in kidney allograft recipients. Here we assessed generation of Nabs after VAD implantation in pre-transplant sera and examined their contribution to cardiac allograft outcome. IgM and IgG Nabs were tested in pre-transplant serum samples collected from 206 orthotopic heart transplant recipients, including 128 patients with VAD (VAD patients) and 78 patients without VAD (no-VAD patients). Nabs were assessed by testing serum reactivity to apoptotic cells by flow cytometry and to the generic oxidized epitope, malondialdehyde, by enzyme-linked immunosorbent assay. No difference was observed in serum levels of IgM Nabs between VAD and no-VAD patients. However, serum IgG Nabs levels were significantly increased in VAD compared with no-VAD patients. This increase was likely due to the presence of the VAD, as revealed by lower serum IgG Nabs levels before implantation. Elevated pre-transplant IgG Nabs level was associated with development of primary graft dysfunction (PGD). Our study demonstrates that VAD support elicits IgG Nabs reactive to apoptotic cells and oxidized epitopes. These findings further support broad and non-specific B-cell activation by VAD, resulting in IgG sensitization. Moreover, the association of serum IgG Nabs levels with development of PGD suggests a possible role for these antibodies in the inflammatory reaction accompanying this complication. Copyright © 2017 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Intravenous Busulfan Compared with Total Body Irradiation Pretransplant Conditioning for Adults with Acute Lymphoblastic Leukemia.

PubMed

Kebriaei, Partow; Anasetti, Claudio; Zhang, Mei-Jie; Wang, Hai-Lin; Aldoss, Ibrahim; de Lima, Marcos; Khoury, H Jean; Sandmaier, Brenda M; Horowitz, Mary M; Artz, Andrew; Bejanyan, Nelli; Ciurea, Stefan; Lazarus, Hillard M; Gale, Robert Peter; Litzow, Mark; Bredeson, Christopher; Seftel, Matthew D; Pulsipher, Michael A; Boelens, Jaap-Jan; Alvarnas, Joseph; Champlin, Richard; Forman, Stephen; Pullarkat, Vinod; Weisdorf, Daniel; Marks, David I

2018-04-01

Total body irradiation (TBI) has been included in standard conditioning for acute lymphoblastic leukemia (ALL) before hematopoietic cell transplantation (HCT). Non-TBI regimens have incorporated busulfan (Bu) to decrease toxicity. This retrospective study analyzed TBI and Bu on outcomes of ALL patients 18-60 years old, in first or second complete remission (CR), undergoing HLA-compatible sibling, related, or unrelated donor HCT, who reported to the Center for International Blood and Marrow Transplant Research from 2005 to 2014. TBI plus etoposide (25%) or cyclophosphamide (75%) was used in 819 patients, and intravenous Bu plus fludarabine (41%), clofarabine (30%), cyclophosphamide (15%), or melphalan (13%) was used in 299 patients. Bu-containing regimens were analyzed together, since no significant differences for patient outcomes were noted between them. Bu patients were older, with better performance status; took longer to achieve first CR and receive HCT; were treated more recently; and were more likely to receive peripheral blood grafts, antithymocyte globulin, or tyrosine kinase inhibitors. With median follow-up of 3.6 years for Bu and 5.3 years for TBI, adjusted 3-year outcomes showed treatment-related mortality Bu 19% versus TBI 25% (P = .04); relapse Bu 37% versus TBI 28% (P = .007); disease-free survival (DFS) Bu 45% versus TBI 48% (P = .35); and overall survival (OS) Bu 57% versus TBI 53% (P = .35). In multivariate analysis, Bu patients had higher risk of relapse (relative risk, 1.46; 95% confidence interval, 1.15 to 1.85; P = .002) compared with TBI patients. Despite the higher relapse, Bu-containing conditioning led to similar OS and DFS following HCT for ALL. Copyright © 2018. Published by Elsevier Inc.

Octogenarian liver grafts: Is their use for transplant currently justified?

PubMed

Jiménez-Romero, Carlos; Cambra, Felix; Caso, Oscar; Manrique, Alejandro; Calvo, Jorge; Marcacuzco, Alejandro; Rioja, Paula; Lora, David; Justo, Iago

2017-05-07

To analyse the impact of octogenarian donors in liver transplantation. We present a retrospective single-center study, performed between November 1996 and March 2015, that comprises a sample of 153 liver transplants. Recipients were divided into two groups according to liver donor age: recipients of donors ≤ 65 years (group A; n = 102), and recipients of donors ≥ 80 years (group B; n = 51). A comparative analysis between the groups was performed. Quantitative variables were expressed as mean values and SD, and qualitative variables as percentages. Differences in properties between qualitative variables were assessed by χ 2 test. Comparison of quantitative variables was made by t -test. Graft and patient survivals were estimated using the Kaplan-Meier method. One, 3 and 5-year overall patient survival was 87.3%, 84% and 75.2%, respectively, in recipients of younger grafts vs 88.2%, 84.1% and 66.4%, respectively, in recipients of octogenarian grafts ( P = 0.748). One, 3 and 5-year overall graft survival was 84.3%, 83.1% and 74.2%, respectively, in recipients of younger grafts vs 84.3%, 79.4% and 64.2%, respectively, in recipients of octogenarian grafts ( P = 0.524). After excluding the patients with hepatitis C virus cirrhosis (16 in group A and 10 in group B), the 1, 3 and 5-year patient ( P = 0.657) and graft ( P = 0.419) survivals were practically the same in both groups. Multivariate Cox regression analysis demonstrated that overall patient survival was adversely affected by cerebrovascular donor death, hepatocarcinoma, and recipient preoperative bilirubin, and overall graft survival was adversely influenced by cerebrovascular donor death, and recipient preoperative bilirubin. The standard criteria for utilization of octogenarian liver grafts are: normal gross appearance and consistency, normal or almost normal liver tests, hemodynamic stability with use of < 10 μg/kg per minute of vasopressors before procurement, intensive care unit stay < 3 d, CIT < 9 h

Octogenarian liver grafts: Is their use for transplant currently justified?

PubMed Central

Jiménez-Romero, Carlos; Cambra, Felix; Caso, Oscar; Manrique, Alejandro; Calvo, Jorge; Marcacuzco, Alejandro; Rioja, Paula; Lora, David; Justo, Iago

2017-01-01

AIM To analyse the impact of octogenarian donors in liver transplantation. METHODS We present a retrospective single-center study, performed between November 1996 and March 2015, that comprises a sample of 153 liver transplants. Recipients were divided into two groups according to liver donor age: recipients of donors ≤ 65 years (group A; n = 102), and recipients of donors ≥ 80 years (group B; n = 51). A comparative analysis between the groups was performed. Quantitative variables were expressed as mean values and SD, and qualitative variables as percentages. Differences in properties between qualitative variables were assessed by χ2 test. Comparison of quantitative variables was made by t-test. Graft and patient survivals were estimated using the Kaplan-Meier method. RESULTS One, 3 and 5-year overall patient survival was 87.3%, 84% and 75.2%, respectively, in recipients of younger grafts vs 88.2%, 84.1% and 66.4%, respectively, in recipients of octogenarian grafts (P = 0.748). One, 3 and 5-year overall graft survival was 84.3%, 83.1% and 74.2%, respectively, in recipients of younger grafts vs 84.3%, 79.4% and 64.2%, respectively, in recipients of octogenarian grafts (P = 0.524). After excluding the patients with hepatitis C virus cirrhosis (16 in group A and 10 in group B), the 1, 3 and 5-year patient (P = 0.657) and graft (P = 0.419) survivals were practically the same in both groups. Multivariate Cox regression analysis demonstrated that overall patient survival was adversely affected by cerebrovascular donor death, hepatocarcinoma, and recipient preoperative bilirubin, and overall graft survival was adversely influenced by cerebrovascular donor death, and recipient preoperative bilirubin. CONCLUSION The standard criteria for utilization of octogenarian liver grafts are: normal gross appearance and consistency, normal or almost normal liver tests, hemodynamic stability with use of < 10 μg/kg per minute of vasopressors before procurement, intensive care

Enhancing integration of articular cartilage grafts via photochemical bonding.

PubMed

Arvayo, Alberto L; Wong, Ivan J; Dragoo, Jason L; Levenston, Marc E

2018-03-25

The integration of osteochondral grafts to native articular cartilage is critical as the lack of graft integration may lead to continued tissue degradation, poor load transfer and inadequate nutrient transport. Photochemical bonding promotes graft integration by activating a photosensitizer at the interface via a light source and avoids negative effects associated with other bonding techniques. We hypothesized that the bond strength depends on photosensitizer type and concentration in addition to light exposure. Photochemical bonding was evaluated using methylene blue (MB), a cationic phenothiazine photosensitizer, and two phthalocyanine photosensitizers, Al(III) phthalocyanine chloride tetrasulfonic acid (CASPc) and aluminum phthalocyanine chloride (AlPc). Exposure was altered by varying irradiation time for a fixed irradiance or by varying irradiance with a fixed irradiation time. MB was ineffective at producing bonding at the range of concentrations tested while CASPc produced a peak twofold bond strength increase over controls. AlPc produced substantial bonding at all concentrations with a peak 3.9-fold bond strength increase over controls. Parametric tests revealed that bond strength depended primarily on the total energy delivered to the bonding site rather than the rate of light delivery or light irradiance. Bond strength persisted for 1 week of in-vitro culture, which warrants further exploration for clinical applications. These studies indicate that photochemical bonding is a viable strategy for enhancing articular cartilage graft integration. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Posttransplant sCD30 as a predictor of kidney graft outcome.

PubMed

Süsal, Caner; Döhler, Bernd; Sadeghi, Mahmoud; Salmela, Kaija T; Weimer, Rolf; Zeier, Martin; Opelz, Gerhard

2011-06-27

Reliable markers for assessing the biological effect of immunosuppressive drugs and identification of transplant recipients at risk of developing rejection are not available. In a prospective multicenter study, we investigated whether posttransplant measurement of the T-cell activation marker soluble CD30 (sCD30) can be used for estimating the risk of graft loss in kidney transplant recipients. Pre- and posttransplant sera of 2322 adult deceased-donor kidney recipients were tested for serum sCD30 content using a commercial enzyme-linked immunosorbent assay. sCD30 decreased posttransplant and reached a nadir on day 30. Patients with a high sCD30 of more than or equal to 40 U/mL on day 30 showed a subsequent graft survival rate after 3 years of 78.3±4.1%, significantly lower than the 90.3±1.0% rate in recipients with a low sCD30 on day 30 of less than 40 U/mL (log-rank P<0.001; Cox hazard ratio 2.02, P<0.001). Although an association was found between pre- and posttransplant sCD30 levels, patients with high sCD30 on posttransplant day 30 demonstrated significantly lower 3-year graft survival irrespective of the pretransplant level. Our data suggest that posttransplant measurement of sCD30 on day 30 is a predictor of subsequent graft loss in kidney transplant recipients and that sCD30 may potentially serve as an indicator for adjustment of immunosuppressive medication.

Pretransplant thymic function predicts acute rejection in antithymocyte globulin-treated renal transplant recipients.

PubMed

Bamoulid, Jamal; Courivaud, Cécile; Crepin, Thomas; Carron, Clémence; Gaiffe, Emilie; Roubiou, Caroline; Laheurte, Caroline; Moulin, Bruno; Frimat, Luc; Rieu, Philippe; Mousson, Christiane; Durrbach, Antoine; Heng, Anne-Elisabeth; Rebibou, Jean-Michel; Saas, Philippe; Ducloux, Didier

2016-05-01

Lack of clear identification of patients at high risk of acute rejection hampers the ability to individualize immunosuppressive therapy. Here we studied whether thymic function may predict acute rejection in antithymocyte globulin (ATG)-treated renal transplant recipients in 482 patients prospectively studied during the first year post-transplant of which 86 patients experienced acute rejection. Only CD45RA(+)CD31(+)CD4(+) T cell (recent thymic emigrant [RTE]) frequency (RTE%) was marginally associated with acute rejection in the whole population. This T-cell subset accounts for 26% of CD4(+) T cells. Pretransplant RTE% was significantly associated with acute rejection in ATG-treated patients (hazard ratio, 1.04; 95% confidence interval, 1.01-1.08) for each increased percent in RTE/CD4(+) T cells), but not in anti-CD25 monoclonal (αCD25 mAb)-treated patients. Acute rejection was significantly more frequent in ATG-treated patients with high pretransplant RTE% (31.2% vs. 16.4%) or absolute number of RTE/mm(3) (31.7 vs. 16.1). This difference was not found in αCD25 monclonal antibody-treated patients. Highest values of both RTE% (>31%, hazard ratio, 2.50; 95% confidence interval, 1.09-5.74) and RTE/mm(3) (>200/mm(3), hazard ratio, 3.71; 95% confidence interval, 1.59-8.70) were predictive of acute rejection in ATG-treated patients but not in patients having received αCD25 monoclonal antibody). Results were confirmed in a retrospective cohort using T-cell receptor excision circle levels as a marker of thymic function. Thus, pretransplant thymic function predicts acute rejection in ATG-treated patients. Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

Effects of sinus surgery on lung transplantation outcomes in cystic fibrosis.

PubMed

Leung, Man-Kit; Rachakonda, Leelanand; Weill, David; Hwang, Peter H

2008-01-01

In cystic fibrosis (CF) patients who are candidates for lung transplant, pretransplant sinus surgery has been advocated to avoid bacterial seeding of the transplanted lungs. This study reviews the 17-year experience of pretransplant sinus surgery among CF patients at a major transplant center. Retrospective chart review was performed in all CF patients who underwent heart-lung or lung transplantation at Stanford Medical Center between 1988 and 2005. Postoperative culture data from bronchoalveolar lavage (BAL) and sinus aspirates were evaluated, in addition to survival data. Eighty-seven CF transplant recipients underwent pretransplant sinus surgery; 87% (n=59/68) of patients showed recolonization of the lung grafts with Pseudomonas on BAL cultures. The median postoperative time to recolonization was 19 days. Bacterial floras cultured from sinuses were similar in type and prevalence as the floras cultured from BAL. When compared with published series of comparable cohorts in which pretransplant sinus surgery was not performed, there was no statistically significant difference in the prevalence of Pseudomonas recolonization. Times to recolonization also were similar. Survival rates in our cohort were similar to national survival rates for CF lung transplant recipients. Despite pretransplant sinus surgery, recolonization of lung grafts occurs commonly and rapidly with a spectrum of flora that mimics the sinus flora. Survival rates of CF patients who undergo prophylactic sinus surgery are similar to those from centers where prophylactic sinus surgery is not performed routinely. Pretransplant sinus surgery does not appear to prevent lung graft recolonization and is not associated with overall survival benefit.

Preparation and characterization of mono-sheet bipolar membranes by pre-irradiation grafting method for fuel cell applications

NASA Astrophysics Data System (ADS)

Guan, Yingjie; Fang, Jun; Fu, Tao; Zhou, Huili; Wang, Xin; Deng, Zixiang; Zhao, Jinbao

2016-09-01

A new method for the preparation of the mono-sheet bipolar membrane applied to fuel cells was developed based on the pre-irradiation grafting technology. A series of bipolar membranes were successfully prepared by simultaneously grafting of styrene onto one side of the poly(ethylene-co-tetrafluoroethylene) base film and 1-vinylimidazole onto the opposite side, followed by the sulfonation and alkylation, respectively. The chemical structures and microstructures of the prepared membranes were investigated by ATR-FTIR and SEM-EDS. The TGA measurements demonstrated the prepared bipolar membranes have reasonable thermal stability. The ion exchange capacity, water uptake and ionic conductivity of the membranes were also characterized. The H2/O2 single fuel cells using these membranes were evaluated and revealed a maximum power density of 107 mW cm-2 at 35 °C with unhumidified hydrogen and oxygen. The preliminary performances suggested the great prospect of these membranes in application of bipolar membrane fuel cells.

Proton exchange membranes prepared by grafting of styrene/divinylbenzene into crosslinked PTFE membranes

NASA Astrophysics Data System (ADS)

Li, Jingye; Ichizuri, Shogo; Asano, Saneto; Mutou, Fumihiro; Ikeda, Shigetoshi; Iida, Minoru; Miura, Takaharu; Oshima, Akihiro; Tabata, Yoneho; Washio, Masakazu

2005-07-01

Thin PTFE membranes were prepared by coating the PTFE dispersion onto the aluminum films. Thus the thin crosslinked PTFE (RX-PTFE) membranes were obtained by means of electron beam irradiation above the melting temperature of PTFE under oxygen-free atmosphere. The RX-PTFE membranes were pre-irradiated and grafted by styrene with or without divinylbenzene (DVB) in liquid phase. The existence of DVB accelerated the initial grafting rate. The styrene grafted RX-PTFE membranes are white colored, on the other hand, the styrene/DVB grafted RX-PTFE membranes are colorless. The proton exchange membranes (PEMs) were obtained by sulfonating the grafted membranes using chlorosulfonic acid. The ion exchange capacity (IEC) values of the PEMs ranging from 1.5 to 2.8 meq/g were obtained. The PEMs made from the styrene/DVB grafted membranes showed higher chemical stability than those of the styrene grafted membranes under oxidative circumstance.

Peritransplant Soluble CD30 as a Risk Factor for Slow Kidney Allograft Function, Early Acute Rejection, Worse Long-Term Allograft Function, and Patients' Survival.

PubMed

Trailin, Andriy V; Ostapenko, Tetyana I; Nykonenko, Tamara N; Nesterenko, Svitlana N; Nykonenko, Olexandr S

2017-01-01

We aimed to determine whether serum soluble CD30 (sCD30) could identify recipients at high risk for unfavorable early and late kidney transplant outcomes. Serum sCD30 was measured on the day of kidney transplantation and on the 4th day posttransplant. We assessed the value of these measurements in predicting delayed graft function, slow graft function (SGF), acute rejection (AR), pyelonephritis, decline of allograft function after 6 months, and graft and patient survival during 5 years of follow-up in 45 recipients. We found the association between low pretransplant serum levels of sCD30 and SGF. The absence of significant decrease of sCD30 on the 4th day posttransplant was characteristic for SGF, early AR (the 8th day-6 months), late AR (>6 months), and early pyelonephritis (the 8th day-2 months). Lower pretransplant and posttransplant sCD30 predicted worse allograft function at 6 months and 2 years, respectively. Higher pretransplant sCD30 was associated with higher frequency of early AR, and worse patients' survival, but only in the recipients of deceased-donor graft. Pretransplant sCD30 also allowed to differentiate patients with early pyelonephritis and early AR. Peritransplant sCD30 is useful in identifying patients at risk for unfavorable early and late transplant outcomes.

Peritransplant Soluble CD30 as a Risk Factor for Slow Kidney Allograft Function, Early Acute Rejection, Worse Long-Term Allograft Function, and Patients' Survival

PubMed Central

Ostapenko, Tetyana I.; Nykonenko, Tamara N.; Nesterenko, Svitlana N.; Nykonenko, Olexandr S.

2017-01-01

Background We aimed to determine whether serum soluble CD30 (sCD30) could identify recipients at high risk for unfavorable early and late kidney transplant outcomes. Methods Serum sCD30 was measured on the day of kidney transplantation and on the 4th day posttransplant. We assessed the value of these measurements in predicting delayed graft function, slow graft function (SGF), acute rejection (AR), pyelonephritis, decline of allograft function after 6 months, and graft and patient survival during 5 years of follow-up in 45 recipients. Results We found the association between low pretransplant serum levels of sCD30 and SGF. The absence of significant decrease of sCD30 on the 4th day posttransplant was characteristic for SGF, early AR (the 8th day–6 months), late AR (>6 months), and early pyelonephritis (the 8th day–2 months). Lower pretransplant and posttransplant sCD30 predicted worse allograft function at 6 months and 2 years, respectively. Higher pretransplant sCD30 was associated with higher frequency of early AR, and worse patients' survival, but only in the recipients of deceased-donor graft. Pretransplant sCD30 also allowed to differentiate patients with early pyelonephritis and early AR. Conclusions Peritransplant sCD30 is useful in identifying patients at risk for unfavorable early and late transplant outcomes. PMID:28694560

Death with functioning graft in living donor kidney transplantation: analysis of risk factors.

PubMed

El-Agroudy, Amgad E; Bakr, Mohamed A; Shehab El-Dein, Ahmed B; Ghoneim, Mohamed A

2003-01-01

Death with a functioning graft (DWF) has been reported as a major cause of graft loss after renal transplantation. It has been reported to occur in 9-30%. From March 1976 to January 2002, a total of 1400 living donor renal transplants were performed in our center. Out of 257 reported deaths among our patients, 131 recipients died with functioning grafts after a mean period of 53.4 +/- 53.2 months. DWF patients account for 27% of all graft losses in our series. The mean age was 34.9 + 10.6 (range 8-62 years), 98 of them were male and 33 were female. The original kidney disease was GN in 9, PN in 24, PCK in 5 and nephrosclerosis in 8 patients. Acute rejection episodes were diagnosed in 84 patients (63.1). The post-transplant complications encountered were hypertension in 78 patients (59.5%), diabetes mellitus in 30 patients (22.9%), medical infections in 68 (51.5%), hepatic complications in 30 (22.9%) and malignancy in 17 patients (13%). The main causes of death in these patients were infections in 46 (35.6%), cardiovascular in 23 (17.6%), liver cell failure in 15 patients (11.4%) and malignancy in 8 (6.1%). The mean serum creatinine was 2 +/- 0.6 mg/dl at last follow-up before death. We conclude that the relatively higher mortality in renal transplantation is, in part, due to co-morbid medical illness, pre-transplant dialysis treatment, and factors uniquely related to transplantation, including immunosuppression and other drug effects. DWF must be in consideration when calculating graft survival. Copyright 2003 S. Karger AG, Basel

Syngeneic transplantation in aplastic anemia: pre-transplant conditioning and peripheral blood are associated with improved engraftment: an observational study on behalf of the Severe Aplastic Anemia and Pediatric Diseases Working Parties of the European Group for Blood and Marrow Transplantation

PubMed Central

Gerull, Sabine; Stern, Martin; Apperley, Jane; Beelen, Dietrich; Brinch, Lorentz; Bunjes, Donald; Butler, Andrew; Ganser, Arnold; Ghavamzadeh, Ardeshir; Koh, Mickey B; Komarnicki, Mieczyslaw; Kröger, Nicolaus; Maertens, Johan; Maschan, Alexei; Peters, Christina; Rovira, Montserrat; Sengeløv, Henrik; Socié, Gerard; Tischer, Johanna; Oneto, Rosi; Passweg, Jakob; Marsh, Judith

2013-01-01

Aplastic anemia is usually treated with immunosuppression or allogeneic transplant, depending on patient and disease characteristics. Syngeneic transplant offers a rare treatment opportunity with minimal transplant-related mortality, and offers an insight into disease mechanisms. We present here a retrospective analysis of all syngeneic transplants for aplastic anemia reported to the European Group for Blood and Marrow Transplantation. Between 1976 and 2009, 88 patients received 113 transplants. Most transplants (n=85) were preceded by a conditioning regimen, 22 of these including anti-thymocyte globulin. About half of transplants with data available (39 of 86) were followed by posttransplant immunosuppression. Graft source was bone marrow in the majority of cases (n=77). Transplant practice changed over time with more transplants with conditioning and anti-thymocyte globulin as well as peripheral blood stem cells performed in later years. Ten year overall survival was 93% with 5 transplant-related deaths. Graft failure occurred in 32% of transplants. Risk of graft failure was significantly increased in transplants without conditioning, and with bone marrow as graft source. Lack of posttransplant immunosuppression also showed a trend towards increased risk of graft failure, while anti-thymocyte globulin did not have an influence. In summary, syngeneic transplant is associated with a significant risk of graft failure when no conditioning is given, but has an excellent long-term outcome. Furthermore, our comparatively large series enables us to recommend the use of pre-transplant conditioning rather than not and possibly to prefer peripheral blood as a stem cell source. PMID:23894010

The pretransplant neutrophil-lymphocyte ratio as a new prognostic predictor after liver transplantation for hepatocellular cancer: a systematic review and meta-analysis.

PubMed

Xu, Zheng-Guang; Ye, Cheng-Jie; Liu, Lin-Xun; Wu, Gang; Zhao, Zhan-Xue; Wang, Yong-Zhen; Shi, Bing-Qiang; Wang, Yong-Hong

2018-02-01

Recently, many reports showed that the pretransplant neutrophil-lymphocyte ratio (NLR) may be correlated with the prognosis of patients undergoing liver transplantation (LT) for hepatocellular cancer (HCC). However, their results still remained controversial. Thus we performed a meta-analysis of 13 studies to estimate the prognostic value of pretransplant NLR. Databases including PubMed, Embase, Cochrane Library and Web of Science were searched to September 2017. Hazard ratio (HR) or odds ratio (OR) with its 95% CI was used to evaluate the association between elevated NLR and the prognosis or clinical features of liver cancer patients. A total of 13 studies including 1936 patients were included in this meta-analysis. Elevated pretransplant NLR had a close association with the overall survival (HR: 2.22; 95% CI: 1.34-3.68), recurrence-free survival (HR: 3.77; 95% CI: 2.01-7.06) and disease-free survival (HR: 2.51; 95% CI: 1.22-5.15) of patients undergoing LT for HCC, respectively. In addition, elevated NLR was associated with the presence of vascular invasion (OR: 2.39; 95% CI: 1.20-4.77) and Milan criteria (OR: 0.26; 95% CI: 0.17-0.40). The results of this meta-analysis showed that elevated pretransplant NLR may be used as a new prognostic predictor after LT for HCC.

Pre-transplant obesity in heart transplantation: are there predictors of worse outcomes?

PubMed

Macha, Mahender; Molina, Ezequiel J; Franco, Michael; Luyun, Lisa; Gaughan, John P; McClurken, James B; Furukawa, Satoshi

2009-01-01

Morbid obesity is increasingly observed in patients being evaluated for heart transplantation and represents a relative contraindication. We sought to evaluate the influence of pre-transplant obesity on morbidity and mortality after heart transplantation. We retrospectively reviewed 90 consecutive patients with preoperative obesity (BMI > or = 30) and 90 age matched patients with normal weight (BMI 19 - 26) who underwent heart transplantation at our institution between January 1997 and December 2005. Morbidly obese patients experienced higher rates of pre-transplant diabetes (29% vs 15%, p < 0.05) and prolonged waiting time before transplantation (191.4+/-136.1 vs 117.4+/-143.2 days, p < 0.001). There were no significant differences in post-operative complications including rejection and major and minor infections. There was no difference in actuarial survival between the obese and control groups after a mean follow-up of 4.26+/-2.95 years (p = 0.513, log-rank statistic 0.452). Causes of death did not differ. Cox proportional hazard analysis revealed increased association of peripheral vascular disease (HR 31.718, p = 0.001), and pre operative inotropic support (HR 33.725, p = 0.013) with increased mortality in the obese group. This study suggests morbid obesity does not affect survival or rates of infection and rejection after heart transplantation.

Indications and results of omental pedicle grafts in oncology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Petit, J.Y.; Lacour, J.; Margulis, A.

1979-12-01

Sixty omental grafts were performed in our department. Sixty-two percent concerned breast cancer patients. Other grafts were undertaken for other cancers: head and neck, gynecologic urologic and intestinal, skin and soft tissue tumors. These grafts were indicated for radionecrosis or chemonecrosis in 33 cases and for cancer recurrence in 26 cases (among whom 24 were previously irradiated). Only one graft was performed for lymphoedema treatment. Overall, fifty four patients (83.5%) had successful grafts, and six (16.5%) had graft failures. According to the treated lesion we obtained 82% of successful treatment among patients treated for radio or chemonecrosis, and 92% formore » patients treated for recurrences.« less

Study and Optimization on graft polymerization under normal pressure and air atmospheric conditions, and its application to metal adsorbent

NASA Astrophysics Data System (ADS)

Ueki, Yuji; Chandra Dafader, Nirmal; Hoshina, Hiroyuki; Seko, Noriaki; Tamada, Masao

2012-07-01

Radiation-induced graft polymerization of glycidyl methacrylate (GMA) onto non-woven polyethylene (NWPE) fabric was achieved under normal pressure and air atmospheric conditions, without using unique apparatus such as glass ampoules or vacuum lines. To attain graft polymerization under normal pressure and air atmospheric conditions, the effects of the pre-irradiation dose, pre-irradiation atmosphere, pre-irradiation temperature, de-aeration of GMA-emulsion, grafting atmosphere in a reactor, and dissolved oxygen (DO) concentration in GMA-emulsion on the degree of grafting (Dg) were investigated in detail. It was found that the DO concentration had the strongest influence, the pre-irradiation dose, de-aeration of emulsion and grafting atmosphere had a relatively strong impact, and the pre-irradiation atmosphere and pre-irradiation temperature had the least effect on Dg. The optimum DO concentration before grafting was 2.0 mg/L or less. When a polyethylene bottle was used as a reactor instead of a glass ampoule, graft polymerization under normal pressure and air atmospheric conditions could be achieved under the following conditions; the pre-irradiation dose was more than 50 kGy, the volume ratio of GMA-emulsion to air was 50:1 or less, and the DO concentration in GMA-emulsion during grafting was below 2.0 mg/L. Under these grafting conditions, Dg was controlled within a range of up to 362%. The prepared GMA-grafted NWPE (GMA-g-NWPE) fabric was modified with a phosphoric acid to obtain an adsorbent for heavy metal ions. In the column-mode adsorption tests of Pb(II), the adsorption performance of the produced phosphorylated GMA-g-NWPE fabric (fibrous metal adsorbent) was not essentially dependent on the flow rate of the feed. The breakthrough points of 200, 500, and 1000 h-1 in space velocity were 483, 477 and 462 bed volumes, and the breakthrough capacities of the three flow rates were 1.16, 1.15 and 1.16 mmol-Pb(II)/g-adsorbent.

A study on the morphology of polystyrene-grafted poly(ethylene-alt-tetrafluoroethylene) (ETFE) films prepared using a simultaneous radiation grafting method

NASA Astrophysics Data System (ADS)

Song, Ju-Myung; Ko, Beom-Seok; Sohn, Joon-Yong; Nho, Young Chang; Shin, Junhwa

2014-04-01

The morphology of polystyrene-grafted poly(ethylene-alt-tetrafluoroethylene) (ETFE) films prepared using a simultaneous radiation grafting method was investigated using DMA, DSC, XRD, and SAXS instruments. The DMA study indicates that the ETFE amorphous phase and PS amorphous phase are mixed well in the PS-grafted ETFE films while the ETFE crystalline phase and the PS amorphous phase are separated, suggesting that the PS chains are grafted mainly on the ETFE amorphous regions. The DSC and XRD data showed that the natural crystalline structures of ETFE in the grafted ETFE films are not affected by the degree of grafting. The SAXS profiles displayed that the inter-crystalline distance of the ETFE films increases with an increasing degree of grafting, which further implies that the PS graft chains formed by the simultaneous irradiation has a significant impact on the amorphous morphology of the resulting grafted ETFE film. Thus, these results indicate that the styrene monomers are mainly grafted on the ETFE amorphous regions during the simultaneous radiation grafting process.

Donor-Specific Anti-HLA Antibodies in Huntington's Disease Recipients of Human Fetal Striatal Grafts.

PubMed

Porfirio, Berardino; Paganini, Marco; Mazzanti, Benedetta; Bagnoli, Silvia; Bucciantini, Sandra; Ghelli, Elena; Nacmias, Benedetta; Putignano, Anna Laura; Rombolà, Giovanni; Saccardi, Riccardo; Lombardini, Letizia; Di Lorenzo, Nicola; Vannelli, Gabriella B; Gallina, Pasquale

2015-01-01

Fetal grafting in a human diseased brain was thought to be less immunogenic than other solid organ transplants, hence the minor impact on the efficacy of the transplant. How much prophylactic immune protection is required for neural allotransplantation is also debated. High-sensitive anti-HLA antibody screening in this field has never been reported. Sixteen patients with Huntington's disease underwent human fetal striatal transplantation in the frame of an open-label observational trial, which is being carried out at Florence University. All patients had both brain hemispheres grafted in two separate robotic-stereotactic procedures. The trial started in February 2006 with the first graft to the first patient (R1). R16 was given his second graft on March 2011. All patients received triple immunosuppressive treatment. Pre- and posttransplant sera were analyzed for the presence of anti-HLA antibodies using the multiplexed microsphere-based suspension array Luminex xMAP technology. Median follow-up was 38.5 months (range 13-85). Six patients developed anti-HLA antibodies, which turned out to be donor specific. Alloimmunization occurred in a time window of 0-49 months after the first neurosurgical procedure. The immunogenic determinants were non-self-epitopes from mismatched HLA antigens. These determinants were both public epitopes shared by two or more HLA molecules and private epitopes unique to individual HLA molecules. One patient had non-donor-specific anti-HLA antibodies in her pretransplant serum sample, possibly due to previous sensitization events. Although the clinical significance of donor-specific antibodies is far from being established, particularly in the setting of neuronal transplantation, these findings underline the need of careful pre- and posttransplant immunogenetic evaluation of patients with intracerebral grafts.

Surface grafting of a thermoplastic polyurethane with methacrylic acid by previous plasma surface activation and by ultraviolet irradiation to reduce cell adhesion.

PubMed

Alves, P; Pinto, S; Kaiser, Jean-Pierre; Bruinink, Arie; de Sousa, Hermínio C; Gil, M H

2011-02-01

The material performance, in a biological environment, is mainly mediated by its surface properties and by the combination of chemical, physical, biological, and mechanical properties required, for a specific application. In this study, the surface of a thermoplastic polyurethane (TPU) material (Elastollan(®)1180A50) was activated either by plasma or by ultra-violet (UV) irradiation. After surface activation, methacrylic acid (MAA) was linked to the surface of TPU in order to improve its reactivity and to reduce cell adhesion. Grafted surfaces were evaluated by X-ray photoelectron spectroscopy (XPS), by atomic force microscopy (AFM) and by contact angle measurements. Blood compatibility studies and cell adhesion tests with human bone marrow cells (HBMC) were also performed. If was found that UV grafting method led to better results than the plasma activation method, since cell adhesion was reduced when methacrylic acid was grafted to the TPU surface by UV. Copyright © 2010 Elsevier B.V. All rights reserved.

Pre-transplant reversible pulmonary hypertension predicts higher risk for mortality after cardiac transplantation.

PubMed

Butler, Javed; Stankewicz, Mark A; Wu, Jack; Chomsky, Don B; Howser, Renee L; Khadim, Ghazanfar; Davis, Stacy F; Pierson, Richard N; Wilson, John R

2005-02-01

Pre-transplant fixed pulmonary hypertension is associated with higher post-transplant mortality. In this study, we assessed the significance of pre-transplant reversible pulmonary hypertension in patients undergoing cardiac transplantation. Overall, we studied 182 patients with baseline normal pulmonary pressures or reversible pulmonary hypertension, defined as a decrease in pulmonary vascular resistance (PVR) to < or =2.5 Wood units (WU), who underwent cardiac transplantation. Multiple recipient and donor characteristics were assessed to identify independent predictors of mortality. The average duration of follow-up was 42 +/- 28 months. Forty patients (22%) died during the follow-up period. Baseline hemodynamics for alive vs dead patients were as follows: pulmonary artery systolic (PAS) 42 +/- 15 vs 52 +/- 15 mm Hg; PA diastolic 21 +/- 9 vs 25 +/- 9 mm Hg; PA mean 28 +/- 11 vs 35 +/- 10 mm Hg; transpulmonary gradient (TPG) 9 +/- 4 vs 11 +/- 7 mm Hg (all p < 0.05); total pulmonary resistance 7.7 +/- 4.8 vs 8.8 +/- 3.2 WU (p = 0.08); and PVR 2.3 +/- 1.5 vs 2.9 +/- 1.6 WU (p = 0.06). In an unadjusted analysis, patients with PAS >50 mm Hg had a higher risk of death (odds ratio [OR] 5.96, 95% confidence interval [CI] 1.46 to 19.84 as compared with PAS < or =30 mm Hg). There was no significant difference in survival among patients with baseline PVR <2.5, 2.5 to 4.0 or >4.0 WU, but patients with TPG > or =16 had a higher risk of mortality (OR 4.93, 95% CI 1.84 to 13.17). PAS pressure was an independent predictor of mortality (OR 1.04, 95% CI 1.02 to 1.06). Recipient body mass index, history of sternotomy; and donor ischemic time were the other independent predictors of mortality. Pre-transplant pulmonary hypertension, even when reversible to a PVR of < or =2.5 WU, is associated with a higher mortality post-transplant.

Combined keratectomy, strontium-90 irradiation and permanent bulbar conjunctival grafts for corneolimbal squamous cell carcinomas in horses (1990-2002): 38 horses.

PubMed

Plummer, C E; Smith, S; Andrew, S E; Lassaline, M E; Gelatt, K N; Brooks, D E; Kallberg, M E; Ollivier, F J

2007-01-01

The purpose of this study was to evaluate the effectiveness of postoperative beta-irradiation with strontium-90 as an adjunctive treatment to superficial keratectomy and permanent bulbar conjunctival graft for removal of equine corneolimbal squamous cell carcinoma (SCC), in decreasing recurrence rate. The retrospective case study included 38 horses diagnosed and treated for SCC of the eye that involved the limbus and/or cornea. The patients were treated between 1990 and 2002, with strontium-90 irradiation immediately after corneal and conjunctival graft surgery. Recurrence was defined as the postoperative and postirradiation regrowth of SCC in the same site and globe that was previously treated. The Appaloosa was the most commonly represented breed and horses that had more than one base coat color represented the majority of the cases (53%). The coat colors of white, chestnut/sorrel and gray were the most commonly represented colors of the horses treated. Eight horses (21%) could not be assessed for tumor recurrence due to lack of two or more post-treatment examinations, and another horse was enucleated 6 days postoperatively due to progressive corneal ulceration. Twenty-four horses (63% of the entire study population; 83% of the followed cases) had a mean +/- SD of 1754 +/- 1319 days without tumor recurrence, ranging from 14 days to 5110 days. Five horses (13% of the entire study population; 17% of the assessed horses) had tumor recurrence at a mean +/- SD of 449 +/- 339 days with a range of 29 days to 900 days. For the five recurrences, treatment included local excision (n = 1), enucleation (n = 2), and additional strontium-90 therapy (n = 3). The combination of superficial keratectomy, beta-irradiation and permanent bulbar conjunctival grafts for limbal, corneal or corneolimbal SCC in horses is effective in at least 83% of the horses. Recurrence occurred in about 17% of the horses. Multiple biannual re-examinations are recommended to observe for tumor recurrence.

Analysis of spontaneous resolution of cytomegalovirus replication after transplantation in CMV-seropositive patients with pretransplant CD8+IFNG+ response.

PubMed

Páez-Vega, Aurora; Poyato, Antonio; Rodriguez-Benot, Alberto; Guirado, Lluis; Fortún, Jesús; Len, Oscar; Abdala, Edson; Fariñas, María C; Cordero, Elisa; de Gracia, Carmen; Hernández, Domingo; González, Rafael; Torre-Cisneros, Julián; Cantisán, Sara

2018-05-18

This prospective study evaluates whether CMV-seropositive (R+) transplant patients with pretransplant CD8+IFNG+ T-cell response to cytomegalovirus (CMV) (CD8+IFNG+ response) can spontaneously clear the CMV viral load without requiring treatment. A total of 104 transplant patients (kidney/liver) with pretransplant CD8+IFNG+ response were evaluable. This response was determined using QuantiFERON-CMV assay. The incidence of CMV replication and disease was 45.2% (47/104) and 6.7% (7/104), respectively. Of the total patients, 77.9% (81/104) did not require antiviral treatment, either because they did not have CMV replication (n = 57) or because they had asymptomatic CMV replication that could be spontaneously cleared (n = 24). Both situations are likely related to the presence of CD8+IFNG+ response to CMV, which has a key role in controlling CMV infection. However, 22.1% of the patients (23/104) received antiviral treatment, although only 7 of them did so because they had symptomatic CMV replication. These patients developed symptoms in spite of having pretransplant CD8+IFNG+ response, thus suggesting that other immunological parameters might be involved, such as a dysfunctional CD4 + response or that they might have become QFNon-reactive due to the immunosuppression. In conclusion, around 80% of R+ patients with pretransplant CD8+IFNG+ response to CMV did not require antiviral treatment, although this percentage might be underestimated. Nevertheless, other strategies such as performing an additional CD8+IFNG+ response determination at posttransplant time might provide more reliable information regarding the patients who will be able to spontaneously clear the viremia. Copyright © 2018 Elsevier B.V. All rights reserved.

Effects of pre-transplant azithromycin administration on kidney graft function: study protocol for a double-blind randomized clinical trial.

PubMed

Mokhtari, Gholamreza; Teimoori, Mojtaba

2018-06-28

Kidney transplantation is the best strategy for the management of end-stage renal disease; however, the outcomes need to improve further. Macrolides show antimicrobial and anti-inflammatory properties in chronic diseases and intraoperatively, and can accumulate in tissues for extended periods. Therefore, theoretically, when administered to a donor and because of accumulation in the donor kidney, macrolides can cause graft immunomodulation and improve kidney transplantation outcomes. This study is a single-center, randomized clinical trial. A total of 60 kidney donors will be randomly allocated to the azithromycin or placebo group and treated with a single dose (1 g) of azithromycin or placebo, respectively, 1 day before surgery. Recruitment commenced in September 2016 and is expected to be completed by March 2018. The primary outcome is kidney graft function. The secondary outcomes include rejection rate, urinary tract infections in graft recipients, pain and systemic inflammatory response syndrome in live donors, and complications in both donors and recipients. Outcomes will be evaluated at baseline and every day in the first week after transplantation, as well as at 1 and 3 months post transplantation. Adverse reactions will be documented. If the efficacy of azithromycin in reducing adverse outcomes is confirmed, it would serve as an easy to use, economic intervention able to lower post-transplantation risks. Short and mid-term analyses of blood and urine samples as well as immunological assays will facilitate a more in-depth analysis of the effects of azithromycin on transplantation outcomes. Iranian Clinical Trial Registry, IRCT201606141853N11 , registered on September 5, 2016.

Radiation-Induced Grafting with One-Step Process of Waste Polyurethane onto High-Density Polyethylene

PubMed Central

Park, Jong-Seok; Lim, Youn-Mook; Nho, Young-Chang

2015-01-01

The recycling of waste polyurethane (PU) using radiation-induced grafting was investigated. The grafting of waste PU onto a high-density polyethylene (HDPE) matrix was carried out using a radiation technique with maleic anhydride (MAH). HDPE pellets and PU powders were immersed in a MAH-acetone solution. Finally, the prepared mixtures were irradiated with an electron beam accelerator. The grafted composites were characterized by Fourier transformed infrared spectroscopy (FT-IR), surface morphology, and mechanical properties. To make a good composite, the improvement in compatibility between HDPE and PU is an important factor. Radiation-induced grafting increased interfacial adhesion between the PU domain and the HDPE matrix. When the absorbed dose was 75 kGy, the surface morphology of the irradiated PU/HDPE composite was nearly a smooth and single phase, and the elongation at break increased by approximately three times compared with that of non-irradiated PU/HDPE composite. PMID:28787813

Donor liver histology--a valuable tool in graft selection.

PubMed

Flechtenmacher, Christa; Schirmacher, Peter; Schemmer, Peter

2015-07-01

Due to a tremendous organ shortage, livers from donors with extended criteria are increasingly considered for transplantation. Pathologists are more and more requested to evaluate these livers histopathologically using frozen sections at high urgency for acceptability. This article reviews the current knowledge on pre-transplant histology in liver transplantation. Prerequisites and conditions for proper pre-transplant evaluation of donor liver tissue are discussed as well as frozen section evaluation and reporting. Data sources include the relevant medical literature, web sites specialized in organ transplantation, and the authors' experiences in liver transplant centers. Pre-transplant histopathological evaluation is a time-effective, accurate, and reliable tool to assess liver quality from candidate deceased donors. Pre-transplant biopsies are of value in the selection of donor livers for transplantation, especially in case of extended criteria donors, and should be performed more frequently in order to avoid unnecessary loss of organs suitable for transplantation and transplantation of inappropriate organs. Correlation of histopathological findings with clinical conditions is essential and requires excellent communication between pathologists, surgeons, and the other members of the transplant team.

Prevention of Transfusion-Associated Graft-versus-Host Disease by Irradiation: Technical Aspect of a New Ferrous Sulphate Dosimetric System

PubMed Central

Del Lama, Lucas Sacchini; de Góes, Evamberto Garcia; Petchevist, Paulo César Dias; Moretto, Edson Lara; Borges, José Carlos; Covas, Dimas Tadeu; de Almeida, Adelaide

2013-01-01

Irradiation of whole blood and blood components before transfusion is currently the only accepted method to prevent Transfusion-Associated Graft-Versus-Host-Disease (TA-GVHD). However, choosing the appropriate technique to determine the dosimetric parameters associated with blood irradiation remains an issue. We propose a dosimetric system based on the standard Fricke Xylenol Gel (FXG) dosimeter and an appropriate phantom. The modified dosimeter was previously calibrated using a 60Co teletherapy unit and its validation was accomplished with a 137Cs blood irradiator. An ionization chamber, standard FXG, radiochromic film and thermoluminescent dosimeters (TLDs) were used as reference dosimeters to determine the dose response and dose rate of the 60Co unit. The dose distributions in a blood irradiator were determined with the modified FXG, the radiochromic film, and measurements by TLD dosimeters. A linear response for absorbed doses up to 54 Gy was obtained with our system. Additionally, the dose rate uncertainties carried out with gel dosimetry were lower than 5% and differences lower than 4% were noted when the absorbed dose responses were compared with ionization chamber, film and TLDs. PMID:23762345

Venovenous Bypass Is Associated With a Lower Incidence of Acute Kidney Injury After Liver Transplantation in Patients With Compromised Pretransplant Renal Function.

PubMed

Sun, Kai; Hong, Fu; Wang, Yun; Agopian, Vatche G; Yan, Min; Busuttil, Ronald W; Steadman, Randolph H; Xia, Victor W

2017-11-01

Although the hemodynamic benefits of venovenous bypass (VVB) during liver transplantation (LT) are well appreciated, the impact of VVB on posttransplant renal function is uncertain. The aim of this study was to determine if VVB was associated with a lower incidence of posttransplant acute kidney injury (AKI). Medical records of adult (≥18 years) patients who underwent primary LT between 2004 and 2014 at a tertiary hospital were reviewed. Patients who required pretransplant renal replacement therapy and intraoperative piggyback technique were excluded. Patients were divided into 2 groups, VVB and non-VVB. AKI, determined by the Acute Kidney Injury Network criteria, was compared between the 2 groups. Propensity match was used to control selection bias that occurred before VVB and multivariable logistic regression was used to control confounding factors during and after VVB. Of 1037 adult patients who met the study inclusion criteria, 247 (23.8%) received VVB. A total of 442 patients (221 patients in each group) were matched. Aftermatch patients were further divided according to a predicted probability AKI model using preoperative creatinine (Cr), VVB, and intraoperative variables into 2 subgroups: normal and compromised pretransplant renal functions. In patients with compromised pretransplant renal function (Cr ≥1.2 mg/dL), the incidence of AKI was significantly lower in the VVB group compared with the non-VVB group (37.2% vs 50.8%; P = .033). VVB was an independent risk factor negatively associated with AKI (odds ratio, 0.1; 95% confidence interval, 0.1-0.4; P = .001). Renal replacement in 30 days and 1-year recipient mortality were not significantly different between the 2 groups. The incidence of posttransplant AKI was not significantly different between the 2 groups in patients with normal pretransplant renal function (Cr <1.2 mg/dL). In this large retrospective study, we demonstrated that utilization of intraoperative VVB was associated with a significantly

Explainable variation in renal transplant outcomes: a comparison of standard and expanded criteria donors.

PubMed

Gjertson, David W

2004-01-01

In 2002, OPTN/UNOS altered kidney allocation rules to allow patients to be listed separately to receive kidneys from expanded criteria donors (ECD). Our aim was to quantify the short- and long-term impacts of 21 prognostic factors on recipients of ECD as well as recipients of living (LD) and deceased standard criteria (SCD) donors. A factor's impact depends on both the risk and diversity of its effects. Using OPTN/UNOS Registry data from 1996-2003, we have analyzed kidney-only, adult-recipient grafts for factor effects among 35,878 LD, 47,941 SCD and 10,399 ECD transplants. During an early risk period, all 94,218 recipients were followed through one year, and, in the late risk period, 85,270 recipients whose grafts survived beyond one year were followed for 5 years post-transplant. Impact was measured by determining a factor's percentage of assignable variation in one- and 5-year graft failure rates. Scores for 21 factors were estimated via generalized logistic models, which contained a random component for transplant center. The assignable variation associated with a given factor was computed as the factor score variance multiplied by the square of the corresponding regression coefficient. Impacts were heterogeneous with regard to posttransplant period and donor type. The top 5 factors influencing one-year graft survival rates were as follows: * For LD grafts - pretransplant dialysis time (14% of the variation in short-term outcomes), recipient age (13%), body mass (12%), PRA (10%) and induction therapy (10%). * For SCD grafts - donor age (24%), recipient age (12%), pretransplant dialysis time (12%), HLA-DR matching (6%) and pretransplant medical condition (6%). * For ECD grafts - donor age (18%), pre-transplant dialysis time (10%), recipient age (10%), pretransplant medical condition (10%) and recipient body mass (6%). Ranking long-term outcomes demonstrated the following top 5 influential factors: * For LD grafts - donor age (28% of the variation in long

Living unrelated donor kidney transplantation--a fourteen-year experience.

PubMed

Ignjatović, Ljiljana; Jovanović, Dragan; Kronja, Goran; Dujić, Aleksandar; Marić, Mihailo; Ignjatović, Dragan; Hrvacević, Rajko; Kovacević, Zoran; Petrović, Milija; Elaković, Dejan; Marenović, Tomislav; Lukić, Zoran; Trkuljić, Miroljub; Stanković, Bratislav; Maksić, Doko; Butorajac, Josip; Colić, Miodrag; Drasković-Pavlović, Biljana; Kapulica-Kuljić, Nada; Drasković, Nada; Misović, Sidor; Stijelja, Borislav; Milović, Novak; Tosevski, Perica; Filipović, Nikola; Romić, Predrag; Jevtić, Miodrag; Drasković, Miroljub; Vavić, Neven; Rabrenović, Violeta; Paunić, Zoran; Radojević, Milorad; Bjelanović, Zoran; Tomić, Aleksandar; Aleksić, Predrag; Kosević, Branko; Mocović, Dejan; Bancević, Vladimir; Magić, Zvonko; Vojvodić, Danilo; Balint, Bela; Ostojić, Gordana; Tukić, Ljiljana; Murgić, Jadranka; Pervulov, Svetozar; Rusović, Sinisa; Sjenicić, Goran; Vesna, Bućan; Milavić-Vujković, Merica; Jandrić, Dusan; Raicević, Ranko; Mijusković, Mirjana; Obrencević, Katarina; Pilcević, Dejan; Cukić, Zoran; Petrović, Marijana; Petrović, Milica; Tadić, Jelena; Terzić, Brankica; Karan, Zeljko; Bokonjić, Dubravko; Dobrić, Silva; Antunović, Mirjana; Bokun, Radmila; Dimitrijević, Jovan; Vukomanović-Djurdjević, Biserka

2010-12-01

In countries without a national organization for retrieval and distribution of organs of the deceased donors, problem of organ shortage is still not resolved. In order to increase the number of kidney transplantations we started with the program of living unrelated - spousal donors. The aim of this study was to compare treatment outcome and renal graft function in patients receiving the graft from spousal and those receiving ghe graft from living related donors. We retrospectively identified 14 patients who received renal allograft from spousal donors between 1996 and 2009 (group I). The control group consisted of 14 patients who got graft from related donor retrieved from the database and matched than with respect to sex, age, kidney disease, immunological and viral pretransplant status, the initial method of the end stage renal disease treatment and ABO compatibility. In the follow-up period of 41 +/- 38 months we recorded immunosuppressive therapy, surgical complications, episodes of acute rejection, CMV infection and graft function, assessed by serum creatinine levels at the beginning and in the end of the follow-up period. All patients had pretransplant negative cross-match. In ABO incompatible patients pretransplant isoagglutinine titer was zero. The patients with a spousal donor had worse HLA matching. There were no significant differences between the groups in surgical, infective, immunological complications and graft function. Two patients from the group I returned to hemodialysis after 82 and 22 months due to serious comorbidities. In spite of the worse HLA matching, graft survival and function of renal grafts from spousal donors were as good as those retrieved from related donors.

Irradiation inhibits vascular anastomotic stenosis in a canine model.

PubMed

Saito, Takeshi; Iguchi, Atsushi; Tabayashi, Koichi

2009-08-01

The graft patency rate after coronary artery bypass grafting (CABG) correlates with anastomotic stenosis. Intracoronary radiation therapy is effective for preventing restenosis after percutaneous coronary intervention (PCI). We postulated that intracoronary radiation therapy could prevent anastomotic stenosis and tested this hypothesis in an animal model. Femoral arteries and veins of beagle dogs were harvested, and composite arterioarterial and arteriovenous grafts were prepared. After external irradiation of the anastomotic sites, these composite grafts were transplanted into femoral arteries. Histomorphometric and immunohistological analyses of the anastomotic sites were performed. The study groups consisted of controls and animals exposed to 10 Gy, 20 Gy, and 30 Gy (n = 5, in each group). In the artery graft model, the ratio of negative remodeling was significantly increased in all groups exposed to >or=10 Gy. The ratio of neointimal hyperplasia was significantly decreased in all groups exposed to >or=10 Gy. Cell density of anti-alpha-actin antibody-positive cells and anti-proliferating cell nuclear antigen (PCNA) antibody-positive cells was highest in the adventitial layer, and the density decreased as the dosage increased. Experimental results were almost the same in the vein graft models as in the artery graft models. With double immunohistostaining, the anti-PCNA antibody-positive cells expressed alpha-actin. Irradiation can inhibit anastomotic stenosis in a canine model. Adventitia is a factor in the creation of stenosis, and irradiation appears to target the adventitia. We speculate that there might be a possible role for intracoronary irradiation in the future to prevent anastomotic stenosis.

Treatment of ureteroarterial fistula with an endoureteral stent graft.

PubMed

Horikawa, Masahiro; Saito, Hiroya; Hokotate, Hirofumi; Mori, Tatsuya

2012-09-01

A patient with a history of total cystectomy for bladder cancer, cutaneous ureterostomy, irradiation, and long-term indwelling urinary catheters presented with an aortoureteral fistula (UAF), which was treated with an endoureteral stent graft. The described ureteral approach using stent grafts may be considered for the management of UAFs when more traditional approaches are unavailable. Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved.

Abaca/polyester nonwoven fabric functionalization for metal ion adsorbent synthesis via electron beam-induced emulsion grafting

NASA Astrophysics Data System (ADS)

Madrid, Jordan F.; Ueki, Yuji; Seko, Noriaki

2013-09-01

A metal ion adsorbent was developed from a nonwoven fabric trunk material composed of both natural and synthetic polymers. A pre-irradiation technique was used for emulsion grafting of glycidyl methacrylate (GMA) onto an electron beam irradiated abaca/polyester nonwoven fabric (APNWF). The dependence of degree of grafting (Dg), calculated from the weight of APNWF before and after grafting, on absorbed dose, reaction time and monomer concentration were evaluated. After 50 kGy irradiation with 2 MeV electron beam and subsequent 3 h reaction with an emulsion consisting of 5% GMA and 0.5% polyoxyethylene sorbitan monolaurate (Tween 20) surfactant in deionized water at 40 °C, a grafted APNWF with a Dg greater than 150% was obtained. The GMA-grafted APNWF was further modified by reaction with ethylenediamine (EDA) in isopropyl alcohol at 60 °C to introduce amine functional groups. After a 3 h reaction with 50% EDA, an amine group density of 2.7 mmole/gram adsorbent was achieved based from elemental analysis. Batch adsorption experiments were performed using Cu2+ and Ni2+ ions in aqueous solutions with initial pH of 5 at 30 °C. Results show that the adsorption capacity of the grafted adsorbent for Cu2+ is four times higher than Ni2+ ions.

Factors impacting short and long-term kidney graft survival: modification by single intra-operative -high-dose induction with ATG-Fresenius.

PubMed

Kaden, Jürgen; May, Gottfried; Völp, Andreas; Wesslau, Claus

2011-01-01

A majority of recipients benefited from the intra-operative single high-dose induction (HDI) with ATG-Fresenius (ATG-F) still leaving a group of recipients who did not profit from this kind of induction. Therefore the aim of this retrospective analysis was 1st to identify the risk factors impacting short and long-term graft survival, and 2nd to assess the efficacy of this type of induction in kidney graft recipients with or without these risk factors. A total of 606 recipients receiving two different immunosuppressive treatment regimens (1st: Triple drug therapy [TDT, n=196] consisting mainly of steroids, azathioprine and cyclosporine; 2nd: TDT + 9 mg/kg ATG-F intra-operatively [HDI, n=410]) were included in this analysis and grouped according to their kidney graft survival time (short GST: ≤1 yr, n=100 and long GST: >5 yrs, n=506). The main risk factors associated with a shortened graft survival were pre-transplant sensitization, re-transplantation, rejections (in particular vascular or mixed ones) and the necessity of a long-term anti-rejection therapy. Adding ATG-F single high dose induction to TDT was more efficient in prolonging kidney graft survival than TDT alone not only in recipients without any risk factors (p<0.005) but also in recipients with at least one risk factor (p<0.021). Only in 4.6% of recipients having two or more risk factors this effect could not be demonstrated. The intra-operative single high-dose induction with ATG-F significantly improves the kidney graft survival in recipients with or without risk factors and can therefore be recommended.

Pretransplant soluble CD30 level has limited effect on acute rejection, but affects graft function in living donor kidney transplantation.

PubMed

Kim, Myoung Soo; Kim, Hae Jin; Kim, Soon Il; Ahn, Hyung Joon; Ju, Man Ki; Kim, Hyun Jung; Jeon, Kyung Ock; Kim, Yu Seun

2006-12-27

Serum soluble CD30 (sCD30) levels might be a useful marker of immunologic status in pre transplant (Tx) recipients. We retrospectively correlated preTx sCD30 levels (high versus low) on postTx graft survival, incidence of acute rejection, and graft function using stored preTx serum. Of 254 recipients who underwent kidney Tx, 120 recipients were enrolled under the uniform criteria (living donor, age >25 years, viral hepatitis free, diabetes free). The preTx sCD30 was not significantly associated with differences in graft survival rate during 47.5+/-11.4 months of follow-up (P = 0.5901). High sCD30 (> or =115 U/ml) was associated with a higher incidence of clinically or pathologically defined acute rejection than low sCD30, but the difference was not statistically significant (33.9% vs. 22.4%, P = 0.164). The response rate to antirejection therapy in patients with high sCD30 was inferior to those with low sCD30, but also was not statistically significant (33.3% vs. 7.7%, P = 0.087). However, mean serum creatinine levels in high sCD30 patients at one month, one year, and three years postTx were significantly different from those with low sCD30 (P < 0.05). In multiple regression analysis, acute rejection episodes, donor age, kidney weight/recipient body weight ratio, and preTx sCD30 levels were independent variables affecting the serum creatinine level three years postTx. PreTx sCD30 level has a limited effect on the incidence of acute rejection and response to antirejection treatment, but inversely and independently affects serum creatinine level after living donor kidney transplantation.

Urinary tract infection in renal transplant recipients: incidence, risk factors, and impact on graft function.

PubMed

Camargo, L F; Esteves, A B A; Ulisses, L R S; Rivelli, G G; Mazzali, M

2014-01-01

Urinary tract infection (UTI) is the most common infection posttransplant. However, the risk factors for and the impact of UTIs remain controversial. The aim of this study was to identify the incidence of posttransplant UTIs in a series of renal transplant recipients from deceased donors. Secondary objectives were to identify: (1) the most frequent infectious agents; (2) risk factors related to donor; (3) risk factors related to recipients; and (4) impact of UTI on graft function. This was a retrospective analysis of medical records from renal transplant patients from January to December 2010. Local ethics committee approved the protocol. The incidence of UTI in this series was 34.2%. Risk factors for UTI were older age, (independent of gender), biopsy-proven acute rejection episodes, and kidneys from deceased donors (United Network for Organ Sharing criteria). For female patients, the number of pretransplant pregnancies was an additional risk factor. Recurrent UTI was observed in 44% of patients from the UTI group. The most common infectious agents were Escherichia coli and Klebsiella pneumoniae, for both isolated and recurrent UTI. No difference in renal graft function or immunosuppressive therapy was observed between groups after the 1-year follow-up. In this series, older age, previous pregnancy, kidneys from expanded criteria donors, and biopsy-proven acute rejection episodes were risk factors for posttransplant UTI. Recurrence of UTI was observed in 44%, with no negative impact on graft function or survival. Copyright © 2014 Elsevier Inc. All rights reserved.

Pretransplant urinary proteome analysis does not predict development of chronic kidney disease after liver transplantation.

PubMed

Milongo, David; Bascands, Jean-Loup; Huart, Antoine; Esposito, Laure; Breuil, Benjamin; Moulos, Panagiotis; Siwy, Justyna; Ramírez-Torres, Adela; Ribes, David; Lavayssière, Laurence; Del Bello, Arnaud; Muscari, Fabrice; Alric, Laurent; Bureau, Christophe; Rostaing, Lionel; Schanstra, Joost P; Kamar, Nassim

2015-07-01

Chronic kidney disease (CKD) is a common complication after liver transplantation. Kidney biopsies cannot be easily performed before liver transplantation to predict patients at high risk for CKD. The aim of our study was to determine whether pre-, peri- and post-transplant factors, as well as peptides present in preliver transplant urine samples were associated with loss in kidney function at 6 months post-transplantation using proteome analysis. Eighty patients who underwent a liver transplantation and that had pretransplant glomerular filtration rate (GFR) value of ≥60 mL/min/1.73 m² (MDRD) were included in the study. GFR decreased significantly after transplantation. At month 6 post-transplantation, 40 patients displayed a CKD, i.e. eGFR of <60 mL/min/1.73 m², while the other 40 patients did not. Although thousands of peptides were identified, none was significantly associated with the development of CKD at 6 months after liver transplantation. Moreover, using a urinary peptidome classifier to detect preexisting CKD, no difference was found in CKD scores between the 2 groups. After analysis of a large number of pre-, peri- and post-transplant parameters, viral hepatitis as a cause for liver transplantation was the sole independent predictive factor for CKD. No difference in peptides with differential urinary abundance between patients who received a graft for virus related liver disease vs. all other causes of liver disease was observed. Urinary peptidome analysis before liver transplantation failed to identify a peptide pattern associated with the development of CKD at 6 months after liver transplantation. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Pre-transplant and post-transplant soluble CD30 for prediction and diagnosis of acute kidney allograft rejection.

PubMed

Nafar, Mohsen; Farrokhi, Farhat; Vaezi, Mohammad; Entezari, Amir-Ebrahim; Pour-Reza-Gholi, Fatemeh; Firoozan, Ahmad; Eniollahi, Behzad

2009-01-01

Serum levels of soluble CD30 (sCD30) have been considered as a predictor of acute kidney allograft rejection. We have evaluated the pre-transplant and post-transplant levels of sCD30 with the aim of determining its value in predicting and diagnosing kidney rejection. We measured sCD30 serum levels before kidney transplantation, 5 days post-operatively, and at creatinine elevation episodes. The predictive value of sCD30 for diagnosing acute rejection (AR) within the first 6 post-operative months was assessed in 203 kidney recipients from living donors. Pre-transplant and post-operative levels of serum sCD30 were 58.10 +/- 52.55 and 51.55 +/- 49.65 U/ml, respectively (P = 0.12). Twenty-three patients experienced biopsy-proven acute rejection, and 28 had acute allograft dysfunction due to non-immunologic diseases. The pre-transplant sCD30 level was not different between patients with and without AR. However, post-transplant sCD30 was higher in the AR group. The median serum level of post-transplant sCD30 was 52 U/ml in the AR group and 26.3 U/ml in a control group (P < 0.001). The relative changes of sCD30 on day 5 were higher in patients with AR (P = 0.003). Based on post-transplant sCD30 levels, we were able to differentiate between kidney recipients who experienced an AR within 6 months post-surgery and those without an AR (cutoff value 41 U/ml; sensitivity 70%; specificity 71.7%). The level of sCD30 during periods of elevated serum creatinine was not independently associated with the diagnosis of AR. Post-transplant sCD30 levels and their relative changes are higher in patients experiencing AR. We propose further studies on the post-transplant trend of this marker for the prediction of AR.

Modification of flax fibres by radiation induced emulsion graft copolymerization of glycidyl methacrylate

NASA Astrophysics Data System (ADS)

Moawia, Rihab Musaad; Nasef, Mohamed Mahmoud; Mohamed, Nor Hasimah; Ripin, Adnan

2016-05-01

Flax fibres were modified by radiation induced graft copolymerization of glycidyl methacrylate (GMA) by pre-irradiation method in an emulsion medium. The effect of reaction parameters on the degree of grafting (DOG) such as concentration of bleaching agent, absorbed dose, monomer concentration, temperature and reaction time were investigated. The DOG was found to be dependent on the investigated parameters. The incorporation of poly(GMA) grafts in the bleached flax fibres was confirmed by Fourier transform infrared spectroscopy (FTIR) and scanning electron microscopy (SEM). The structural and mechanical changes were evaluated by X-ray diffraction (XRD) and mechanical tester, respectively. The results revealed that reacting bleached flax fibres irradiated with 20 kGy with 5% GMA emulsion containing 0.5% polyoxyethylene-sorbitan monolaurate (Tween 20) surfactant at 40 °C for 1 h led to a maximum DOG of 148%. The grafted fibres showed sufficient mechanical strength and hydrophobicity which make them promising precursors for development of adsorbents after appropriate chemical treatments.

Rapid, facile microwave-assisted synthesis of xanthan gum grafted polyaniline for chemical sensor.

PubMed

Pandey, Sadanand; Ramontja, James

2016-08-01

Grafting method, through microwave radiation procedure is extremely productive in terms of time consumption, cost effectiveness and environmental friendliness. In this study, conductive and thermally stable composite (mwXG-g-PANi) was synthesized by grafting of aniline (ANi) on to xanthan gum (XG) using catalytic weight of initiator, ammonium peroxydisulfate in the process of microwave irradiation in an aqueous medium. The synthesis of mwXG-g-PANi were confirm by FTIR, XRD, TGA, and SEM. The influence of altering the microwave power, exposure time of microwave, concentration of monomer and the amount of initiator of graft polymerization were studied over the grafting parameters, for example, grafting percentage (%G) and grafting efficiency (%E). The maximum %G and %E achieved was 172 and 74.13 respectively. The outcome demonstrates that the microwave irradiation strategy can increase the reaction rate by 72 times over the conventional method. Electrical conductivity of XG and mwXG-g-PANi composite film was performed. The fabricated grafted sample film were then examined for the chemical sensor. The mwXG-g-PANi, effectively integrated and handled, are NH3 sensitive and exhibit a rapid sensing in presence of NH3 vapor. Chemiresistive NH3 sensors with superior room temperature sensing performance were produced with sensor response of 905 at 1ppb and 90% recovery within few second. Copyright © 2016 Elsevier B.V. All rights reserved.

Inactivation of enveloped and non-enveloped viruses in the process of chemical treatment and gamma irradiation of bovine-derived grafting materials.

PubMed

Lee, Kwang-Il; Lee, Jung-Soo; Jung, Hong-Hee; Lee, Hwa-Yong; Moon, Seong-Hwan; Kang, Kyoung-Tak; Shim, Young-Bock; Jang, Ju-Woong

2012-01-01

Xenografts, unlike other grafting products, cannot be commercialized unless they conform to stringent safety regulations. Particularly with bovine-derived materials, it is essential to remove viruses and inactivate infectious factors because of the possibility that raw materials are imbrued with infectious viruses. The removal of the characteristics of infectious viruses from the bovine bone grafting materials need to be proved and inactivation process should satisfy the management provision of the Food and Drug Administration (FDA). To date, while most virus inactivation studies were performed in human allograft tissues, there have been almost no studies on bovine bone. To evaluate the efficacy of virus inactivation after treatment of bovine bone with 70% ethanol, 4% sodium hydroxide, and gamma irradiation, we selected a variety of experimental model viruses that are known to be associated with bone pathogenesis, including bovine parvovirus (BPV), bovine herpes virus (BHV), bovine viral diarrhea virus (BVDV), and bovine parainfluenza-3 virus (BPIV-3). The cumulative virus log clearance factor or cumulative virus log reduction factor for the manufacturing process was obtained by calculating the sum of the individual virus log clearance factors or log reduction factors determined for individual process steps with different physicochemical methods. The cumulative log clearance factors achieved by three different virus inactivation processes were as follows: BPV ≥ 17.73, BHV ≥ 20.53, BVDV ≥ 19.00, and BPIV-3 ≥ 16.27. On the other hand, the cumulative log reduction factors achieved were as follows: BPV ≥ 16.95, BHV ≥ 20.22, BVDV ≥ 19.27, and BPIV-3 ≥ 15.58. Treatment with 70% ethanol, 4% sodium hydroxide, or gamma irradiation was found to be very effective in virus inactivation, since all viruses were at undetectable levels during each process. We have no doubt that application of this established process to bovine bone graft manufacture will be

Impact of pretransplant anti-HLA antibodies on outcomes in lung transplant candidates.

PubMed

Kim, Miae; Townsend, Keri R; Wood, Isabelle G; Boukedes, Steve; Guleria, Indira; Gabardi, Steven; El-Chemaly, Souheil; Camp, Phillip C; Chandraker, Anil K; Milford, Edgar L; Goldberg, Hilary J

2014-05-15

The prevalence of anti-HLA antibodies in lung transplant candidates and their impact on waitlist and transplant outcomes is not known. We examined the prevalence of pretransplant anti-HLA antibodies at varying thresholds and evaluated their impact on outcomes before and after lung transplantation. We performed a single-center retrospective cohort study including all patients listed for lung transplantation between January 2008 and August 2012. Per protocol, transplant candidates were assessed by solid phase LABscreen mixed Class I and II and LABscreen Single Antigen assays. Among 224 patients, 34% had anti-HLA antibodies at mean fluorescent intensity (MFI) greater than or equal to 3,000 (group III), and 24% had antibodies at MFI 1,000 to 3,000 (group II). Ninety percent of the patients with pretransplant anti-HLA antibodies had class I antibodies, whereas only seven patients developed class II alone. Patients in group III were less likely to receive transplants than patients without any anti-HLA antibodies (group I) (45.5 vs. 67.7%, P = 0.005). Wait time to transplant was longer in group III than group I, although this difference did not meet statistical significance, and waitlist mortality was similar. Among transplant recipients, antibody-mediated rejection (AMR) was more frequent in group III than in group II (20% vs. 0%, P = 0.01) or group I (6.3%, P = 0.05). The presence of anti-HLA antibodies at the high MFI threshold (>3,000) was associated with lower transplant rate and higher rates of AMR. Screening for anti-HLA antibodies using the 3,000 MFI threshold may be important in managing transplant candidates and recipients.

Irradiation autogenous mandibular grafts in primary reconstructions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hamaker, R.C.

1981-07-01

The procedure, irradiated mandibular autografts, for primary reconstruction, is presented with an immediate success rate of 88%. Eight cases have undergone primary mandibular reconstruction with the tumorous mandible irradiated to 10,000 rads in a single dose. The longest follow-up is 2 3/4 years. The autograft has proven to be an ideal implant. Major resections of the mandible in conjunction with large myocutaneous flaps have been reconstructed utilizing this implant.

Radiation-grafting of vinyl monomers separately onto polypropylene monofilament sutures

NASA Astrophysics Data System (ADS)

López-Saucedo, Felipe; Alvarez-Lorenzo, Carmen; Concheiro, Angel; Bucio, Emilio

2017-03-01

N-isopropylacrylamide (NIPAAm), 2-hydroxyethylmethacrylate (HEMA) and N-vinylimidazole (NVIm) were grafted separately onto polypropylene (PP) monofilament sutures. These grafted copolymers have properties with potential application in the synthesis of new medical devices. Co-60 gamma radiation was employed with dose rate of 9.2 kGyh-1 in synthesis of copolymers with different grafting percentages: PP-g-PNIPAAm from 11% to 175%, PP-g-PHEMA from 6% to 130%, and PP-g-PNVIm from 10% to 17%. Both NIPAAm and HEMA were grafted applying the pre-irradiation method under different reaction conditions: dose, temperature, monomer concentration and reaction time; NVIm was grafted by simultaneous method with doses from 20 up to 60 kGy. Grafted polymers were characterized by FTIR-ATR, TGA and DSC; and their swelling in water was recorded. Modified suture PP-g-PNIPAAm had thermo-responsive properties while PP-g-PNVIm exhibited pH-sensitive swelling. Overall, the implemented grafting strategies provided a hydrophilic surface layer that did not cause detrimental effects on mechanical properties and cytocompatibility of the sutures.

Ultralow dose effects in ion-beam induced grafting of polymethylmethacrylate (PMMA)

NASA Astrophysics Data System (ADS)

Corelli, J. C.; Steckl, A. J.; Pulver, D.; Randall, J. N.

We have investigated the process of image enhancement in high resolution lithography through polymer grafting techniques. Sensitivity gains of 10 3-10 4 were obtained for H +, X-ray, e-beam and deep-UV irradiations. Ultralow dose effects in 60 keV H + irradiated PMMA have been observed through the use of the acrylic acid (AA) monomer grafting with irradiated PMMA. At conventional doses of 10 10 cm -2 an inner structure of each feature is revealed. At doses of (1-2) X 10 9 cm -2, discrete events within the exposed regions are observable. This is the first time that individual events have been observable in a lithography process and sets the upper limit in the useful sensitivity of the resist and ion lithography process. This effect is directly observable only with ions, because of their higher efficiency per particle than either photons or electrons.

Graft versus host disease after stem cell allotransplantation with low-dose total body irradiation, fludarabine, and antithymocyte globulin.

PubMed

Grosskreutz, Celia; Scigliano, Eileen; Osman, Keren; Isola, Luis

2007-09-15

We previously showed that antithymocyte globulin (ATG) given with total body irradiation (TBI) 200 cGy and fludarabine results in high rate of donor engraftment. Its influence on acute and chronic graft versus host disease (GVHD) and on graft versus tumor effect is less known. Sixty-five patients underwent nonmyeloablative stem cell transplant with ATG, TBI 200 cGy, and fludarabine. GVHD prophylaxis was mycophenolate mofetil and cyclosporine. Forty-two patients (pts) (65%) had match related donors, 18 (27%) match unrelated, 1 (1.5%) mismatch related, and 4 (6%) mismatch unrelated donors. At a median follow-up of 862 days, 24 patients (37%) developed GVHD. The median age of the patients with and without GVHD was 56 years respectively. Acute GVHD grade II-IV developed in 19 pts (29%). Fatal GVHD of liver and/or gut occurred in nine pts (14%). Forty-one pts survived more than 100 days. Five pts (12%) had chronic GVHD, two had extensive, and three had limited involvement. Relapsed disease was observed in 22 pts (34%). Infections occurred in 15 pts (23%) and were fatal in 13 (20%). The addition of ATG to TBI 200cGy and fludarabine resulted in a modest incidence of GVHD. The best transplant outcomes were observed in pts with lymphoid malignancies.

The Need for New Donor Stratification to Predict Graft Survival in Deceased Donor Kidney Transplantation.

PubMed

Yang, Shin Seok; Yang, Jaeseok; Ahn, Curie; Min, Sang Il; Ha, Jongwon; Kim, Sung Joo; Park, Jae Berm

2017-05-01

The aim of this study was to determine whether stratification of deceased donors by the United Network for Organ Sharing (UNOS) criteria negatively impacts graft survival. We retrospectively reviewed deceased donor and recipient pretransplant variables of kidney transplantations that occurred between February 1995 and December 2009. We compared clinical outcomes between standard criteria donors (SCDs) and expanded criteria donors (ECDs). The deceased donors consisted of 369 patients. A total of 494 transplant recipients were enrolled in this study. Mean age was 41.7±11.4 year (range 18-69) and 273 patients (55.4%) were male. Mean duration of follow-up was 8.8±4.9 years. The recipients from ECD kidneys were 63 patients (12.8%). The overall mean cold ischemia time was 5.7±3.2 hours. Estimated glomerular filtration rate at 1, 2, and 3 years after transplantation were significantly lower in ECD transplants (1 year, 62.2±17.6 vs. 51.0±16.4, p<0.001; 2 year, 62.2±17.6 vs. 51.0±16.4, p=0.001; 3 year, 60.9±23.5 vs. 54.1±18.7, p=0.047). In multivariate analysis, donor age (≥40 years) was an independent risk factor for graft failure. In Kaplan-Meier analyses, there was no significant difference in death-censored graft survival (Log rank test, p>0.05), although patient survival was lower in ECDs than SCDs (Log rank test, p=0.011). Our data demonstrate that stratification by the UNOS criteria does not predict graft survival. In order to expand the donor pool, new criteria for standard/expanded donors need to be modified by regional differences. © Copyright: Yonsei University College of Medicine 2017

Maleic anhydride-g-low density polyethylene: Modification of LDPE molecular structure by γ-irradiation

NASA Astrophysics Data System (ADS)

Sheeja, Manaf, O.; Sujith, A.

2017-06-01

Polymer modification by radiation grafting of monomers onto polymers has received much attention recently. In the current study, γ-irradiation technique was used to achieve graft copolymerization of maleic anhydride (MA) onto low-density polyethylene (LDPE). To optimize, the process was performed at different γ-irradiation doses and MA concentration. The microstructure of grafted polymer film has been characterized by Fourier transform infrared spectroscopy, thermogravimetric analysis, differential scanning calorimetry, field emission-scanning electron microscopy, and atomic force microscopy. The studies performed made possible the selection of experimental protocols adequate for the production of new copolymeric materials with high grafting yield.

Preparation of metal adsorbent from poly(methyl acrylate)-grafted-cassava starch via gamma irradiation

NASA Astrophysics Data System (ADS)

Suwanmala, Phiriyatorn; Hemvichian, Kasinee; Hoshina, Hiroyuki; Srinuttrakul, Wannee; Seko, Noriaki

2012-08-01

Metal adsorbent containing hydroxamic acid groups was successfully synthesized by radiation-induced graft copolymerization of methyl acrylate (MA) onto cassava starch. The optimum conditions for grafting were studied in terms of % degree of grafting (Dg). Conversion of the ester groups present in poly(methyl acrylate)-grafted-cassava starch copolymer into hydroxamic acid was carried out by treatment with hydroxylamine (HA) in the presence of alkaline solution. The maximum percentage conversion of the ester groups of the grafted copolymer, % Dg=191 (7.63 mmol/g of MA), into the hydroxamic groups was 70% (5.35 mmol/g of MA) at the optimum condition. The adsorbent of 191%Dg had total adsorption capacities of 2.6, 1.46, 1.36, 1.15 and 1.6 mmol/g-adsorbent for Cd2+, Al3+, UO22+, V5+ and Pb2+, respectively, in the batch mode adsorption.

Gamma-Irradiated Sterile Cornea for Use in Corneal Transplants in a Rabbit Model

PubMed Central

Yoshida, Junko; Heflin, Thomas; Zambrano, Andrea; Pan, Qing; Meng, Huan; Wang, Jiangxia; Stark, Walter J.; Daoud, Yassine J.

2015-01-01

Purpose: Gamma irradiated corneas in which the donor keratocytes and endothelial cells are eliminated are effective as corneal lamellar and glaucoma patch grafts. In addition, gamma irradiation causes collagen cross inking, which stiffens collagen fibrils. This study evaluated gamma irradiated corneas for use in corneal transplantations in a rabbit model comparing graft clarity, corneal neovascularization, and edema. Methods: Penetrating keratoplasty was performed on rabbits using four types of corneal grafts: Fresh cornea with endothelium, gamma irradiated cornea, cryopreserved cornea, and fresh cornea without endothelium. Slit lamp examination was performed at postoperative week (POW) one, two, and four. Corneal clarity, edema, and vascularization were graded. Confocal microscopy and histopathological evaluation were performed. A P < 0.05 was statistically significant. Results: For all postoperative examinations, the corneal clarity and edema were statistically significantly better in eyes that received fresh cornea with endothelium compared to the other three groups (P < 0.05). At POW 1, gamma irradiated cornea scored better than the cryopreserved and fresh cornea without endothelium groups in clarity (0.9 vs. 1.5 and 2.6, respectively), and edema (0.6 vs. 0.8 and 2.0, respectively). The gamma irradiated corneas, cryopreserved corneas and the fresh corneas without endothelium, developed haze and edema after POW 2. Gamma irradiated cornea remained statistically significantly clearer than cryopreserved and fresh cornea without endothelium during the observation period (P < 0.05). Histopathology indicated an absence of keratocytes in gamma irradiated cornea. Conclusion: Gamma irradiated corneas remained clearer and thinner than the cryopreserved cornea and fresh cornea without endothelium. However, this outcome is transient. Gamma irradiated corneas are useful for lamellar and patch grafts, but cannot be used for penetrating keratoplasty. PMID:26180475

Serum sCD30 in monitoring of alloresponse in well HLA-matched cadaveric kidney transplantations.

PubMed

Matinlauri, Irma H; Kyllönen, Lauri E J; Salmela, Kaija T; Helin, Heikki; Pelzl, Steffen; Süsal, Caner

2005-12-27

In kidney transplantation, pretransplant serum sCD30 testing has been proposed in immunological risk estimation together with anti-HLA antibodies. We evaluated the risks associated with high pretransplant serum sCD30 in well HLA-matched cadaveric kidney recipients recruited in a clinical study comparing different immunosuppressive regimens. Rejection rate was similar in 37 recipients with high pretransplant serum sCD30 compared to 117 recipients with low serum sCD30 (16% vs. 15%, P=NS). Compared to pretransplant levels, the posttransplant sCD30 levels generally decreased, also in patients with rejection, although on day 21 posttransplant, rejecting patients had significantly higher relative sCD30 than nonrejecting patients (P<0.01). However, steroid-resistant rejection was associated with increasing posttransplant sCD30 levels. High pretransplant sCD30 values were associated with tubulointerstitial rejection. There was no correlation of sCD30 with delayed graft function. Good HLA matching seems to be effective in neutralizing the negative effect of a high pretransplant serum sCD30.

Potential advantages of treatment of transplanted saphenous vein aorto-coronary artery bypass grafts with beta irradiation to prevent graft occlusion.

PubMed

Smith, R G

1997-01-01

Intimal proliferation or Neointimal hyperplasia (NIH) is a vascular lesion that often arises in arteries after balloon angioplasty or other vessel wall injuries. FIH is a vascular lesion that develops in autologous saphenous vein grafts (SVG) after transplantation into the aorto-coronary circulation or the peripheral vascular circulation. FIH shares elements of smooth muscle migration, proliferation and fibrous tissue deposition in common with nibrointimal proliferation (NIH). Either NIH of a coronary artery or FIH of a SVG obstruct the vascular lumen and result in myocardial dysfunction. Local radiotherapy has been used for several decades to reduce the post-operative recurrence of the fibrovascular proliferations of pterygia and keloids. Similarly, in animal and human experiments, endovascular radiotherapy has been shown to reduce arterial smooth muscle proliferation. Consideration of the similarities of vascular smooth muscle cell proliferation in NIH and FIH leads one to suggest that endovascular beta irradiation can reduce FIH as well as it reduces NIH. The goal of such treatment is to achieve a clinically significant decrease in the morbidity and mortality resulting from SVG occlusions. The potential for large reduction of the consequences of SVG occlusion, the very large number of patients at risk, and the simplicity of the proposed intervention encourages prompt scientific evaluation of this technique.

Modifying glass fiber surface with grafting acrylamide by UV-grafting copolymerization for preparation of glass fiber reinforced PVDF composite membrane.

PubMed

Luo, Nan; Zhong, Hui; Yang, Min; Yuan, Xing; Fan, Yaobo

2016-01-01

Experimental design and response surface methodology (RSM) were used to optimize the modification of conditions for glass surface grafting with acrylamide (AM) monomer for preparation of a glass fiber reinforced poly(vinylidene fluoride) (PVDF) composite membrane (GFRP-CM). The factors considered for experimental design were the UV (ultraviolet)-irradiation time, the concentrations of the initiator and solvent, and the kinds and concentrations of the silane coupling agent. The optimum operating conditions determined were UV-irradiation time of 25 min, an initiator concentration of 0-0.25 wt.%, solvent of N-Dimethylacetamide (DMAC), and silane coupling agent KH570 with a concentration of 7 wt.%. The obtained optimal parameters were located in the valid region and the experimental confirmation tests conducted showed good accordance between predicted and experimental values. Under these optimal conditions, the water absorption of the grafted modified glass fiber was improved from 13.6% to 23%; the tensile strength was enhanced and the peeling strength of the glass fiber reinforced PVDF composite membrane was improved by 23.7% and 32.6% with an AM concentration at 1 wt.% and 2 wt.%. The surface composition and microstructure of AM grafted glass fiber were studied via several techniques including Field Emission Scanning Electron Microscopy (FESEM), Fourier transform infrared spectroscopy-attenuated total reflectance (FTIR-ATR) and energy dispersive X-ray spectroscopy (EDX). The analysis of the EDX and FTIR-ATR results confirmed that the AM was grafted to the glass fiber successfully by detecting and proving the existence of nitrogen atoms in the GFRP-CM. Copyright © 2015. Published by Elsevier B.V.

Adhesion monitoring of skin grafts by photoacoustic measurement: experiment using rat allograft models

NASA Astrophysics Data System (ADS)

Yamazaki, Mutsuo; Sato, Shunichi; Saito, Daizo; Okada, Yoshiaki; Ashida, Hiroshi; Obara, Minoru

2004-07-01

Adhesion monitoring of grafted skins is very important in successful treatment of severe burns and traumas. However, current diagnosis of skin grafting is usually done by visual observation, which is not reliable and gives no quantitative information on the skin graft adhesion. When the grafted skin adheres well, neovascularities will be generated in the grafted skin tissue, and therefore adhesion may be monitored by detecting the neovascularities. In this study, we attempted to measure photoacoustic signals originate from the neovascularities by irradiating the grafted skins with 532-nm nanosecond light pulses in rat autograft and allograft models. The measurement showed that immediately after skin grafting, photoacoustic signal originate from the blood in the dermis was negligibly small, while 6 - 24 hours after skin grafting, signal was observed from the dermis in the graft. We did not observe a significant difference between the signals from the autograft and the allograft models. These results indicate that neovascularization would take place within 6 hours after skin grafting, and the rejection reaction would make little effect on adhesion within early hours after grafting.

Identification of subgroups by risk of graft failure after paediatric renal transplantation: application of survival tree models on the ESPN/ERA-EDTA Registry.

PubMed

Lofaro, Danilo; Jager, Kitty J; Abu-Hanna, Ameen; Groothoff, Jaap W; Arikoski, Pekka; Hoecker, Britta; Roussey-Kesler, Gwenaelle; Spasojević, Brankica; Verrina, Enrico; Schaefer, Franz; van Stralen, Karlijn J

2016-02-01

Identification of patient groups by risk of renal graft loss might be helpful for accurate patient counselling and clinical decision-making. Survival tree models are an alternative statistical approach to identify subgroups, offering cut-off points for covariates and an easy-to-interpret representation. Within the European Society of Pediatric Nephrology/European Renal Association-European Dialysis and Transplant Association (ESPN/ERA-EDTA) Registry data we identified paediatric patient groups with specific profiles for 5-year renal graft survival. Two analyses were performed, including (i) parameters known at time of transplantation and (ii) additional clinical measurements obtained early after transplantation. The identified subgroups were added as covariates in two survival models. The prognostic performance of the models was tested and compared with conventional Cox regression analyses. The first analysis included 5275 paediatric renal transplants. The best 5-year graft survival (90.4%) was found among patients who received a renal graft as a pre-emptive transplantation or after short-term dialysis (<45 days), whereas graft survival was poorest (51.7%) in adolescents transplanted after long-term dialysis (>2.2 years). The Cox model including both pre-transplant factors and tree subgroups had a significantly better predictive performance than conventional Cox regression (P < 0.001). In the analysis including clinical factors, graft survival ranged from 97.3% [younger patients with estimated glomerular filtration rate (eGFR) >30 mL/min/1.73 m(2) and dialysis <20 months] to 34.7% (adolescents with eGFR <60 mL/min/1.73 m(2) and dialysis >20 months). Also in this case combining tree findings and clinical factors improved the predictive performance as compared with conventional Cox model models (P < 0.0001). In conclusion, we demonstrated the tree model to be an accurate and attractive tool to predict graft failure for patients with specific characteristics. This may

Neurologic outcome of urea cycle disorder liver transplant recipients may be predicted by pretransplant neurological imaging.

PubMed

Bolton, Scott M; Campbell, Kathleen M; Kukreja, Marcia; Kohli, Rohit

2015-08-01

Liver transplantation treats the hepatic affectation of UCDs; however, irreversible neurologic damage pretransplant is difficult to assess providing transplant teams with ethical dilemmas for liver transplantation. The purpose of our study was to determine whether pretransplant neuroimaging can predict developmental outcomes post-liver-transplant in children with UCDs. Patients undergoing liver transplantation for UCDs at Cincinnati Children's Hospital Medical Center between 2002 and 2012 were identified. Neurologic assessments prior to and after transplantation were categorized into mild, moderate, or severe disability. Neuroimaging data were categorized into mild, moderate, or severe by a single pediatric neuroradiologist. Fifteen patients were identified of whom eight had neuroimaging prior to transplantation. Of the eight patients that had neuroimaging, four were categorized as severe, one moderate, and three no-to-mild delay. All four patients whose imaging was severe were found to have moderate-to-severe neurologic delay. Of the three patients with no-to-mild changes on neuroimaging two of three were found to have no-to-mild delay on developmental assessments after transplantation. Neuroimaging may be a helpful tool in determining developmental prognosis and outcomes post-liver-transplantation for UCDs. Further studies maybe needed to validate our preliminary findings. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Reconstruction of irradiated bone segmental defects with a biomaterial associating MBCP+(R), microstructured collagen membrane and total bone marrow grafting: an experimental study in rabbits.

PubMed

Jégoux, Franck; Goyenvalle, Eric; Cognet, Ronan; Malard, Olivier; Moreau, Francoise; Daculsi, Guy; Aguado, Eric

2009-12-15

The bone tissue engineering models used today are still a long way from any oncologic application as immediate postimplantation irradiation would decrease their osteoinductive potential. The aim of this study was to reconstruct a segmental critical size defect in a weight-bearing bone irradiated after implantation. Six white New Zealand rabbits were immediately implanted with a biomaterial associating resorbable collagen membrane EZ(R) filled and micro-macroporous biphasic calcium phosphate granules (MBCP+(R)). After a daily schedule of radiation delivery, and within 4 weeks, a total autologous bone marrow (BM) graft was injected percutaneously into the center of the implant. All the animals were sacrificed at 16 weeks. Successful osseous colonization was found to have bridged the entire length of the defects. Identical distribution of bone ingrowth and residual ceramics at the different levels of the implant suggests that the BM graft plays an osteoinductive role in the center of the defect. Periosteum-like formation was observed at the periphery, with the collagen membrane most likely playing a role. This model succeeded in bridging a large segmental defect in weight-bearing bone with immediate postimplantation fractionated radiation delivery. This has significant implications for the bone tissue engineering approach to patients with cancer-related bone defects.

The effects of different schedules of total-body irradiation in heterotopic vascularized bone transplantation. An experimental study in the Lewis rat

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gonzalez del Pino, J.; Benito, M.; Randolph, M.A.

1990-12-01

To evaluate the effects of irradiation on heterotopically placed vascularized knee isografts, a single dose of 10 Gy of total-body irradiation was given to Lewis donor rats. Irradiation was delivered either 2 or 6 days prior to harvesting or subsequent transplantation, and evaluated at 1, 2, and 4 weeks after grafting. Irradiation caused endothelial depopulation of the graft artery, although vascular pedicle patency was maintained throughout the study. Bone graft viability and mineralization were normal. Dramatic changes in the bone marrow were seen that included an increase of its fat content (P less than 0.001), and a concomitant decrease inmore » bone marrow-derived immunocompetent cells. These changes were more prominent in recipients of grafts from day -6 irradiated donor rats. Total-body irradiation did not prejudice the use of vascularized bone grafts, and exhibited an associated immunosuppresant effect over the vascular endothelium and bone marrow. This may be a further rational conditioning procedure to avoid recipient manipulation in vascularized bone allotransplantation.« less

Prolonged survival of reconstituted skin grafts without immunosuppression.

PubMed

Sasamoto, Y; Alexander, J W; Babcock, G F

1990-01-01

Reconstituted skin composed of a cultured allogeneic epithelial sheet (CAES) and a cultured allogeneic dermis (CAD) was evaluated in a rat model to determine whether it could survive for a prolonged period without immunosuppression. Additionally, free CAD grafts were evaluated for their suitability as dermal substitutes. Male Buffalo rats were used as donors and male Lewis rats as recipients. Split-thickness skin obtained from Buffalo rats was separated into epidermis and dermis by means of Dispase II enzyme. The epidermal layers were minced and trypsinized. Then dispersed single keratinocytes were inoculated onto a irradiated 3T3 cell feeder layer. After a suitable period, a confluent cultured keratinocyte layer was detached and provided CAES grafts. Cultured allogeneic dermis grafts were prepared from cultures of the dermal component. Cultured allogeneic dermis grafts, covered by split thickness isografts (STIG) or local skin flaps, became revascularized at a rate of 94.6% and 90.9%, respectively, 7 days after grafting. However, only 25% of CAD grafts covered by synthetic materials became vascularized. Four types of wound coverage were compared including: (1) CAES grafts, (2) CAES over CAD grafts, (3) split-thickness isografts, and (4) STIG over CAD grafts. In groups 2 and 4, CAD grafts were applied 7 days before CAES grafts or STIG. Grafts of groups 1 and 2 were successful in only 36.7% and 31.1% of the animals and resulted in a high rate of wound contracture--72.4%, 66.7%, respectively. On the other hand, in groups 3 and 4, higher average rates of revascularization (92.0% and 88.3%) and lower rates of wound contracture (25.4% and 24.2%) were obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

Radiolytic preparation and characterization of hydrophilic poly(acrylonitrile-co-vinylsulfonate)-grafted porous poly(tetrafluoroethylene) substrates

NASA Astrophysics Data System (ADS)

Park, Byeong-Hee; Sohn, Joon-Yong; Shin, Junhwa

2016-01-01

In this study, a hydrophilic copolymer of acrylonitrile (AN) and sodium vinylsulfonate (SVS) was grafted into a highly hydrophobic porous poly(tetrafluoroethylene) (PTFE) substrate using a gamma-ray irradiation method and the grafted substrate was used as a substrate for impregnating a hydrophilic ionomer, Nafion. The results of FT-IR and TGA analysis of the prepared substrate showed that the SVS/AN monomers were successfully grafted into the porous PTFE film. The results of degree of grafting, elemental analyzer, and contact angle analysis showed that the hydrophilicity of the prepared PTFE-g-P(AN-co-VS) substrate was increased with an increase in the amount of SVS/AN graft copolymers. Also, the results of FE-SEM and Gurley number measurement showed that the pores in the substrate were reduced as the amount of SVS/AN copolymers grafted into the substrate increased. The prepared porous PTFE-g-P(AN-co-VS) substrate at an irradiation dose of 70 kGy was found to impregnate Nafion ionomer effectively compared to the original porous PTFE substrate. These results suggest that the prepared PTFE-g-P(AN-co-VS) substrate can be effectively used for the impregnation of polymer electrolyte (Nafion) to prepare a reinforced composite membrane.

Impact of pretransplant rifaximin therapy on early post-liver transplant infections.

PubMed

Esfeh, Jamak Modaresi; Hanouneh, Ibrahim A; Koval, Christine E; Kovacs, Christopher; Dalal, Deepan S; Ansari-Gilani, Kianoush; Confer, Bradley D; Eghtesad, Bijan; Zein, Nizar N; Menon, K V Narayanan

2014-05-01

Bacterial and fungal infections are major causes of morbidity and mortality after liver transplantation (LT). The role of intestinal decontamination in the prevention of post-LT infections is controversial. Rifaximin is widely used for the treatment of hepatic encephalopathy. The effect of rifaximin on post-LT infections is unknown. The aim of our study was to determine the effect of rifaximin therapy in the pretransplant period on early bacterial infections (EBIs) and fungal infections within the first 30 days after LT. All adult patients who underwent LT at our institution (January 2009 to July 2011) were included in this retrospective cohort study. Patients receiving antibiotics other than pretransplant protocol antibiotics were excluded. Patients were stratified into 2 groups based on the presence or absence of rifaximin therapy for at least 2 days before LT. Infections were defined by the isolation of any bacterial or fungal organisms within 30 days of LT. Multivariate regression analysis, Student t tests, and Pearson's chi-square tests were used to compare the 2 groups. Two hundred sixty-eight patients were included, and 71 of these patients (26.5%) were on rifaximin at the time of LT. The 2 groups were comparable with respect to age, sex, race, and Model for End-Stage Liver Disease score. There were no significant differences in the rates of EBIs (30% for the non-rifaximin group and 25% for the rifaximin group, P = 0.48) or fungal infections between the 2 groups. There was no increase in antimicrobial resistance among the infecting organisms. There was no difference in survival between the rifaximin and non-rifaximin groups (98% versus 97%, P = 0.36). In conclusion, the use of rifaximin in the pre-LT period was not associated with an increased risk of bacterial or fungal infections in the early post-LT period. © 2014 American Association for the Study of Liver Diseases.

Investigation of grafted ETFE-based polymer membranes as alternative electrolyte for direct methanol fuel cells

NASA Astrophysics Data System (ADS)

Aricò, A. S.; Baglio, V.; Cretı̀, P.; Di Blasi, A.; Antonucci, V.; Brunea, J.; Chapotot, A.; Bozzi, A.; Schoemans, J.

Low cost ethylene-tetrafluoroethylene (ETFE)-based grafted membranes have been prepared by a process based on electron beam irradiation, subsequent grafting, cross-linking and sulfonation procedure. Two different grafted membranes varying by their grafting and cross-linking levels have been investigated for applications in direct methanol fuel cells (DMFCs) operating between 90 and 130 °C. DMFC assemblies based on these membranes showed cell resistance and performance values comparable to Nafion 117. Stable electrochemical performance was recorded during 1 month of cycled operation. Tailoring of grafting and cross-linking properties allows a significant reduction of methanol cross-over while maintaining suitable conductivity and performance levels.

Synthesis of modified sepiolite-g-polystyrene sulfonic acid nanohybrids by radiation induced graft polymerization

NASA Astrophysics Data System (ADS)

Taimur, Shaista; Hassan, Muhammad Inaam ul; Yasin, Tariq; Ali, Syed Wasim

2018-07-01

In this study, polystyrene (PS) grafted sepiolite nanohybrid (MS-g-PS) was synthesized by using simultaneous radiation grafting technique in the presence of dichloromethane (DCM) as solvent. The radiation grafting process was carried out under inert atmosphere at room temperature using gamma rays from a Co-60 irradiator. The degree of grafting was affected by absorbed dose and monomer concentration in the mixture. Sulfonation of synthesized nanohybrid was carried out with sulfuric acid. Both the grafting of styrene and its sulfonate derivative were verified by Fourier transform infrared spectroscopy (FT-IR). The structural and morphological investigations of these nanohybrids have been investigated by X-ray diffraction (XRD) and field emission scanning electron microscopy (FESEM). The gravimetric investigations showed that grafting yield increases with the absorbed dose. Results showed that the system allows the controlled grafting of styrene onto sepiolite (Sep) in DCM.

Surface grafting of styrene on polypropylene fibers by argon plasma and its adsorption-regeneration of BTX

NASA Astrophysics Data System (ADS)

Xu, J. J.; Guo, M. L.; Chen, Q. G.; Lian, Z. Y.; Wei, W. J.; Luo, Z. W.; Xie, G.; Chen, H. N.; Dong, K.

2017-08-01

Active macromolecular free radicals were generated on polypropylene (PP) fibers surfaces by argon (Ar) plasma irradiation, then, PP surface modified fibers (PP-g-St fibers) were prepared by in-situ grafting reaction of styrene monomers (St). Effects of reaction parameters on grafting percentage were studied and adsorption capacities of PP-g-St fibers for benzene, toluene and xylene (BTX) were evaluated. Afterwards, regeneration adsorption efficiencies after maximum adsorption were explored. The results indicated that the optimum input power, irradiation time and grafting reaction time are 90 W, 3 min and 3 h respectively and the grafting percentage of St reached 5.7 %. The adsorption capacities of PP-g-St fibers towards toluene and xylene emulsions and solutions in water increased by 336.89 % and 344.57 % respectively, compared to pristine PP fibers. In addition, regeneration adsorption efficiencies of modified fibers remained > 90 % after six cycles of regeneration-adsorption experiments, which showed excellent regeneration ability.

Allograft tissue irradiation and failure rate after anterior cruciate ligament reconstruction: A systematic review.

PubMed

Dashe, Jesse; Parisien, Robert L; Cusano, Antonio; Curry, Emily J; Bedi, Asheesh; Li, Xinning

2016-06-18

To evaluate whether anterior cruciate ligament (ACL) allograft irradiation is effective for sterility without compromising graft integrity and increasing failure rate. A literature search was conducted using PubMed, Cochrane, and Google. The following search terms were used: "Gamma irradiation AND anterior cruciate ligament AND allograft" with a return of 30 items. Filters used included: English language, years 1990-2015. There were 6 hits that were not reviewed, as there were only abstracts available. Another 5 hits were discarded, as they did not pertain to the topic of interest. There were 9 more articles that were excluded: Three studies were performed on animals and 6 studies were meta-analyses. Therefore, a total of 10 articles were applicable to review. There is a delicate dosing crossover where gamma irradiation is both effective for sterility without catastrophically compromising the structural integrity of the graft. Of note, low dose irradiation is considered less than 2.0 Mrad, moderate dose is between 2.1-2.4 Mrad, and high dose is greater than or equal to 2.5 Mrad. Based upon the results of the literature search, the optimal threshold for sterilization was found to be sterilization at less than 2.2 Mrad of gamma irradiation with the important caveat of being performed at low temperatures. The graft selection process also must include thorough donor screening and testing as well as harvesting the tissue in a sterile fashion. Utilization of higher dose (≥ 2.5 Mrad) of irradiation causes greater allograft tissue laxity that results in greater graft failure rate clinically in patients after ACL reconstruction. Allograft ACL graft gamma irradiated with less than 2.2 Mrad appears to be a reasonable alternative to autograft for patients above 25 years of age.

Allograft tissue irradiation and failure rate after anterior cruciate ligament reconstruction: A systematic review

PubMed Central

Dashe, Jesse; Parisien, Robert L; Cusano, Antonio; Curry, Emily J; Bedi, Asheesh; Li, Xinning

2016-01-01

AIM: To evaluate whether anterior cruciate ligament (ACL) allograft irradiation is effective for sterility without compromising graft integrity and increasing failure rate. METHODS: A literature search was conducted using PubMed, Cochrane, and Google. The following search terms were used: “Gamma irradiation AND anterior cruciate ligament AND allograft” with a return of 30 items. Filters used included: English language, years 1990-2015. There were 6 hits that were not reviewed, as there were only abstracts available. Another 5 hits were discarded, as they did not pertain to the topic of interest. There were 9 more articles that were excluded: Three studies were performed on animals and 6 studies were meta-analyses. Therefore, a total of 10 articles were applicable to review. RESULTS: There is a delicate dosing crossover where gamma irradiation is both effective for sterility without catastrophically compromising the structural integrity of the graft. Of note, low dose irradiation is considered less than 2.0 Mrad, moderate dose is between 2.1-2.4 Mrad, and high dose is greater than or equal to 2.5 Mrad. Based upon the results of the literature search, the optimal threshold for sterilization was found to be sterilization at less than 2.2 Mrad of gamma irradiation with the important caveat of being performed at low temperatures. The graft selection process also must include thorough donor screening and testing as well as harvesting the tissue in a sterile fashion. Utilization of higher dose (≥ 2.5 Mrad) of irradiation causes greater allograft tissue laxity that results in greater graft failure rate clinically in patients after ACL reconstruction. CONCLUSION: Allograft ACL graft gamma irradiated with less than 2.2 Mrad appears to be a reasonable alternative to autograft for patients above 25 years of age. PMID:27335815

Intraoperative red blood cell transfusion, delayed graft function, and infection after kidney transplant: an observational cohort study.

PubMed

Mazzeffi, Michael; Jonna, Srikar; Blanco, Natalia; Mavrothalassitis, Orestes; Odekwu, Obi; Fontaine, Magali; Rock, Peter; Tanaka, Kenichi; Thom, Kerri

2018-06-01

Kidney transplant patients are frequently anemic and at risk for red blood cell (RBC) transfusion. Previous studies suggest that pre-transplant RBC transfusion may improve kidney transplant outcomes; however, RBC transfusion is also associated with infection. The purpose of our study was to characterize the relationships between intraoperative RBC transfusion, delayed graft function (DGF), postoperative surgical site infection (SSI), and sepsis. Analysis was performed on a historical cohort of adult kidney transplant patients from a single medical center during a two-year period. Crude odds ratios for DGF, superficial and deep SSI, and sepsis were calculated for transfused patients and multivariate regression was used to control for potential confounders when significant relationships were identified. Four hundred forty-one patients had kidney transplant during the study period; 27.0% had RBC transfusion, 38.8% had DGF, 7.0% had superficial SSI, 7.9% had deep SSI, and 1.8% had sepsis. High dose RBC transfusion was associated with improved graft function, but this was negated after adjusting for confounders (OR = 0.86, 95% CI  0.26 to 2.88). There was no association between RBC transfusion and SSI. RBC transfusion was independently associated with sepsis (OR = 8.98, 95% CI  1.52 to 53.22), but the confidence interval was wide. Intraoperative RBC transfusion during kidney transplant is not associated with improved allograft function or incisional SSI, but is associated with postoperative sepsis. RBCs should not be liberally transfused during kidney transplant surgery to improve graft outcomes.

Raman ratios on the repair of grafted surgical bone defects irradiated or not with laser (λ780 nm) or LED (λ850 nm).

PubMed

Pinheiro, Antonio Luiz B; Soares, Luiz Guilherme P; Marques, Aparecida Maria C; Aciole, Jouber Mateus S; de Souza, Renato Aparecido; Silveira, Landulfo

2014-09-05

This work aimed to assess biochemical changes associated to mineralization and remodeling of bone defects filled with Hydroxyapatite+Beta-Beta-tricalcium phosphate irradiated or not with 2 light sources. Ratios of intensities, band position and bandwidth of selected Raman peaks of collagen and apatites were used. Sixty male Wistar rats were divided into 6 groups subdivided into 2 subgroups (15th and 30th days). A standard surgical defect was created on one femur of each animal. In 3 groups the defects were filled with blood clot (Clot, Clot+Laser and Clot+LED groups) and in the remaining 3 groups the defects were filled with biomaterial (Biomaterial, Biomaterial+Laser and Biomaterial+LED groups). When indicated, the defects were irradiated with either Laser (λ780 nm, 70 mW, Φ∼0.4 cm(2)) or LED (λ850±10 nm, 150 mW, Φ∼0.5 cm(2)), 20 J/cm(2) each session, at 48 h intervals/2 weeks (140 J/cm(2) treatment). Following sacrifice, bone fragments were analyzed by Raman spectroscopy. Statistical analysis (ANOVA General Linear Model, p<0.05) showed that both grafting and time were the variables that presented significance for the ratios of ∼1660/∼1670 cm(-1) (collagen maturation), ∼1077/∼854 cm(-1) (mineralization), ∼1077/∼1070 cm(-1) (carbonate substitution) and the position of the ∼960 cm(-1) (bone maturation). At 30th day, the ratios indicated an increased deposition of immature collagen for both Clot and Biomaterial groups. Biomaterial group showed increased collagen maturation. Only collagen deposition was significantly dependent upon irradiation independently of the light source, being the amount of collagen I increased in the Clot group at the end of the experimental time. On the other hand, collagen I deposition was reduced in biomaterial irradiated groups. Raman ratios of selected protein matrix and phosphate and carbonate HA indicated that the use of biphasic synthetic micro-granular HA+Beta-TCP graft improved the repair of bone defects

Effect of low dose and moderate dose gamma irradiation on the mechanical properties of bone and soft tissue allografts.

PubMed

Balsly, Colleen R; Cotter, Andrew T; Williams, Lisa A; Gaskins, Barton D; Moore, Mark A; Wolfinbarger, Lloyd

2008-12-01

The increased use of allograft tissue for musculoskeletal repair has brought more focus to the safety of allogenic tissue and the efficacy of various sterilization techniques. Gamma irradiation is an effective method for providing terminal sterilization to biological tissue, but it is also reported to have deleterious effects on tissue mechanics in a dose-dependent manner. At irradiation ranges up to 25 kGy, a clear relationship between mechanical strength and dose has yet to be established. The aim of this study was to investigate the mechanical properties of bone and soft tissue allografts, irradiated on dry ice at a low absorbed dose (18.3-21.8 kGy) and a moderate absorbed dose (24.0-28.5 kGy), using conventional compressive and tensile testing, respectively. Bone grafts consisted of Cloward dowels and iliac crest wedges, while soft tissue grafts consisted of patellar tendons, anterior tibialis tendons, semitendinosus tendons, and fascia lata. There were no statistical differences in mechanical strength or modulus of elasticity for any graft irradiated at a low absorbed dose, compared to control groups. Also, bone allografts and two soft tissue allografts (anterior tibialis and semitendinosus tendon) that were irradiated at a moderate dose demonstrated similar strength and modulus of elasticity values to control groups. The results of this study support the use of low dose and moderate dose gamma irradiation of bone grafts. For soft tissue grafts, the results support the use of low dose irradiation.

Anisotropic proton-conducting membranes prepared from swift heavy ion-beam irradiated ETFE films

NASA Astrophysics Data System (ADS)

Kimura, Yosuke; Chen, Jinhua; Asano, Masaharu; Maekawa, Yasunari; Katakai, Ryoichi; Yoshida, Masaru

2007-10-01

Poly(ethylene-co-tetrafluoroethylene) (ETFE) films were irradiated by swift heavy ion-beams of 129Xe 23+ with fluences of 0, 3 × 10 6, 3 × 10 7, 3 × 10 8 and 3 × 10 9 ions/cm 2, followed by γ-ray pre-irradiation for radiation grafting of styrene onto the ETFE films and sulfonation of the grafted ETFE films to prepare highly anisotropic proton-conducting membranes. The fluence of Xe ions and the addition of water in the grafting solvent were examined to determine their effect on the proton conductivity of the resultant membranes. It was found that the polymer electrolyte membrane prepared by grafting the styrene monomer in a mixture of 67% isopropanol and 33% water to the ETFE film with an ion-beam irradiation fluence of 3.0 × 10 6 ions/cm 2 was a highly anisotropic proton-conducting material, as the proton conductivity was three or more times higher in the thickness direction than in the surface direction of the membrane.

High serum level of the soluble CD30 identifies Chinese kidney transplant recipients at high risk of unfavorable outcome.

PubMed

Iv, R; He, Q; Wang, H P; Jin, J; Chen, Y; Chen, J H

2008-12-01

We sought to investigate the relationship between serum level of sCD30 and recipient/graft survival rates, rejection types, as well as other prognostic factors among Chinese kidney transplant patients. We performed enzyme-linked immunosorbent assays of serum sCD30 levels in duplicate among retrospective cohort of 707 renal transplant patients. The incidences of rejection increased in relation to the pretransplant sCD30 level. The reversal rates of rejection were 100%, 90.6%, and 78.6% for the low, intermediate, and high sCD30 groups. This observation suggested that high levels of sCD30 and pretransplant panel-reactive antibody (PRA)-positive patients are risk factors for acute rejection with odds ratios of 6.862 and 1.756. High sCD30 was an independent risk factor for functional graft survival. The 5-year graft survival rates were 99.39% +/- 6.1%, 93.11% +/- 1.93%, and 82.07% +/- 3.97% among the low, intermediate, and high sCD30 groups, while the 5-year recipient survival rates were 89.25% +/- 2.41%, 91.82% +/- 1.64%, and 88.85% +/- 2.36%, respectively. Increased sCD30 levels were observed among patients who were PRA-positive, cytomegalovirus antigens or antibodies positive, on long-term dialysis, and Pretransplant sCD30 serum levels reflect immune status.

A Review on the Modification of Polysaccharide Through Graft Copolymerization for Various Potential Applications

PubMed Central

Kumar, Deepak; Pandey, Jyoti; Raj, Vinit; Kumar, Pramendra

2017-01-01

Introduction: Graft copolymerization is one of the most promising technique uses to modify the properties of naturally available polymers with a minimum loss in their native characteristics. Methods and Materials: Graft copolymerization is a very significant technique to add hybrid properties in backbone of polymers. The grafting generally initiated through the formation of free radical centers on the polymer backbone as well as monomer. Results: Grafted polysaccharides have various applications in different important scientific areas such as drug delivery, pharmaceutical field, plastic industry, waste water treatment, tannery effluent treatment, textile industry, agriculture area, etc. all of this fascinated us to summarize the major research articles over the last two decades outlining different methods of grafting, surface modification, graft copolymerization of synthetic and natural polymers. Conclusion: Various redox initiator systems viz. Ceric ammonium nitrate, per sulfate, Irradiation, FAS-H2O2 etc. is also explored for grafting of vinyl through conventional and non-conventional techniques. PMID:29151987

Liver Transplantation for Fulminant Hepatic Failure

PubMed Central

Farmer, Douglas G.; Anselmo, Dean M.; Ghobrial, R. Mark; Yersiz, Hasan; McDiarmid, Suzanne V.; Cao, Carlos; Weaver, Michael; Figueroa, Jesus; Khan, Khurram; Vargas, Jorge; Saab, Sammy; Han, Steven; Durazo, Francisco; Goldstein, Leonard; Holt, Curtis; Busuttil, Ronald W.

2003-01-01

Objective To analyze outcomes after liver transplantation (LT) in patients with fulminant hepatic failure (FHF) with emphasis on pretransplant variables that can potentially help predict posttransplant outcome. Summary Background Data FHF is a formidable clinical problem associated with a high mortality rate. While LT is the treatment of choice for irreversible FHF, few investigations have examined pretransplant variables that can potentially predict outcome after LT. Methods A retrospective review was undertaken of all patients undergoing LT for FHF at a single transplant center. The median follow-up was 41 months. Thirty-five variables were analyzed by univariate and multivariate analysis to determine their impact on patient and graft survival. Results Two hundred four patients (60% female, median age 20.2 years) required urgent LT for FHF. Before LT, the majority of patients were comatose (76%), on hemodialysis (16%), and ICU-bound. The 1- and 5-year survival rates were 73% and 67% (patient) and 63% and 57% (graft). The primary cause of patient death was sepsis, and the primary cause of graft failure was primary graft nonfunction. Univariate analysis of pre-LT variables revealed that 19 variables predicted survival. From these results, multivariate analysis determined that the serum creatinine was the single most important prognosticator of patient survival. Conclusions This study, representing one of the largest published series on LT for FHF, demonstrates a long-term survival of nearly 70% and develops a clinically applicable and readily measurable set of pretransplant factors that determine posttransplant outcome. PMID:12724633

Air Pump-Assisted Graft Centration, Graft Edge Unfolding, and Graft Uncreasing in Young Donor Graft Pre-Descemet Endothelial Keratoplasty.

PubMed

Jacob, Soosan; Narasimhan, Smita; Agarwal, Amar; Agarwal, Athiya; A I, Saijimol

2017-08-01

To assess an air pump-assisted technique for graft centration, graft edge unfolding, and graft uncreasing while performing pre-Descemet endothelial keratoplasty (PDEK) using young donor grafts. Continuous pressurized air infusion was used for graft centration, graft edge unfolding, and graft unwrinkling. Ten eyes of 10 patients underwent PDEK with donors aged below 40 years. In all eyes, the donor scrolled into tight scrolls. In all cases, the air pump-assisted technique was effective in positioning and centering the graft accurately and in straightening infolded graft edges and smoothing out graft creases and wrinkles. Endothelial cell loss was 38.6%. Postoperative best-corrected visual acuity at 6 months was 0.66 ± 0.25 in decimal equivalent. Continuous pressurized air infusion acted as a third hand providing a continuous pressure head that supported the graft and prevented graft dislocation as well as anterior chamber collapse during intraocular maneuvering. Adequate maneuvering space was available in all cases, and bleeding, if any, was tamponaded successfully in all cases. Although very young donor grafts may be used for PDEK, they are difficult to center and unroll completely before floating against host stroma. An air pump-assisted technique using continuous pressurized air infusion allows successful final graft positioning even with very young donor corneas. It thus makes surgery easier as several key steps are made easier to handle. It additionally helps in tamponading hemorrhage during peripheral iridectomy, increasing surgical space, preventing fluctuations in the anterior chamber depth, and promoting graft adherence.

Pretransplant Tacrolimus Dose Requirements Predict Early Posttransplant Dose Requirements in Blood Group AB0-Incompatible Kidney Transplant Recipients.

PubMed

Shuker, Nauras; de Man, Femke M; de Weerd, Annelies E; van Agteren, Madelon; Weimar, Willem; Betjes, Michiel G H; van Gelder, Teun; Hesselink, Dennis A

2016-04-01

The aim of this study was to investigate whether pretransplant tacrolimus (Tac) dose requirements of patients scheduled to undergo living donor kidney transplantation correlate with posttransplantation dose requirements. The predictive value of Tac dose requirements (defined as the ratio of the Tac predose concentration, C0, divided by the total daily Tac dose, D) pretransplantation on this same parameter posttransplantation was assessed retrospectively in a cohort of 57 AB0-incompatible kidney transplant recipients. These patients started immunosuppressive therapy 14 days before transplant surgery. All patients were using a stable dose of glucocorticoids and were at steady-state Tac exposure before transplantation. Tac dose requirements immediately before transplantation (C0/Dbefore) explained 63% of the Tac dose requirements on day 3 after transplantation: r = 0.633 [F (1, 44) = 75.97, P < 0.01]. No other clinical and demographic variables predicted Tac dose requirements early after transplantation. Steady-state Tac dose requirement before transplantation largely predicted posttransplantation Tac dose requirements in AB0-incompatible kidney transplant recipients. The importance of this finding is that the posttransplantation Tac dose can be individualized based on a patient's pretransplantation Tac concentration/dose ratio. Pretransplant Tac phenotyping therefore has the potential to improve transplantation outcomes.

Radiation induced graft copolymerization of methyl methacrylate onto chrome-tanned pig skins

NASA Astrophysics Data System (ADS)

Pietrucha, K.; Pȩkala, W.; Kroh, J.

Graft copolymerization of methyl methacrylate (MMA) onto chrome-tanned pig skins was carried out by the irradiation with 60Co ?-rays. The grafted polymethyl methacrylate (PMMA) chains were isolated by acid hydrolysis of the collagen backbone in order to characterize the graft copolymers. Proof of grafting was obtained through the detection of amino acid endgroups in the isolated grafts by reaction with ninhydrin. The grafting yield of MMA in aqueous emulsion was found to be higher than that for pure MMA and MMA in acetone. The degree of grafting increases with increasing monomer concentration in emulsion and reaches maximum at radiation dose ca 15 kGy. The yield of grafting is very high - ca 90% of monomer converts into copolymer and only 10% is converted into homopolymer. The present paper reports the physical properties of chrome-tanned pig skins after graft polymerization with MMA in emulsion. Modified leathers are more resistant against water absorption and abrasion in comparison with unmodified ones. They have more uniform structure over the whole surface, greater thickness and stiffness. The results reported seem to indicate that MMA may be used in the production of shoe upper and sole leathers. The mechanism of some of the processes occuring during radiation grafting of MMA in water emulsion on tanned leathers has been also suggested and discussed.

Treatment of whole blood with riboflavin plus ultraviolet light, an alternative to gamma irradiation in the prevention of transfusion-associated graft-versus-host disease?

PubMed

Fast, Loren D; Nevola, Martha; Tavares, Jennifer; Reddy, Heather L; Goodrich, Ray P; Marschner, Susanne

2013-02-01

Exposure of blood products to gamma irradiation is currently the standard of care in the prevention of transfusion-associated graft-versus-host disease (TA-GVHD). Regulatory, technical, and clinical challenges associated with the use of gamma irradiators are driving efforts to develop alternatives. Pathogen reduction methods were initially developed to reduce the risk of microbial transmission by blood components. Through modifications of nucleic acids, these technologies interfere with the replication of both pathogens and white blood cells (WBCs). To date, systems for pathogen and WBC inactivation of products containing red blood cells are less well established than those for platelets and plasma. In this study, the in vitro and in vivo function of WBCs present in whole blood after exposure to riboflavin plus ultraviolet light (Rb-UV) was examined and compared to responses of WBCs obtained from untreated or gamma-irradiated blood by measuring proliferation, cytokine production, activation, and antigen presentation and xenogeneic (X-)GVHD responses in an in vivo mouse model. In vitro studies demonstrated that treatment of whole blood with Rb-UV was as effective as gamma irradiation in preventing WBC proliferation, but was more effective in preventing antigen presentation, cytokine production, and T-cell activation. Consistent with in vitro findings, treatment with Rb-UV was as effective as gamma irradiation in preventing X-GVHD, a mouse model for TA-GVHD. The ability to effectively inactivate WBCs in fresh whole blood using Rb-UV, prior to separation into components, provides the transfusion medicine community with a potential alternative to gamma irradiation. © 2012 American Association of Blood Banks.

2010 report from the Center for International Blood and Marrow Transplant Research (CIBMTR): current uses and outcomes of hematopoietic cell transplants for blood and bone marrow disorders.

PubMed

Pasquini, Marcelo C; Wang, Zhiwei; Horowitz, Mary M; Gale, Robert Peter

2010-01-01

These data indicate increasing use of HCT for persons with blood and bone marrow disorders. Recent trends include increasing use of alternative donors including HLA-matched unrelated persons and of HLA-matched umbilical cord blood cells, increasing use of blood cell rather than bone marrow grafts and increasing use of reduced-intensity pretransplant conditioning regimens. Many of these shifts are driven by logistical considerations like the need for donors in persons without an HLA-identical sibling or expanding access to allotransplants to older patients. In other instances, like the shift from bone marrow to blood cell grafts or from conventional to reduced-intensity pretransplant conditioning regimens few randomized clinical trials have been reported to justify these shifts. More data are needed to critically-assess the impact of these changes.

Graft-versus-host disease in the ovary potentially causes female infertility after allogeneic hematopoietic stem cell transplantation.

PubMed

Shimoji, Sonoko; Hashimoto, Daigo; Teshima, Takanori

2017-01-01

Ovarian failure-associated infertility is a serious late complication for female patients who have undergone allogeneic hematopoietic stem cell transplantation (SCT). Although the role of a pretransplant conditioning regimen has been well appreciated, the increasing application of reduced-intensity conditioning has led us to reconsider other factors possibly affecting ovarian function after allogeneic SCT. We recently reported that graft-versus-host disease (GVHD) targets granulosa cells of the ovarian follicles, thereby significantly reducing ovarian reserves and fertility after SCT. We also found that ovarian GVHD impairs fertility independently of the toxicities of the conditioning regimens, and pharmacological GVHD prophylaxis preserves fertility after SCT. For the first time, these results demonstrated that GVHD targets the ovary and impairs ovarian functions and fertility, thereby having important clinical implications in young female transplant recipients with nonmalignant diseases, for whom minimally toxic regimens are used. Here we review recently published articles regarding clinical and basic researches on female infertility after SCT.

Graft-versus-host disease after radiation therapy in patients who have undergone allogeneic stem cell transplantation: two case reports.

PubMed

Milgrom, Sarah A; Nieto, Yago; Pinnix, Chelsea C; Smith, Grace L; Wogan, Christine F; Rondon, Gabriela; Medeiros, L Jeffrey; Kebriaei, Partow; Dabaja, Bouthaina S

2016-07-28

Patients who undergo allogeneic stem cell transplantation and subsequent radiation therapy uncommonly develop graft-versus-host disease within the irradiated area. We quantified the incidence of this complication, which is a novel contribution to the field. From 2010 to 2014, 1849 patients underwent allogeneic stem cell transplantation, and 41 (2 %) received radiation therapy afterward. Of these, two patients (5 %) developed graft-versus-host disease within the irradiated tissues during or immediately after radiation therapy. The first patient is a 37-year-old white man who had Hodgkin lymphoma; he underwent allogeneic stem cell transplantation from a matched unrelated donor and received radiation therapy for an abdominal and pelvic nodal recurrence. After 28.8 Gy, he developed grade 4 gastrointestinal graft-versus-host disease, refractory to tacrolimus and steroids, but responsive to pentostatin and photopheresis. The other patient is a 24-year-old white man who had acute leukemia; he underwent allogeneic stem cell transplantation from a matched related donor and received craniospinal irradiation for a central nervous system relapse. After 24 cobalt Gy equivalent, he developed severe cutaneous graft-versus-host disease, sharply delineated within the radiation therapy field, which was responsive to tacrolimus and methylprednisolone. We conclude that graft-versus-host disease within irradiated tissues is an uncommon but potentially serious complication that may follow radiation therapy in patients who have undergone allogeneic stem cell transplantation. Clinicians must be aware of this complication and prepared with strategies to mitigate risk. Patients who have undergone allogeneic stem cell transplantation represent a unique population that may offer novel insight into the pathways involved in radiation-related inflammation.

The use of radiation-induced graft polymerization for modification of polymer track membranes

NASA Astrophysics Data System (ADS)

Shtanko, N. I.; Kabanov, V. Ya.; Apel, P. Yu.; Yoshida, M.

1999-05-01

Track membranes (TM) made of poly(ethylene terephtalate) (PET) and polypropylene (PP) films have a number of peculiarities as compared with other ones. They have high mechanical strength at a low thickness, narrow pore size distribution, low content of extractables. However, TM have some disadvantages such as low chemical resistance in alkaline media (PET TM), the low water flow rate due to the hydrophobic nature of their surface. The use of radiation-induced graft polymerization makes it possible to improve the basic characteristics of TM. In this communication our results on the modification of PET and PP TM are presented. The modified membranes were prepared by radiation-induced graft polymerization from the liquid phase. Three methods of grafting were used: (a) the direct method in argon atmosphere; (b) the pre-irradiation of TM in air followed by grafting in argon atmosphere; (c) pre-irradiation in vacuum followed by grafting in vacuum without contacting oxygen. The aim of the work was to investigate some properties of TM modified by grafted poly(methylvinyl pyridine) (PMVP) and poly(N-isopropylacrylamide) (PNIPAAM). It was shown that the modification of TM with hydrophilic polymer results in the growth of the water flow rate. In the past few years many works have been devoted to the synthesis of new polymers - the so-called "intelligent" materials - such as PNIPAAM. However, it is very difficult to make thin membranes of this polymer. Recently, it has been proposed to manufacture composite membranes by grafting stimulus-responsive polymers onto TM. Following this principle, we prepared thermosensitive membranes by the radiation-induced graft polymerization of N-isopropylacrylamide (NIPAAM) onto PET TM. PET TM with the pore size of about 1 μm and pore density of 10 6 cm -2 were first inserted into a solution of NIPAAM containing inhibitor of homopolymerization (CuCl 2) and then exposed to the γ-rays from a 60Co source. The transport properties of the grafted

Graft-versus-host disease targets ovary and causes female infertility in mice.

PubMed

Shimoji, Sonoko; Hashimoto, Daigo; Tsujigiwa, Hidetsugu; Miyawaki, Kohta; Kato, Koji; Takahashi, Shuichiro; Ogasawara, Reiki; Jiromaru, Takashi; Iwasaki, Hiromi; Miyamoto, Toshihiro; Akashi, Koichi; Teshima, Takanori

2017-03-02

Infertility associated with ovarian failure is a serious late complication for female survivors of allogeneic hematopoietic stem cell transplantation (SCT). Although pretransplant conditioning regimen has been appreciated as a cause of ovarian failure, increased application of reduced-intensity conditioning allowed us to revisit other factors possibly affecting ovarian function after allogeneic SCT. We have addressed whether donor T-cell-mediated graft-versus-host disease (GVHD) could be causally related to female infertility in mice. Histological evaluation of the ovaries after SCT demonstrated donor T-cell infiltration in close proximity to apoptotic granulosa cells in the ovarian follicles, resulting in impaired follicular hormone production and maturation of ovarian follicles. Mating experiments showed that female recipients of allogeneic SCT deliver significantly fewer newborns than recipients of syngeneic SCT. GVHD-mediated ovary insufficiency and infertility were independent of conditioning. Pharmacologic GVHD prophylaxis protected the ovary from GVHD and preserved fertility. These results demonstrate for the first time that GVHD targets the ovary and impairs ovarian function and fertility and has important clinical implications in young female transplant recipients with nonmalignant diseases, in whom minimally toxic regimens are used. © 2017 by The American Society of Hematology.

Long-term cognitive effects of human stem cell transplantation in the irradiated brain.

PubMed

Acharya, Munjal M; Martirosian, Vahan; Christie, Lori-Ann; Limoli, Charles L

2014-09-01

Radiotherapy remains a primary treatment modality for the majority of central nervous system tumors, but frequently leads to debilitating cognitive dysfunction. Given the absence of satisfactory solutions to this serious problem, we have used human stem cell therapies to ameliorate radiation-induced cognitive impairment. Here, past studies have been extended to determine whether engrafted cells provide even longer-term benefits to cognition. Athymic nude rats were cranially irradiated (10 Gy) and subjected to intrahippocampal transplantation surgery 2 days later. Human embryonic stem cells (hESC) or human neural stem cells (hNSC) were transplanted, and animals were subjected to cognitive testing on a novel place recognition task 8 months later. Grafting of hNSC was found to provide long lasting cognitive benefits over an 8-month post-irradiation interval. At this protracted time, hNSC grafting improved behavioral performance on a novel place recognition task compared to irradiated animals not receiving stem cells. Engrafted hESC previously shown to be beneficial following a similar task, 1 and 4 months after irradiation, were not found to provide cognitive benefits at 8 months. Our findings suggest that hNSC transplantation promotes the long-term recovery of the irradiated brain, where intrahippocampal stem cell grafting helps to preserve cognitive function.

One-pot synthesis of fluorescent polysaccharides: adenine grafted agarose and carrageenan.

PubMed

Oza, Mihir D; Prasad, Kamalesh; Siddhanta, A K

2012-08-01

New fluorescent polysaccharides were synthesized by grafting the nucleobase adenine on to the backbones of agarose and κ-carrageenan, which were characterized by FT-IR, (13)C NMR, TGA, XRD, UV, and fluorescence properties. The synthesis involved a rapid water based potassium persulfate (KPS) initiated method under microwave irradiation. The emission spectra of adenine grafted agarose and κ-carrageenan were recorded in aqueous (5×10(-5) M) solution, exhibiting λ(em,max) 347 nm by excitation at 261 nm, affording ca. 30% and 40% enhanced emission intensities, respectively compared to that of pure adenine solution in the same concentration. Similar emission intensity was recorded in the pure adenine solution at its molar equivalent concentrations present in the 5×10(-5) M solution of the agarose and carrageenan grafted products, that is, 3.28×10(-5) M and 4.5×10(-5) M respectively. These fluorescent adenine grafted products may have potential utility in various sensor applications. Copyright © 2012. Published by Elsevier Ltd.

Evaluating the impact of pre-transplant desensitization utilizing a plasmapheresis and low-dose intravenous immunoglobulin protocol on BK viremia in renal transplant recipients.

PubMed

Gabardi, S; Townsend, K; Martin, S T; Chandraker, A

2013-08-01

A correlation exists between polyomavirus BK (BKV) viremia in renal transplant recipients (RTR) and the degree of immunosuppression. However, the impact of pre-transplant desensitization on the incidence of BKV viremia is unknown. This retrospective study evaluated living-donor RTR between January 2004 and December 2008 receiving routine BKV viral load monitoring. Patients were divided into those who underwent pre-transplant desensitization (n = 20) and those who did not (n = 71). The primary endpoint was the incidence of BKV viremia at 1 year post transplant. All demographic data were similar, except for more female patients (65% vs. 36.6%; P = 0.0392) in the desensitized group. More desensitized patients had a previous transplant (75% vs. 12.7%; P < 0.0001) and were more likely to be induced with basiliximab (75% vs. 35.2%; P = 0.0021). Following transplantation, antibody-mediated rejection (AMR) rates were highest in the desensitized group (55% vs. 1.4%; P < 0.0001). The incidence of BKV viremia at 1 year post transplant was significantly higher in desensitized patients (45% vs. 19.7%; P = 0.0385). Desensitization was also associated with a higher prevalence of BKV viremia at any time post transplant (50% vs. 22.5%; P = 0.0245), polyomavirus-associated nephropathy (20% vs. 2.8%; P = 0.0198) and BKV-related allograft loss (10% vs. 0%; P = 0.0464). Also of note, in a subgroup analysis of only our desensitized patients, it did not appear that development of AMR significantly impacted the incidence of BKV viremia in these individuals. This analysis reveals that pre-transplant desensitization significantly increases the risk for BKV viremia and nephropathy. © 2013 John Wiley & Sons A/S.

Pretransplant soluble CD30 is a better predictor of posttransplant development of donor-specific antibodies and acute vascular rejection than panel reactive antibodies.

PubMed

Vaidya, Smita; Partlow, David; Barnes, Titus; Gugliuzza, Kristine

2006-12-27

This study tests a hypothesis that pretransplant concentration of soluble CD30 (sCD30) is a better predictor of posttransplant development of donor-specific HLA antibodies (DSA) and acute vascular rejection (AVR) than panel reactive HLA antibodies (PRA). Pretransplant sera from 115 patients were evaluated for their PRA and sCD30 concentrations. All patients received calcineurin-inhibitor based immunosuppressive therapy. Objective measurements for rejection were biopsy-proven AVR episodes within first 6 months of the transplant. Posttransplant sera of patients with or without AVR were tested for the presence of DSA. AVR rate was 16% (18/115). Patients positive for PRA and sCD30 tests were at significantly higher risk for AVR compared to those patients negative for both tests (36% versus 5%, p = 0.01). Among negative PRA patients risk for AR was significantly elevated if they were also tested positive for sCD30 concentrations (21% versus 5%, p = 0.04). Of the 18 patients with AVR, 14 were positive for sCD30, and 13 of them (93%) developed DSA posttransplant (p = 0.001) Nineteen patients without AVR were tested for DSA and sCD30 concentrations. Only two of these 19 patients were positive for sCD30 and DSA. AVR was strongly associated with the patients tested positive for both the tests: DSA and sCD30 (p = 0.00007). Furthermore, patients with AVR are more likely to produce DSA than those without AVR (p = 0.02). These data support our hypothesis that patients positive for sCD30 contents are at high risk the development of DSA and AVR posttransplant regardless of their pretransplant PRA.

Chemical and radiation crosslinked polymer electrolyte membranes prepared from radiation-grafted ETFE films for DMFC applications

NASA Astrophysics Data System (ADS)

Chen, Jinhua; Asano, Masaharu; Yamaki, Tetsuya; Yoshida, Masaru

To develop a highly chemically stable polymer electrolyte membrane for application in a direct methanol fuel cell (DMFC), doubly crosslinked membranes were prepared by chemical crosslinking using bifunctional monomers, such as divinylbenzene (DVB) and bis(p, p-vinyl phenyl) ethane (BVPE), and by radiation crosslinking. The membranes were prepared by grafting of m, p-methylstyrene (MeSt) and p-tert-butylstyrene (tBuSt) into poly(ethylene- co-tetrafluoroethylene) (ETFE) films and subsequent sulfonation. The effects of the DVB and BVPE crosslinkers on the grafting kinetics and the properties of the prepared membranes, such as water uptake, proton conductivity and chemical stability were investigated. Radiation crosslinking was introduced by irradiation of the ETFE base film, the grafted film or the sulfonated membrane. The membrane crosslinked by DVB and BVPE crosslinkers and post-crosslinked by γ-ray irradiation of the corresponding grafted film possessed the highest chemical stability among the prepared membranes, a significantly lower methanol permeability compared to Nafion ® membranes, and a better DMFC performance for high methanol feed concentration. Therefore, this doubly crosslinked membrane was promising for application in a DMFC where relatively high methanol concentration could be fed.

Associations of Pre-transplant Prescription Narcotic Use with Clinical Complications after Kidney Transplantation

PubMed Central

Lentine, Krista L.; Lam, Ngan N.; Xiao, Huiling; Tuttle-Newhall, Janet E.; Axelrod, David; Brennan, Daniel C.; Dharnidharka, Vikas R.; Yuan, Hui; Nazzal, Mustafa; Zheng, Jie; Schnitzler, Mark A.

2015-01-01

Background Associations of narcotic use before kidney transplantation with post-transplant clinical outcomes are not well described. Methods We examined integrated national transplant registry, pharmacy records, and Medicare billing claims to follow 16,322 kidney transplant recipients, of whom 28.3% filled a narcotic prescription in the year before transplantation. Opioid analgesic fills were normalized to morphine equivalents (ME) and expressed as mg/kg exposures (approximate quartiles: 0.1– 1.7, 1.8–5.4, 5.5–23.7, and ≥23.8 mg/kg, respectively). Post-transplant cardiovascular, respiratory, neurological, accidents, substance abuse, and non-compliance events were identified using diagnosis codes on Medicare billing claims. Adjusted associations of ME level with post-transplant complications were quantified by multivariate Cox regression. Results The incidence of complications at 3 years post-transplant among those with the highest pre-transplant ME exposure compared to no use included: ventricular arrhythmias, 1.1% vs. 0.2% (p<0.001); cardiac arrest, 4.7% vs. 2.7% (p<0.05); hypotension, 14% vs. 8% (p<0.0001); hypercapnia, 1.6% vs. 0.9% (p<0.05); mental status changes, 5.3% vs. 2.7% (p<0.001); drug abuse/dependence, 7.0% vs. 1.7% (p<0.0001); alcohol abuse, 1.8% vs. 0.6% (p=0.0001); accidents, 0.9% vs. 0.3% (p<0.05); and non-compliance, 3.5% vs. 2.3% (p<0.05). In multivariate analyses, transplant recipients with the highest level of pre-transplant narcotic use had approximately 2-to-4-times the risks of post-transplant ventricular arrhythmias, mental status changes, drug abuse, alcohol abuse, and accidents compared with non-users, and 35% to 45% higher risks of cardiac arrest and hypotension. Conclusion Although associations may reflect underlying conditions or behaviors, high-level prescription narcotic use before kidney transplantation predicts increased risk of clinical complications after transplantation. PMID:25832723

Implications of false positive serology of Toxoplasma gondii in a pre-transplant patient.

PubMed

Beal, Stacy; Racsa, Lori; Alatoom, Adnan

2014-01-01

A 21-year-old white male with cystic fibrosis. Pre-transplant workup in preparation for bilateral lung transplant. Cystic fibrosis diagnosed at age 3, onset of insulin-dependent diabetes around age 20, and multiple hospitalizations for pulmonary and gastrointestinal complications. FAMILY AND SOCIAL HISTORY: The patient lives with his father and stepmother, has a pet bearded dragon, and has multiple tattoos and piercings. His stepmother has a cat, but he does not clean the litter box. The pre-transplant workup included several tests for infectious diseases, tests of organ function, radiology studies, and markers of malignancy. The only significant finding was a positive Toxoplasma gondii (T. gondii) IgM titer (> or = 1:40) (reference values for IgM: negative; < 1:40, positive; > or = 1:40) and IgG (1:2048) (reference values for IgG: negative; < 1:16, equivocal; > or = 1:16 - < 1:256, positive; > or = 1:256). Testing was done by indirect immunofluorescence assay (IFA) in April 2012 in our hospital laboratory. The patient was treated with sulfadiazine, leucovorin, and pyrimethamine. Three months later (July), he returned for follow-up testing. Real-time polymerase chain reaction (PCR) for T. gondii DNA performed by a reference laboratory was negative. One month later (August), Toxoplasma serology was performed by enzyme-linked immunosorbent assay (ELISA) by a different reference laboratory and showed an elevated IgM of 0.95 IU/mL (reference values: negative; < 0.55 IU/mL, equivocal; > or = 0.55- < 0.65 IU/mL, positive; > or = 0.65 IU/mL) and a normal level of IgG (< 4 IU/mL). At this time, PCR was repeated and was negative. An additional month later (September), the patient's serology studies were performed at a third reference laboratory and showed an elevated IgM of 1.32 IU/mL (reference values: negative; 0.89, equivocal; 0.90 - 1.09, positive; > 1.10) and a normal IgG.

Graft-Sparing Strategy for Thoracic Prosthetic Graft Infection.

PubMed

Uchino, Gaku; Yoshida, Takeshi; Kakii, Bunpachi; Furui, Masato

2018-04-01

 Thoracic prosthetic graft infection is a rare but serious complication with no standard management. We reported our surgical experience on graft-sparing strategy for thoracic prosthetic graft infection.  This study included patients who underwent graft-sparing surgery for thoracic prosthetic graft infection at Matsubara Tokushukai Hospital in Japan from January 2000 to October 2017.  There were 17 patients included in the analyses, with a mean age at surgery of 71.0 ± 10.5 years; 11 were men. In-hospital mortality was observed in five patients (29.4%).  Graft-sparing surgery for thoracic prosthetic graft infection is an alternative option particularly for early graft infection after hemiarch replacement. Georg Thieme Verlag KG Stuttgart · New York.

Thermal and mechanical properties of gamma-irradiated prevulcanized natural rubber latex/low nitrosamines latex blends

NASA Astrophysics Data System (ADS)

Ibrahim, Pairu; Daik, Rusli; Wan Zin, Wan Manshol

2016-12-01

Thermal and mechanical properties of blended radiation prevulcanized natural rubber latex (RVNRL) and low nitrosamines latex (LNL) were studied. RVNRL was blended with LNL at various composition ratios. From the tensile test, it was found that the optimum tensile value was attained at a total blending ratio of 70% RVNRL and 30% LNL. Latex blending with optimum tensile strength was then subjected to gamma irradiation at various doses with the presence and absence of methyl methacrylate (MMA) at 10 pphr. It was found that the gamma irradiation of latex blend with the presence of MMA could help increase further the tensile value. Composition of blending at a specific ratio and gamma irradiation at a specific dose has led to a significant improvement in the mechanical properties of the latex blend. The formation of grafting in the latex blend was characterized by Fourier transform infrared spectra (FTIR) spectroscopy and differential scanning calorimetry (DSC). FTIR spectroscopy confirmed that MMA could be grafted onto blended latex effectively under appropriate irradiation conditions. Two new peaks at 1731 and 1149 cm-1 were observed after irradiation, indicating the presence of an ester group from poly(methyl methacrylate) (PMMA), which was grafted onto rubber chains. This finding was proved by the presence of new Tg in DSC analysis. The increase in new Tg indicates the movement of grafting chains, which are tightly bound onto rubber chains.

Graft polymerization of acrylic acid and methacrylic acid onto poly(vinylidene fluoride) powder in presence of metallic salt and sulfuric acid

NASA Astrophysics Data System (ADS)

Deng, Bo; Yu, Yang; Zhang, Bowu; Yang, Xuanxuan; Li, Linfan; Yu, Ming; Li, Jingye

2011-02-01

Poly(vinylidene fluoride) (PVDF) powder was grafted with acrylic acid (AAc) or methacrylic acid (MAA) by the pre-irradiation induced graft polymerization technique. The presence of graft chains was proven by FT-IR spectroscopy. The degree of grafting (DG) was calculated by the acid-base back titration method. The synergistic effect of acid and Mohr's salt on the grafting kinetics was examined. The results indicated that adding sulfuric acid and Mohr's salt simultaneously in AAc or MAA solutions led to a strong enhancement in the degree of grafting. The grafted PVDF powder was cast into microfiltration (MF) membranes using the phase inversion method and some properties of the obtained MF membranes were characterized.

Swelling properties of cassava starch grafted with poly (potassium acrylate-co-acrylamide) superabsorbent hydrogel prepared by ionizing radiation

NASA Astrophysics Data System (ADS)

Barleany, Dhena Ria; Ulfiyani, Fida; Istiqomah, Shafina; Heriyanto, Heri; Rahmayetty, Erizal

2015-12-01

Natural and synthetic hydrophylic polymers can be phisically or chemically cross-linked in order to produce hydrogels. Starch based hydrogels grafted with copolymers from acrylic acid or acrylamide have become very popular for water absorbent application. Superabsorbent hydrogels made from Cassava starch grafted with poly (potassium acrylate-co-acrylamide) were prepared by using of ϒ-irradiation method. Various important parameters such as irradiation doses, monomer to Cassava starch ratio and acrylamide content were investigated. The addition of 7,5 % w w-1 acrylamide into the reaction mixture generated a starch graft copolymer with a water absorption in distilled water as high as 460 g g-1 of its dried weight. The effectivity of hydrogel as superabsorbent for aqueous solutions of NaCl and urea was evaluated. The obtained hydrogel showed the maximum absorptions of 317 g g-1 and 523 g g-1 for NaCl and urea solution, respectively (relative to its own dry weight). The structure of the graft copolymer was analyzed by using Fourier Transform Infrared Spectroscopy (FTIR) and Scanning Electron Microscope (SEM).

Survival and endogenous colony formation in irradiated mice grafted with normal or infectious mononucleosis bone marrow

DOE Office of Scientific and Technical Information (OSTI.GOV)

Louwagie, A. C.; Verwilghen, R. L.

1973-07-01

Mice were exposed to 850 or 975 rad of whole-body radiation; three hr later mice were given normal human bone marrow, infectious mononucleosis bone marrow, or cells from malignant blood diseases. The surviving mice were killed at day 9 and the spleen nodules were counted. Some mice were also given antihuman antilymphocytic serum (ALS). In mice exposed to 975 rad, the highest survival was observed in mice grafted with infectious mononucleosis bone marrow, while none of the animals grafted with cells from malignant blood diseases survived 9 days. In mice exposed to 850 rad, grafting of normal or infectious mononucleosismore » bone marrow markedly decreased the survival. Endogenous spleen colonies were induced in all animals grafted with normal or infectious mononucleosis bone marrow. (HLW)« less

Intensifying radiation induced grafting of 4-vinylpyridine/glycidyl methacrylate mixtures onto poly(ethylene-co-tetrafluoroethylene) films using ultrasound

NASA Astrophysics Data System (ADS)

Nasef, Mohamed Mahmoud; Sithambaranathan, Paveswari; Ahmad, Arshad; Abouzari-lotf, Ebrahim

2017-05-01

A new ultrasound-aided method was used to enhance grafting of 4-vinylpyridine (4-VP) and glycidyl methacrylate (GMA) monomers mixtures onto electron beam (EB) irradiated poly(ethylene-co-tetrafluoroethylene) (ETFE) film for the first time. The effects of reaction parameters such as absorbed dose, monomer concentration, reaction time on both of degree of grafting (DG) and grafting efficiency (GE) were investigated under sonication and conventional grafting at similar temperatures. Fourier transform infrared (FTIR) and atomic force microscopy (AFM) were used to monitor the impact of the applied ultrasound on composition and surfaces of the grafted films whereas 1H-NMR was used to investigate composition of the grafting residues. The ultrasound-aided grafting of 4-VP/GMA was found to enhance both of DG% and GE remarkably. Moreover, it produced grafted ETFE films having smoother surfaces without homopolymer contamination compared to grafted films obtained from conventional grafting. The results of this study suggest that the use of ultrasound is a promising way for intensifying grafting process and improving its economy.

The Use Of Laser Irradiation To Stimulate Adipose Derived Stem Cell Proliferation And Differentiation For Use In Autologous Grafts

NASA Astrophysics Data System (ADS)

Abrahamse, Heidi

2009-09-01

fluences on ADSC viability and proliferation. This paper reviews the development of MSCs as potential therapeutic interventions such as autologous grafts as well as the contribution of low intensity laser irradiation on the maintenance of these cells.

Radiation-grafting of flame retardants on flax fabrics - A comparison between different flame retardant structures

NASA Astrophysics Data System (ADS)

Teixeira, Marie; Sonnier, Rodolphe; Otazaghine, Belkacem; Ferry, Laurent; Aubert, Mélanie; Tirri, Teija; Wilén, Carl-Eric; Rouif, Sophie

2018-04-01

Three unsaturated compounds bearing respectively phosphate, aryl bromide and sulfenamide moieties were used as flame retardants (FR) for flax fabrics. Due to the presence of carbon-carbon double bonds, radiation-grafting was considered to covalently bond these FR onto fiber structure. Grafting efficiency and location of FR molecules were investigated by weight measurements and SEM-EDX observations. Flammability and especially self-extinguishment were assessed by thermogravimetric analysis, pyrolysis-combustion flow calorimetry and a non-standardized fire test already used in previous studies. All FRs were able to diffuse into elementary fiber bulk. Nevertheless only the phosphonated monomer (noted FR-P) was significantly grafted onto flax. Self-extinguishment was obtained for fabrics containing at least around 0.5 wt% of phosphorus. On the contrary the FR content of flax fibers after radiation-grafting procedure and washing was negligible for FR-S and FR-Br, evidencing that these molecules have not been grafted upon irradiation. Moreover, the combination of these molecules prevents the radiation-grafting of other molecules which showed good grafting rate when used alone.

Radiation-grafted proton exchange membranes based on co-grafting from binary monomer mixtures into poly(ethylene-co-tetrafluoroethylene) (ETFE) film

NASA Astrophysics Data System (ADS)

Sohn, Joon-Yong; Sung, Hae-Jun; Song, Joo-Myung; Shin, Junhwa; Nho, Young-Chang

2012-08-01

In this study, proton exchange membranes (PEMs) based on a poly(ethylene-co-tetrafluoroethylene) (ETFE) film were synthesized through the graft copolymerization of styrene and VTMS (vinyltrimethoxysilane), or styrene and TMSPM (3-(trimethoxysilyl) propyl methacrylate) binary monomer systems using a simultaneous irradiation method. The prepared membranes with the similar degrees of grafting were investigated by measuring ion exchange capacity, proton conductivity, water uptake, chemical stability, and dimensional stability. The results indicate that the silane-crosslinked proton exchange membrane (PEM) has not only lower water uptake and dimensional change but also high proton conductivity at low humidity condition compared to non-crosslinked poly(ethylene-co-tetrafluoroethylene)-g-poly(styrene sulfonic acid) (ETFE-g-PSSA). Also, the chemical stability of silane-crosslinked fuel cell membranes was more improved than that of non-crosslinked fuel cell membrane.

Pre-transplantation glucose testing for predicting new-onset diabetes mellitus after renal transplantation.

PubMed

Ramesh Prasad, G V; Huang, M; Bandukwala, F; Nash, M M; Rapi, L; Montada-Atin, T; Meliton, G; Zaltzman, J S

2009-02-01

New-onset diabetes after renal transplantation (NODAT) adversely affects graft and patient survival. However, NODAT risk based on pre-transplant blood glucose (BG) levels has not been defined. Our goal was to identify the best pre-transplant testing method and cut-off values. We performed a case-control analysis of non-diabetic recipients who received a live donor allograft with at least 6 months post-transplant survival. Pre-transplant glucose abnormalities were excluded through 75 g oral glucose tolerance testing (OGTT) and random BG (RBG) measurement. NODAT was defined based on 2003 Canadian Diabetes Association criteria. Multivariate logistic and Cox regression analysis was performed to determine independent predictor variables for NODAT. Receiver-operating-characteristic (ROC) curves were constructed to determine threshold BG values for diabetes risk. 151 recipients met initial entry criteria. 12 had pre-transplant impaired fasting glucose and/or impaired glucose tolerance, among who 7 (58%) developed NODAT. In the remaining 139, 24 (17%) developed NODAT. NODAT risk exceeded 25% for those with pre-transplant RBG > 6.0 mmol/l and 50% if > 7.2 mmol/l. Pre-transplant RBG provided the highest AUC (0.69, p = 0.002) by ROC analysis. Increasing age (p = 0.025), acute rejection (p = 0.011), and RBG > 6.0 mmol/l (p = 0.001) were independent predictors of NODAT. Pre-transplant glucose testing is a specific marker for NODAT. Patients can be counseled of their incremental risk even within the normal BG range if the OGTT is normal.

Preparation and characterization of maleoylagarose/PNIPAAm graft copolymers and formation of polyelectrolyte complexes with chitosan.

PubMed

Ortiz, J Andrés; Matsuhiro, Betty; Zapata, Paula A; Corrales, Teresa; Catalina, Fernando

2018-02-15

A water soluble derivative in 98% yield with 23.1% incorporation of maleoyl groups was obtained by esterification of agarose with maleic anhydride. Graft copolymers were synthesized through vinyl groups of maleoylagarose with N-isopropylacrylamide using ceric ammonium nitrate or ammonium persulfate as initiator, by conventional method or microwave irradiation. High nitrogen content (4.6%) was obtained in the grafting process using ceric ammonium nitrate as initiator without microwave irradiation. Copolymers were characterized by FT-IR and NMR spectroscopies, TGA, DSC and morphological analysis by AFM and SEM microscopy, confirming the grafting of PNIPAAm onto polysaccharide backbone. Hydrogel films were obtained by ionic complexation between opposite charged groups of maleoylagarose-g-poly(N-isopropylacrylamide) and chitosan. The swelling of 1:1w/v maleoylagarose-g-PNIPAAm:chitosan film was higher than 2:1w/v film at 25 and 37°C. 53% release in vitro of diclofenac sodium from 1:1w/v maleoylagarose-g-PNIPAAm:chitosan was obtained at 37°C and pH 6.0 with <0.5 diffusional constant values. Copyright © 2017 Elsevier Ltd. All rights reserved.

Efficacy of extracorporeal membrane oxygenation as a bridge to lung transplantation.

PubMed

Toyoda, Yoshiya; Bhama, Jay K; Shigemura, Norihisa; Zaldonis, Diana; Pilewski, Joseph; Crespo, Maria; Bermudez, Christian

2013-04-01

transplants on pump (cardiopulmonary bypass/ECMO), and single lung transplants were performed in 171 patients (25%) and pump was used in 243 patients (35%) in the control group. The cardiopulmonary bypass time was longer in the pretransplant ECMO group (277 ± 69 minutes vs 225 ± 89 minutes, P = .02), with no difference in ischemic time (343 ± 93 minutes vs 330 ± 98 minutes, P = .54). Cadaveric lobar lung transplants were performed because of the urgency to overcome size mismatch with an oversized donor more frequently in 25% (n = 6, no mortality with the longest follow-up at 6 years) of patients in the pretransplant ECMO group versus 0.3% (n = 2) of patients in the control group (P < .01). Post-transplant ECMO was used for primary graft dysfunction in 13 patients (54%) in the pretransplant ECMO group and 41 patients (6%) in the control group (P < .01). The median hospital stay was 46 days in the pretransplant ECMO group versus 27 days in the control group (P = .16). The actuarial survivals after lung transplants at 1, 3, 6, 12, and 24 months were 96%, 88%, 83%, 74%, and 74%, respectively, in the pretransplant ECMO group, and 97%, 94%, 90%, 83%, and 74%, respectively, in the control group (P = .787). Although the incidence of primary graft dysfunction requiring post-transplant ECMO is higher and the hospital stay is longer in patients receiving pretransplant ECMO, the graft survival is good (2-year survival, 74%). ECMO is efficacious as a bridge to lung transplantation with good post-lung transplant outcomes. Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Independent Pre-Transplant Recipient Cancer Risk Factors after Kidney Transplantation and the Utility of G-Chart Analysis for Clinical Process Control.

PubMed

Schrem, Harald; Schneider, Valentin; Kurok, Marlene; Goldis, Alon; Dreier, Maren; Kaltenborn, Alexander; Gwinner, Wilfried; Barthold, Marc; Liebeneiner, Jan; Winny, Markus; Klempnauer, Jürgen; Kleine, Moritz

2016-01-01

The aim of this study is to identify independent pre-transplant cancer risk factors after kidney transplantation and to assess the utility of G-chart analysis for clinical process control. This may contribute to the improvement of cancer surveillance processes in individual transplant centers. 1655 patients after kidney transplantation at our institution with a total of 9,425 person-years of follow-up were compared retrospectively to the general German population using site-specific standardized-incidence-ratios (SIRs) of observed malignancies. Risk-adjusted multivariable Cox regression was used to identify independent pre-transplant cancer risk factors. G-chart analysis was applied to determine relevant differences in the frequency of cancer occurrences. Cancer incidence rates were almost three times higher as compared to the matched general population (SIR = 2.75; 95%-CI: 2.33-3.21). Significantly increased SIRs were observed for renal cell carcinoma (SIR = 22.46), post-transplant lymphoproliferative disorder (SIR = 8.36), prostate cancer (SIR = 2.22), bladder cancer (SIR = 3.24), thyroid cancer (SIR = 10.13) and melanoma (SIR = 3.08). Independent pre-transplant risk factors for cancer-free survival were age <52.3 years (p = 0.007, Hazard ratio (HR): 0.82), age >62.6 years (p = 0.001, HR: 1.29), polycystic kidney disease other than autosomal dominant polycystic kidney disease (ADPKD) (p = 0.001, HR: 0.68), high body mass index in kg/m2 (p<0.001, HR: 1.04), ADPKD (p = 0.008, HR: 1.26) and diabetic nephropathy (p = 0.004, HR = 1.51). G-chart analysis identified relevant changes in the detection rates of cancer during aftercare with no significant relation to identified risk factors for cancer-free survival (p<0.05). Risk-adapted cancer surveillance combined with prospective G-chart analysis likely improves cancer surveillance schemes by adapting processes to identified risk factors and by using G-chart alarm signals to trigger Kaizen events and audits for root

IMPACT OF PRE-TRANSPLANT RITUXIMAB ON SURVIVAL AFTER AUTOLOGOUS HEMATOPOIETIC STEM CELL TRANSPLANTATION FOR DIFFUSE LARGE B-CELL LYMPHOMA

PubMed Central

Fenske, Timothy S.; Hari, Parameswaran N.; Carreras, Jeanette; Zhang, Mei-Jie; Kamble, Rammurti T.; Bolwell, Brian J.; Cairo, Mitchell S.; Champlin, Richard E.; Chen, Yi-Bin; Freytes, César O.; Gale, Robert Peter; Hale, Gregory A.; Ilhan, Osman; Khoury, H. Jean; Lister, John; Maharaj, Dipnarine; Marks, David I.; Munker, Reinhold; Pecora, Andrew L.; Rowlings, Philip A.; Shea, Thomas C.; Stiff, Patrick; Wiernik, Peter H.; Winter, Jane N.; Rizzo, J. Douglas; van Besien, Koen; Lazarus, Hillard M.; Vose, Julie M.

2010-01-01

Incorporation of the anti-CD20 monoclonal antibody rituximab into front-line regimens for diffuse large B-cell lymphoma (DLBCL) has resulted in improved survival. Despite this progress, many patients develop refractory or recurrent DLBCL and then receive autologous hematopoietic stem cell transplantation (AuHCT). It is unclear to what extent pre-transplant exposure to rituximab affects outcomes following AuHCT. Outcomes of 994 patients receiving AuHCT for DLBCL between 1996 and 2003 were analyzed according to whether rituximab was (n=176, “+R” group) or was not (n=818, “ −R” group) administered with front-line or salvage therapy prior to AuHCT. The +R group had superior progression-free survival (50% versus 38%, p=0.008) and overall survival (57% versus 45%, p=0.006) at 3 years. Platelet and neutrophil engraftment were not affected by exposure to rituximab. Non-relapse mortality (NRM) did not differ significantly between the +R and −R groups. In multivariate analysis, the +R group had improved progression-free survival (relative risk of relapse/progression or death 0.64, p<0.001) and improved overall survival (relative risk of death of 0.74, p=0.039). We conclude that pre-transplant rituximab is associated with a lower rate of progression and improved survival following AuHCT for DLBCL, with no evidence of impaired engraftment or increased NRM. PMID:19822306

Evolution of skin grafting for treatment of burns: Reverdin pinch grafting to Tanner mesh grafting and beyond.

PubMed

Singh, Mansher; Nuutila, Kristo; Collins, K C; Huang, Anne

2017-09-01

Skin grafting is the current standard care in the treatment of full thickness burns. It was first described around 1500 BC but the vast majority of advancements have been achieved over the past 200 years. An extensive literature review was conducted on Pubmed, Medline and Google Scholar researching the evolution of skin grafting techniques. The authors concentrated on the major landmarks of skin grafting and also provide an overview of ongoing research efforts in this field. The major innovations of skin grafting include Reverdin pinch grafting, Ollier grafting, Thiersch grafting, Wolfe grafting, Padgett dermatome and modifications, Meek-wall microdermatome and Tanner mesh grafting. A brief description of the usage, advantages and limitations of each technique is included in the manuscript. Skin grafting technique have evolved significantly over past 200 years from Reverdin pinch grafting to modern day meshed skin grafts using powered dermatome. Increasing the expansion ratio and improving the cosmetic and functional outcome are the main focus of ongoing skin grafting research and emerging techniques (such as Integra ® , Recell ® , Xpansion ® ) are showing promise. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Application of Sepharose and Sephadex modified by means of radiation grafting in separation of biomolecules

NASA Astrophysics Data System (ADS)

Li, Jun; Yi, Min; Ha, Hongfei

1995-02-01

In this work Sepharose-NASI-BSA and Sephadex-NASI-BSA were prepared by means of pre-irradiation grafting and direct radiation grafting separately. The radiation grafting condition were given. In order to get those compounds the conjugation reaction between NASI and BSA was investigated as well. The reaction was performed at 37 °C for 2hs, but in the case of Sephadex-NASI, it took longer time, 6hs, to finish the conjugation reaction. The application of the radiation modified matrixes as a kind of filling materials of column chromatography in separation of D,L-tryptophans was studied. The results showed that this method was accessible after some improvements.

Skin graft

MedlinePlus

... that need skin grafts to heal Venous ulcers, pressure ulcers , or diabetic ulcers that do not heal Very ... graft; Full thickness skin graft Patient Instructions Preventing pressure ulcers Surgical wound care - open Images Skin graft Skin ...

Microwave Assisted Grafting of Gums and Extraction of Natural Materials.

PubMed

Singh, Inderbir; Rani, Priya; Kumar, Pradeep

2017-01-01

Microwave assisted modification of polymers has become an established technique for modifying the functionality of polymers. Microwave irradiation reduces reaction time as well as the use of toxic solvents with enhanced sensitivity and yields of quality products. In this review article instrumentation and basic principles of microwave activation have been discussed. Microwave assisted grafting of natural gums, characterization of grafted polymers and their toxicological parameters have also been listed. Pharmaceutical applications viz. drug release retardant, mucoahesion and tablet superdisintegrant potential of microwave assisted gums has also been discussed. An overview of microwave assisted extraction of plant based natural materials has also been presented. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Swelling properties of cassava starch grafted with poly (potassium acrylate-co-acrylamide) superabsorbent hydrogel prepared by ionizing radiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barleany, Dhena Ria, E-mail: dbarleany@yahoo.com; Ulfiyani, Fida; Istiqomah, Shafina

Natural and synthetic hydrophylic polymers can be phisically or chemically cross-linked in order to produce hydrogels. Starch based hydrogels grafted with copolymers from acrylic acid or acrylamide have become very popular for water absorbent application. Superabsorbent hydrogels made from Cassava starch grafted with poly (potassium acrylate-co-acrylamide) were prepared by using of ϒ-irradiation method. Various important parameters such as irradiation doses, monomer to Cassava starch ratio and acrylamide content were investigated. The addition of 7,5 % w w{sup −1} acrylamide into the reaction mixture generated a starch graft copolymer with a water absorption in distilled water as high as 460 gmore » g{sup −1} of its dried weight. The effectivity of hydrogel as superabsorbent for aqueous solutions of NaCl and urea was evaluated. The obtained hydrogel showed the maximum absorptions of 317 g g{sup −1} and 523 g g{sup −1} for NaCl and urea solution, respectively (relative to its own dry weight). The structure of the graft copolymer was analyzed by using Fourier Transform Infrared Spectroscopy (FTIR) and Scanning Electron Microscope (SEM)« less

Electron-beam-induced post-grafting polymerization of acrylic acid onto the surface of Kevlar fibers

NASA Astrophysics Data System (ADS)

Xu, Lu; Hu, Jiangtao; Ma, Hongjuan; Wu, Guozhong

2018-04-01

The surface of Kevlar fibers was successfully modified by electron beam (EB)-induced post-grafting of acrylic acid (AA). The generation of radicals in the fibers was confirmed by electron spin resonance (ESR) measurements, and the concentration of radicals was shown to increase as the absorbed dose increased, but decrease with increasing temperature. The influence of the synthesis conditions on the degree of grafting was also investigated. The surface microstructure and chemical composition of the modified Kevlar fibers were characterized by scanning electron microscopy (SEM) and X-ray photoelectron spectroscopy (XPS). The SEM images revealed that the surface of the grafted fibers was rougher than those of the pristine and irradiated fibers. XPS analysis confirmed an increase in C(O)OH groups on the surface of the Kevlar fibers, suggesting successful grafting of AA. These results indicate that EB-induced post-grafting polymerization is effective for modifying the surface properties of Kevlar fibers.

Access to Heart Transplantation: A Proper Analysis of the Competing Risks of Death and Transplantation Is Required to Optimize Graft Allocation.

PubMed

Cantrelle, Christelle; Legeai, Camille; Latouche, Aurélien; Tuppin, Philippe; Jasseron, Carine; Sebbag, Laurent; Bastien, Olivier; Dorent, Richard

2017-08-01

Heart allocation systems are usually urgency-based, offering grafts to candidates at high risk of waitlist mortality. In the context of a revision of the heart allocation rules, we determined observed predictors of 1-year waitlist mortality in France, considering the competing risk of transplantation, to determine which candidate subgroups are favored or disadvantaged by the current allocation system. Patients registered on the French heart waitlist between 2010 and 2013 were included. Cox cause-specific hazards and Fine and Gray subdistribution hazards were used to determine candidate characteristics associated with waitlist mortality and access to transplantation. Of the 2053 candidates, 7 variables were associated with 1-year waitlist mortality by the Fine and Gray method including 4 candidate characteristics related to heart failure severity (hospitalization at listing, serum natriuretic peptide level, systolic pulmonary artery pressure, and glomerular filtration rate) and 3 characteristics not associated with heart failure severity but with lower access to transplantation (blood type, age, and body mass index). Observed waitlist mortality for candidates on mechanical circulatory support was like that of others. The heart allocation system strongly modifies the risk of pretransplant mortality related to heart failure severity. An in-depth competing risk analysis is therefore a more appropriate method to evaluate graft allocation systems. This knowledge should help to prioritize candidates in the context of a limited donor pool.

Changes in Antihypertensive Therapy After Renal Transplantation.

PubMed

Villanego, F; Moreno, A; Wu, J; Naranjo, J; Delgado, A; Cazorla, J M; Garcia, T; Mazuecos, A

2018-03-01

Post-transplant hypertension is extremely frequent, occurring in 60% to 90% of cases. It is involved in the pathogenesis of chronic graft dysfunction and patient survival. We sought to describe changes in antihypertensive therapy after renal transplantation (RT) depending on the type of pretransplant renal replacement therapy (RRT), hemodialysis (HD) or peritoneal dialysis (PD). We performed a retrospective cohort study of RT patients who were divided into 2 groups according to the type of pretransplant RRT (HD group: 69 patients; PD group: 38 patients). Patients with a diagnosis of nonessential hypertension etiology, diagnosis of renal artery stenosis of the graft, active urologic complications, and history of acute graft rejection were excluded. Variables related to chronic kidney disease and RT as well as antihypertensive therapy were studied. PD patients had reduced number of antihypertensive drugs at 1 month after RT (1.39 ± 1.03) compared with pre-RT (2.16 ± 1.30; P = .001), a trend that was maintained at 6 months (1.70 ± 1.18; P = .06). In HD group, the number of antihypertensive drugs increased at 6 months after RT (1.59 ± 1.17) compared with pretransplant (1.15 ± 1.13; P = .027). The use of calcium channel blockers increased by 10.2% by 1 month (P = .071) and 9.2% (P = .036) by 6 months after RT. By 1 month after RT, antihypertensive therapy was reduced. Calcium channel blockers were the most common drug group, although it is usually necessary to use more than 1 drug. Copyright © 2017 Elsevier Inc. All rights reserved.

Immune mechanisms in organ allograft rejection. V. Pivotal role of the cytotoxic-suppressor T cell subset in the rejection of heart grafts bearing isolated class I disparities in the inbred rat

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lowry, R.P.; Forbes, R.D.; Blackburn, J.H.

1985-11-01

The cellular requirements for rejection of heart grafts bearing isolated major histocompatibility complex (MHC) subregion RT1A-encoded class I disparities was assessed by adoptive transfer. Sublethally irradiated (780 rads) (PVG X WF)F1 recipients of irradiated PVG-RT1r1 heart grafts were selectively reconstituted with spleen cells from syngeneic donors previously sensitized with two sequential PVG-RT1r1 skin grafts. PVG-RT1r1 heart grafts were rejected acutely in recipients reconstituted with 10 X 10(6) unfractionated immune spleen cells or inocula (5 X 10(6) cells) depleted of SIg+ cells, but additional depletion of cytotoxic T cells and their precursors resulted in marked prolongation of graft survival. Reducing themore » reconstituting inocula from 4 X 10(6) to 2.5 X 10(6) spleen cells prolonged graft survival to that observed in unreconstituted recipients. Additional studies were performed to define the immunologic basis for prolonged survival of PVG-RT1r1 heart grafts in homozygous PVG recipients. Although lymphoid cells of naive PVG failed to proliferate on coculture with irradiated PVG-RT1r1, bulk cultures yielding but weak and variable CTL generation, lymphoid cells from specifically sensitized PVG proliferated and generated greater cytotoxic T lymphocyte (CTL) activity under identical conditions, strongly suggesting, therefore, that prolonged heart graft survival in this strain combination is related to low CTL precursor frequency.« less

Lysozyme immobilization onto PVC catheters grafted with NVCL and HEMA for reduction of bacterial adhesion

NASA Astrophysics Data System (ADS)

Guadarrama-Zempoalteca, Yesica; Díaz-Gómez, Luis; Meléndez-Ortiz, H. Iván; Concheiro, Angel; Alvarez-Lorenzo, Carmen; Bucio, Emilio

2016-09-01

The aim of the present work was to functionalize poly(vinyl chloride) (PVC) urinary catheters with grafted copolymers that can improve the biocompatibility and serve as binding points of lysozyme. PVC catheters were modified by grafting a mixture of N-vinylcaprolactam (NVCL) and 2-hydroxyethylmethacrylate (HEMA) applying a gamma-ray pre-irradiation method. The effect of absorbed dose, monomer concentration, temperature, and reaction time on the grafting percentage was evaluated. The grafted catheters were characterized regarding surface composition (FTIR-ATR spectroscopy), thermal properties (DSC and TGA) and swelling in aqueous medium. Lysozyme was directly coupled onto PVC-g-(NVCL/HEMA) previously activated using carbonyldiimidazole. Antimicrobial lytic activity of the modified catheters over time was tested against Micrococcus lysodeikticus. Lysozyme diminished the adhesion of Staphylococcus aureus onto the functionalized catheters, which may be suitable to prevent biofilm formation.

Assessment laser phototherapy on bone defects grafted or not with biphasic synthetic micro-granular HA + β-tricalcium phosphate: histological study in an animal model

NASA Astrophysics Data System (ADS)

Soares, Luiz Guilherme P.; Marques, Aparecida M. C.; Aciole, Jouber Mateus S.; Trindade, Renan; Santos, Jean N.; Pinheiro, Antônio Luiz B.

2014-02-01

Beside of biomaterials, Laser phototherapy has shown positive results as auxiliary therapy on bone repair. The aim of this study was to evaluate, through histological analysis, the influence of Laser phototherapy in the process of repair of bone defects grafted or not with Hydroxyapatite. Forty rats were divided into 4 groups each subdivided into 2 subgroups according to the time of sacrifice. Surgical bone defects were made on femur of each animal with a trephine drill. On animals of group Clot the defect was filled only by blood, on group Laser the defect filled with the clot and further irradiated. In group Biomaterial the defect was filled with HA + β-TCP graft. In group Laser + Biomaterial, the defect was filled with biomaterial and further irradiated. The irradiation protocols were performed every 48 hours during for 15 days. Animal death occurred after 15 and 30 days. The specimens were routinely processed and evaluated by light microscopy. Qualitative analysis showed that group Laser + Biomaterial was in a more advanced stage of repair at the end of the experimental time. It was concluded that the Laser irradiation improved the repair of bone defects grafted or not.

Electrostrictive Graft Elastomers

NASA Technical Reports Server (NTRS)

Su, Ji (Inventor); Harrison, Joycelyn S. (Inventor); St.Clair, Terry L. (Inventor)

2003-01-01

An electrostrictive graft elastomer has a backbone molecule which is a non-crystallizable, flexible macromolecular chain and a grafted polymer forming polar graft moieties with backbone molecules. The polar graft moieties have been rotated by an applied electric field, e.g., into substantial polar alignment. The rotation is sustained until the electric field is removed. In another embodiment, a process for producing strain in an elastomer includes: (a) providing a graft elastomer having a backbone molecule which is a non-crystallizable, flexible macromolecular chain and a grafted polymer forming polar graft moieties with backbone molecules; and (b) applying an electric field to the graft elastomer to rotate the polar graft moieties, e.g., into substantial polar alignment.

A comparative study of the effect of Ni9+ and Au8+ ion beams on the properties of poly(methacrylic acid) grafted gum ghatti films

NASA Astrophysics Data System (ADS)

Sharma, Kashma; Kaith, B. S.; Kumar, Vijay; Kumar, Vinod; Kalia, Susheel; Kapur, B. K.; Swart, H. C.

2014-04-01

A systematic comparative study was carried out for the induced changes in the chemical, structural, morphological and thermal properties of poly(methacrylic acid) grafted gum ghatti i.e. [Gg-cl-poly(MAA)] material by irradiation of 120 MeV Ni9+ and Au8+ ions at various fluences ranging from 3×1011 to 3×1012 ions/cm2. The degradation of the material was observed after ion irradiation. A significant loss of crystallinity and change in the crystallite size was observed in irradiated samples of Gg-cl-poly(MAA). The changes in chemical properties and surface morphology were observed by Fourier transform infrared spectroscopy and scanning electron microscopy respectively. The magnitude of the effect of the irradiation was observed to be greater in the case of Au8+ ions irradiation than those of Ni9+ ions irradiation due to the high electronic energy loss of the Au8+ ions in the grafted samples.

Psychological impact of working with patients with cystic fibrosis at end-of-life, pre-transplant stage.

PubMed

Clisby, Nicola; Shaw, Samantha; Cormack, Maggie

2013-04-01

Multidisciplinary staff who work with end-of-life, pre-transplant patients with cystic fibrosis (CF) have to juggle two seemingly opposing care approaches; active care to maintain their patients' health and condition in anticipation of a transplant, and sensitive palliative care that takes their end-of-life wishes into consideration should they not receive a transplant. Little is known about the psychological impact on staff working within this care dichotomy. The aim of this study is to explore staff's experiences and understand more about the psychological impact of this work on them professionally and personally, and how this affects their ability to provide appropriate care for their patients. A qualitative explorative research design was used. Ten semistructured interviews with multidisciplinary staff working in cystic fibrosis centers and units across the United Kingdom were analyzed using interpretative phenomenological analysis (IPA). Two superordinate themes emerged from the analysis: factors contributing to the "juggle" of active and palliative care, and extent of emotional impact on staff. The study indicates that there is an emotional impact on staff working with patients with CF at end-of-life, pre-transplant stages. Specifically, it reveals the extent of the unpredictability that staff work with, and the range of emotions that staff experience, including uncertainty about professional identity and anxiety about working practices. The depth and intimacy of professional-patient relationships is highlighted, particularly for staff in close contact with and similar in age to their patients. Additionally, the strength of staff's commitment and desire to care for patients within broader humanistic terms that mesh with their own personal values is brought to light. Despite the difficulties with their work, the majority of staff adopted numerous coping strategies to manage their emotions, many of which emphasized the link between their professional and

Polymethacrylic acid grafted psyllium (Psy- g-PMA): a novel material for waste water treatment

NASA Astrophysics Data System (ADS)

Kumar, Ranvijay; Sharma, Kaushlendra; Tiwary, K. P.; Sen, Gautam

2013-03-01

Polymethacrylic acid grafted psyllium (Psy- g-PMA) was synthesized by microwave assisted method, which involves a microwave irradiation in synergism with silver sulfate as a free radical initiator to initiate grafting reaction. Psy- g-PMA grades have been synthesized and characterized on structural basis (elemental analysis, FTIR spectroscopy, intrinsic viscosity study) as well as morphological and thermal studies, taking psyllium as reference. The effects of reaction time, amount of monomer and silver sulfate (free radical initiator) on grafting of PMA on psyllium backbone have been studied. It is observed that all the grades of Psy- g-PMA have higher intrinsic viscosities than that of psyllium. The best synthesized grade was Psy- g-PMA having intrinsic viscosity of 6.93 and 58 % grafting of PMA on the main polymer backbone. Further Psy- g-PMA applications as flocculants for waste water treatment have been investigated. Psy- g-PMA resulted in higher decrease in the flocculation parameters such as total dissolved solid or total solids compared to psyllium. Hence the result shows the possible application of grafted psyllium in wastewater treatment.

Bone grafts.

PubMed

Hubble, Matthew J W

2002-09-01

Bone grafts are used in musculoskeletal surgery to restore structural integrity and enhance osteogenic potential. The demand for bone graft for skeletal reconstruction in bone tumor, revision arthroplasty, and trauma surgery, couple with recent advances in understanding and application of the biology of bone transplantation, has resulted in an exponential increase in the number of bone-grafting procedures performed over the last decade. It is estimated that 1.5 million bone-grafting procedures are currently performed worldwide each year, compared to a fraction of that number 20 years ago. Major developments also have resulted in the harvesting, storage, and use of bone grafts and production of graft derivatives, substitutes, and bone-inducing agents.

Cross-Linking as an Adjuvant Treatment for Tectonic Corneal Lamellar Graft Preparation

PubMed Central

Kymionis, George D.; Plaka, Argyro D.; Diakonis, Vasilios F.; Grentzelos, Michael A.; Kontadakis, Georgios A.; Mersinoglou, Andreana C.; Detorakis, Efstathios T.; Topouzis, Fotis

2013-01-01

Purpose: To describe a new surgical approach for the tectonic reconstruction of the anterior ocular segment and the management of scleral and conjuctival melting. Methods: Case series of patients demonstrating anterior segment anomalies, such as scleral and conjunctival melting. The anterior stromal part of a pre-cut corneal graft for Descemet’s stripping automated endothelial keratoplasty (DSAEK) was cross-linked with riboflavin and ultraviolet A irradiation and was used to cover scleral (scleral melting in a patient with necrotizing scleritis, one case) and conjuctival (dehiscence of the conjunctiva in patients with anti-glaucomatous valve exposure, two cases) areas. The endothelial part of all corneal grafts was used for DSAEK in patients with need of corneal endothelial transplantation. Results: Repair of scleral and conjuctival melting was successful in all cases. No intra- or post- operative complications occured. Visual acuity of all patients remained stable during the follow up period. One year postoperatively the corneal graft remained in place and no signs of inflammation were evident, while all grafts were epithelialized. Conclusions: The use of cross-linked corneal graft for the tectonic reconstruction of the anterior ocular segment represents an adequate surgical approach for the management of scleral and conjuctival melting; while, at the same time it offers the advantage of using one corneal graft for two recipients. PMID:24278090

Microwave based synthesis and spectral characterization of thermo-sensitive poly(N,N-diethylacrylamide) grafted pectin copolymer.

PubMed

Işıklan, Nuran; Tokmak, Şeyma

2018-07-01

The functionalization of polysaccharides with synthetic polymers has attracted great attention owing to its application in many industrial fields. The aim of this work was to study the impact of pectin functionalization with N,N-diethylacrylamide (DEAAm). Pectin was modified via microwave-induced graft copolymerization of DEAAm using ceric ammonium nitrate (CAN) and N,N,N',N'-tetramethylethylenediamine (TEMED). FTIR, 13 C NMR, DSC/TGA, XRD, and SEM techniques were used to verify the structure of graft copolymers. Various reaction conditions such as microwave irradiation time, temperature, microwave power, monomer, initiator, and TEMED concentrations were investigated to get a maximum grafting yield of 192%. Lower critical solution temperatures (LCST) of graft copolymers were determined by UV spectroscopy. Graft copolymers were found to be thermo-sensitive, with LCST of 31°C and high thermal resistance. Biocompatibility test of copolymers showed that copolymers were not cytotoxic to L929 fibroblasts cells and can be used as a biomaterial. Copyright © 2018 Elsevier B.V. All rights reserved.

Assessment of the use of LED phototherapy on bone defects grafted with hydroxyapatite on rats with iron-deficiency anemia and nonanemic: a Raman spectroscopy analysis.

PubMed

de Castro, Isabele Cardoso Vieira; Rosa, Cristiane Becher; Dos Reis Júnior, João Alves; Moreira, Luiz Gaudêncio Passos; Aragão, Juliana S; Barbosa, Artur Felipe dos Santos; Silveira, Landulfo; Pinheiro, Antonio L B

2014-09-01

This study aimed to assess bone repair in defects grafted or not with hydroxyapatite (HA) on healthy and iron-deficiency anemia (IDA) rats submitted or not to LED phototherapy (LED-PT) by Raman spectroscopy. The animals were divided in eight groups with five rats each: Clot; Clot + LED; IDA + Clot; IDA + LED; Graft; Graft + LED; IDA + Graft; and IDA + Graft + LED. When appropriated, irradiation with IR LED (λ850 ± 10 nm, 150 mW, CW, Φ = 0.5 cm(2), 16 J/cm(2), 15 days) was carried out. Raman shifts: ∼ 960 [symmetric PO4 stretching (phosphate apatite)], ∼ 1,070 [symmetric CO3 stretching (B-type carbonate apatite)], and ∼ 1,454 cm(-1) [CH2/CH3 bending in organics (protein)] were analyzed. The mean peak values for ∼ 960, ∼ 1,070, and ∼ 1,454 cm(-1) were nonsignificantly different on healthy or anemic rats. The group IDA + Graft + LED showed the lowest mean values for the peak ∼ 960 cm(-1) when compared with the irradiated IDA group or not (p ≤ 0.001; p ≤ 0.001). The association of LED-PT and HA-graft showed lowest mean peak at ∼ 1,454 cm(-1) for the IDA rats. The results of this study indicated higher HA peaks as well as a decrease in the level of organic components on healthy animals when graft and LED phototherapy are associated. In the other hand, IDA condition interfered in the graft incorporation to the bone as LED phototherapy only improved bone repair when graft was not used.

Independent Pre-Transplant Recipient Cancer Risk Factors after Kidney Transplantation and the Utility of G-Chart Analysis for Clinical Process Control

PubMed Central

Kurok, Marlene; Goldis, Alon; Dreier, Maren; Kaltenborn, Alexander; Gwinner, Wilfried; Barthold, Marc; Liebeneiner, Jan; Winny, Markus; Klempnauer, Jürgen; Kleine, Moritz

2016-01-01

Background The aim of this study is to identify independent pre-transplant cancer risk factors after kidney transplantation and to assess the utility of G-chart analysis for clinical process control. This may contribute to the improvement of cancer surveillance processes in individual transplant centers. Patients and Methods 1655 patients after kidney transplantation at our institution with a total of 9,425 person-years of follow-up were compared retrospectively to the general German population using site-specific standardized-incidence-ratios (SIRs) of observed malignancies. Risk-adjusted multivariable Cox regression was used to identify independent pre-transplant cancer risk factors. G-chart analysis was applied to determine relevant differences in the frequency of cancer occurrences. Results Cancer incidence rates were almost three times higher as compared to the matched general population (SIR = 2.75; 95%-CI: 2.33–3.21). Significantly increased SIRs were observed for renal cell carcinoma (SIR = 22.46), post-transplant lymphoproliferative disorder (SIR = 8.36), prostate cancer (SIR = 2.22), bladder cancer (SIR = 3.24), thyroid cancer (SIR = 10.13) and melanoma (SIR = 3.08). Independent pre-transplant risk factors for cancer-free survival were age <52.3 years (p = 0.007, Hazard ratio (HR): 0.82), age >62.6 years (p = 0.001, HR: 1.29), polycystic kidney disease other than autosomal dominant polycystic kidney disease (ADPKD) (p = 0.001, HR: 0.68), high body mass index in kg/m2 (p<0.001, HR: 1.04), ADPKD (p = 0.008, HR: 1.26) and diabetic nephropathy (p = 0.004, HR = 1.51). G-chart analysis identified relevant changes in the detection rates of cancer during aftercare with no significant relation to identified risk factors for cancer-free survival (p<0.05). Conclusions Risk-adapted cancer surveillance combined with prospective G-chart analysis likely improves cancer surveillance schemes by adapting processes to identified risk factors and by using G-chart alarm

Radiation grafting of various water-soluble monomers on ultra-high molecular weight polyethylene powder. Part II: Thermal, FTIR and morphological characterisation

NASA Astrophysics Data System (ADS)

Aydınlı, Bahattin; Tin c̡er, Teoman

2001-10-01

Radiation induced grafted polyacrylic acid (PAA), polymethacrylic acid (PMAA), polyacrylamide (PAAm), poly N,N-dimethyl acrylamide (PNDAAm) and poly 1-vinyl-2 pyrrolidone (PVP) on ultra-high molecular weight polyethylene (UHMWPE) were characterised by DSC, FTIR and SEM analysis. While the effect of irradiation on pure UHMWPE was found to increase crystallinity and cause higher enthalpy of crystallisation, grafted UHMWPE powders showed lower crystallinity and enthalpy of crystallisation. In all grafted UHMWPE there existed secondary transitions corresponding to grafting polymers in the first run of DSC above 60°C and they became clearer at a higher grafting level. In the second run of DSC some Tg values appeared to shift to higher temperatures while some were not detected. FTIR analysis indicated the presence of water-soluble polymers in the grafted UHMWPE. The characteristic peaks of water-soluble polymers became sharper in the grafted UHMWPE. SEM analysis revealed that the grafting occurs both on fiber and microparticles of UHMWPE while flowing characteristic of powder is retained.

Study on thermal properties and crystallization behavior of electron beam irradiated ethylene vinyl acetate (EVA)/waste tyre dust (WTD) blends in the presence of polyethylene graft maleic anhydride (PEgMAH)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ramli, Syuhada; Ahmad, S. H.; Ratnam, C. T.

2013-11-27

The aim of this article is to show the effects of the electron beam irradiation dose and presence of a compatibiliser on the thermal properties and crystallinity of EVA/WTD blends. The purpose of applying electron beam radiation with doses range 50 to 200 kGy and adding a compatibiliser was to enhance the compatibility of the studied blends and at the same time to investigate the possibility of using this technique in the process of recycling polymeric materials. As the compatibilisers, the polyethylene grafted maleic anhydride (PEgMAH) was utilized, they were added at the amounts of 1-5 phr respectively. The enhancementmore » of thermal properties was accompanied by the following effects, discussed in this article: i) an irradiated EVA/WTD blend at 200kGy was found to improve the thermal properties of EVA, ii) the addition of PEgMAH in EVA/WTD blends and the subsequent irradiation allowed prevention of degradation mechanism. iii) the ΔH{sub f} and crystallinity percentage decrease at higher PEgMAH content.« less

Radiation-induced graft copolymerization of poly(ethylene glycol) monomethacrylate onto deoxycholate-chitosan nanoparticles as a drug carrier

NASA Astrophysics Data System (ADS)

Pasanphan, Wanvimol; Rattanawongwiboon, Thitirat; Rimdusit, Pakjira; Piroonpan, Thananchai

2014-01-01

Poly(ethylene glycol) monomethacrylate-grafted-deoxycholate chitosan nanoparticles (PEGMA-g-DCCSNPs) were successfully prepared by radiation-induced graft copolymerization. The hydrophilic poly(ethylene glycol) monomethacrylate was grafted onto deoxycholate-chitosan in an aqueous system. The radiation-absorbed dose is an important parameter on degree of grafting, shell thickness and particle size of PEGMA-g-DCCSNPs. Owing to their amphiphilic architecture, PEGMA-g-DCCSNPs self-assembled into spherical core-shell nanoparticles in aqueous media. The particle size of PEGMA-g-DCCSNPs measured by TEM varied in the range of 70-130 nm depending on the degree of grafting as well as the irradiation dose. Berberine (BBR) as a model drug was encapsulated into the PEGMA-g-DCCSNPs. Drug release study revealed that the BBR drug was slowly released from PEGMA-g-DCCSNPs at a mostly constant rate of 10-20% in PBS buffer (pH 7.4) at 37 °C over a period of 23 days.

Pre-transplant depression as a predictor of adherence and morbidities after orthotopic heart transplantation.

PubMed

Delibasic, Maja; Mohamedali, Burhan; Dobrilovic, Nikola; Raman, Jaishankar

2017-07-25

Psychosocial factors are useful predictors of adverse outcomes after solid organ transplantation. Although depression is a known predictor of poor outcomes in patients who undergo orthotopic heart transplantation (OHT) and is actively screened for during pre-transplant evaluation, the effects of early identification of this entity on post-transplant outcomes are not clearly understood. The purpose of this study was to evaluate the impact of pre-transplant depression on outcomes after OHT. In this retrospective study, 51 patients that underwent psychosocial evaluation performed by a social worker prior to the transplant and followed up in our center post-transplant were enrolled. Patients were stratified by the presence/absence of depression during the initial encounter. Primary end-points were overall survival, 1st-year hospitalizations, overall hospitalizations, rejections, and compliance with medications and outpatient appointments. Depressed patients were 3.5 times more likely to be non-compliant with medications; RR = 3.5, 95% CI (1.2,10.2), p = 0.046 and had higher incidence of first year hospitalizations (4.7 ± 3.1 vs. 2.2 ± 1.9, p = 0.046), shorter time to first hospitalization 25 days (IQR 17-39) vs. 100 days (IQR 37-229), p = 0.001. Patients with depression also had higher overall hospitalizations (8.3 ± 4.4 vs. 4.6 ± 4.2, p = 0.025,) and higher number of admissions for infections (2.8 ± 1.3 vs. 1.5 ± 1.4, p = 0.018) compared to patients without depression. There were no statistically significant differences in total number of rejections or compliance with outpatient appointments. Kaplan-Meier survival analysis did not reveal differences between the two groups (mean 3705 vs. 3764 days, log-rank p = 0.52). Depression was a strong predictor of poor medication compliance and higher rates of hospitalization in transplant recipients. No difference in survival between depressed and non-depressed patients after OHT was noted.

The Presence of Pretransplant HLA Antibodies Does Not Impact the Development of Chronic Lung Allograft Dysfunction or CLAD-Related Death.

PubMed

Zazueta, Oscar E; Preston, Sara E; Moniodis, Anna; Fried, Sabrina; Kim, Miae; Townsend, Keri; Wood, Isabelle; Boukedes, Steve; Guleria, Indira; Camp, Phillip; El-Chemaly, Souheil; Rosas, Ivan O; Chandraker, Anil; Milford, Edgar; Goldberg, Hilary J

2017-09-01

Development of donor-specific antibodies (DSA) after lung transplantation is associated with antibody mediated rejection, acute cellular rejection, and bronchiolitis obliterans syndrome; however, the significance of circulating antibodies before transplant remains unclear. We performed a retrospective cohort study including recipients of primary lung transplants between 2008 and 2012. We assessed the impact of circulating HLA and noncytotoxic DSA detected before transplant on development of Chronic Lung Allograft Dysfunction (CLAD) or CLAD-related death. 30% of subjects had circulating class I antibodies alone, 4% Class II, and 14.4% class I and class II at mean fluorescent intensity greater than 1000. Nine percent of the subjects had DSA class I, 9% class II, and 2.4% both DSA classes 1 and 2. Neither the presence of circulating antibodies (adjusted hazard ratio, 0.87; 95% confidence interval, 0.50-1.54) nor the presence of DSA (adjusted hazard ratio, 1.56; 95% confidence interval, 0.77-3.18) before transplant at mean fluorescent intensity greater than 1000 was associated with the development of CLAD or CLAD-related death. Although in previous studies we have shown an increased incidence of antibody-mediated rejection in patients with pretransplant DSA, neither the presence of HLA antibodies nor DSA translated to an increased risk of allograft dysfunction or death if prospective crossmatch testing was negative. Prospective studies are needed to define the impact of pretransplant sensitization on lung transplant recipients.

Cell engineering: nanometric grafting of poly-N-isopropylacrylamide onto polystyrene film by different doses of gamma radiation

PubMed Central

Biazar, Esmaeil; Zeinali, Reza; Montazeri, Naser; Pourshamsian, Khalil; Behrouz, Mahmoud Jabarvand; Asefnejad, Azadeh; Khoshzaban, Ahad; Shahhosseini, Gholamreza; Najafabadi, Mostafa Soleimannejad; Abyani, Reza; Jamalzadeh, Hamidreza; Fouladi, Mahdi; Hagh, Sasan Rahbar F; Khamaneh, Aylar Shams; Kabiri, Soudabeh; Keshel, Saeed Heidari; Mansourkiaei, Ana

2010-01-01

Poly-N-isopropylacrylamide was successfully grafted onto a polystyrene cell culture dish and γ-preirradiated in air. In this study, the effect of a γ-pre-irradiation dose of radiation (radiation absorbed dosages of 10, 20, 30, 40 KGy) under appropriate temperature and grafting conditions was investigated. The Fourier transform infrared spectroscopy analysis showed the existence of the graft poly-N-isopropylacrylamide (PNIPAAm) on the substrate. The optimal value of the dose for grafting was 40 KGy at 50°C. The scanning electron microscopy and atomic force microscopy (AFM) images clearly showed that increasing the absorbed dose of radiation would increase the amount of grafting. Surface topography and graft thickness in AFM images of the radiated samples showed that the PNIPAAm at the absorbed dose of radiation was properly grafted. The thickness of these grafts was about 50–100 nm. The drop water contact angles of the best grafted sample at 37°C and 10°C were 55.3 ± 1.2° and 61.2 ± 0.9° respectively, which showed the hydrophilicity and hydrophobicity of the grafted surfaces. Differential scanning calorimetry analysis also revealed the low critical solution temperature of the grafted sample to be 32°C. Thermoresponsive polymers were grafted to dishes covalently which allowed fibroblast cells to attach and proliferate at 37°C; the cells also detached spontaneously without using enzymes when the temperature dropped below 32°C. This characteristic proves that this type of grafted material has potential as a biomaterial for cell sheet engineering. PMID:20957116

Evaluation of pre- and posttransplantation serum interferon-gamma and soluble CD30 for predicting liver allograft rejection.

PubMed

Kim, K H; Oh, E-J; Jung, E-S; Park, Y-J; Choi, J Y; Kim, D-G; Lee, K Y; Kang, C S

2006-06-01

The aim of the present study was to identify whether the serum interferon-gamma (IFNgamma), a Th1 cytokine, or soluble CD30 (sCD30), a marker for activation of Th2 cytokine-producing T cells, predict acute cellular rejection episodes among liver graft patients. Pretransplant and posttransplant sera from 32 living donor liver transplant recipients obtained on days 1, 3, and 7 after surgery were tested for serum IFNgamma and sCD30 concentrations using commercial enzyme-linked immunosorbent assay kits. Recipients with an acute rejection episode (ARE) (n=14) displayed significantly higher IFNgamma concentrations pretransplant than did the patients with no ARE (n=18) (P<.05). The pretransplant serum levels of sCD30 were not different between the non-ARE and ARE groups. However, in comparison with the non-ARE group, who showed steadily decreasing serum sCD30 levels after transplantation, 12 among the 14 patients in the ARE group showed increasing sCD30 levels from day 1 to day 3 after transplantation (P<.05). These results suggest that the sCD30 increment during the early period after liver transplantation affects the immune response of rejection. This observation emphasizes the clinical relevance of serum sCD30, in addition to serum IFNgamma, as predictive markers for acute liver graft rejection.

Grafting the alar rim: application as anatomical graft.

PubMed

Gruber, Ronald P; Fox, Paige; Peled, Anne; Belek, Kyle A

2014-12-01

Alar rim contour and alar rim grafts have become essential components of rhinoplasty. Ideally, grafts of the nose should be anatomical in shape. So doing might make grafts of the alar rim more robust. The authors considered doing that by applying the graft as a continuous extension of the lateral crus. Twelve patients (two men and 10 women) constituted the study group (seven primary and five secondary cases). Of those, there were five concave rims, two concave rims with rim retraction, two boxy tips, and three cephalically oriented lateral crura. Surgical technique included the following: (1) an open approach was used; (2) a marginal incision that ignored the caudal margin of the lateral crus (the incision went straight posteriorly to a point 5 to 6 mm from the rim margin) was used; (3) a triangular graft was made to cover the exposed vestibular skin; (4) it was secured end to end to the caudal border of the lateral crus; and (5) the poster end was allowed to sit in a small subcutaneous pocket. Follow-up was 11 to 19 months. All 12 patients exhibited good rims as judged by a blinded panel. Rim retraction was not fully corrected in one patient, but no further treatment was required. One patient did require a secondary small rim graft for residual rim concavity. The concept of grafting the alar rim is strongly supported by the authors' results. The modifications the authors applied by designing the graft to be anatomical in shape has been a technical help.

Pre- and post-transplant monitoring of soluble CD30 levels as predictor of acute renal allograft rejection.

PubMed

Wang, Dong; Wu, Guo-Jun; Wu, Wei-Zhen; Yang, Shun-Liang; Chen, Jin-Hua; Wang, He; Lin, Wen-Hong; Wang, Qing-Hua; Zeng, Zhang-Xin; Tan, Jian-Ming

2007-06-01

Identification of renal graft candidates at high risk of impending acute rejection (AR) and graft loss may be helpful for patient-tailored immunosuppressive regimens and renal graft survival. To investigate the feasibility with soluble CD30 (sCD30) as predictor of AR, sCD30 levels of 70 patients were detected on day 0 pre-transplant and day 1, 3, 5, 7, 10, 14, 21, and 30 post-transplant. AR episodes in 6 months were recorded and then patients were divided into Group AR (n=11) and Group UC (n=59). Results showed that the patients had higher pre-transplant sCD30 levels than healthy people. A significant decrease of sCD30 was observed on the first day post-transplant and continued until day 14 post-transplant. Soluble CD30 presented a stable level from day 14 to 30 post-transplant. Pre-transplant sCD30 levels of Group AR were much higher than those of Group UC (P<0.001). Patients of Group AR also had higher sCD30 levels than those of Group UC on day 1, 3, 5, 7, 10 and 14 (P<0.001). The sCD30 level presented a significantly delayed decrease in the patients of Group AR. Statistical results showed that the highest value of area under ROC curve (0.95) was obtained on day 5 post-transplant, suggesting that sCD30 levels on day 5 are of high predictive value. Therefore, sCD30 level may be a good marker of increased alloreactivity and of significant predictive value. It's necessary to monitor the variation of sCD30 in the early period post-transplant.

Multifactorial analysis of renal transplants reported to the United Network for Organ Sharing Registry: a 1994 update.

PubMed

Gjertson, D W

1994-01-01

1. From a multivariate log-linear analysis of 57,303 renal transplants between 1988 and 1994, the top 10 factors influencing one-year and 3-year cadaveric graft survival rates were ranked as follows: [table: see text] 2. Center effects accounted for 30% and 28% of all assignable variations in one-year and 3-year outcomes, respectively. Although center variation dominated 32 other variables, most factors were relatively independent of transplant center. 3. Novel to our own multifactorial analyses of the UNOS Kidney Transplant Registry were 6 pretransplant factors (recipient pretransplant dialysis, pregnancy, PRA technique, donor disposition and preservation, and ABO compatibility). Survival rates over the various combinations of these new factors were not significantly different. 4. For the first time in our multivariate analyses, 4 posttransplantation factors (delayed graft function, rejection episodes prior to discharge, induction and maintenance drug therapies) were included in the log-linear model. It is noteworthy that graft survival in both transplant periods was seriously imperiled following delayed graft function or rejection prior to discharge, yet the accounting for these pseudo-outcome variables did not alter the influence of the remaining 31 transplant factors. Finally, maintenance drug therapies strongly influenced short-term outcomes but did not influence long-term results, except for a noteworthy trend toward increased survival rates for FK506 therapy.

Studies on possibility for alleviation of lifestyle diseases by low-dose irradiation or radon inhalation.

PubMed

Kataoka, Takahiro; Sakoda, Akihiro; Yoshimoto, Masaaki; Nakagawa, Shinya; Toyota, Teruaki; Nishiyama, Yuichi; Yamato, Keiko; Ishimori, Yuu; Kawabe, Atsushi; Hanamoto, Katsumi; Taguchi, Takehito; Yamaoka, Kiyonori

2011-07-01

Our previous studies showed the possibility that activation of the antioxidative function alleviates various oxidative damages, which are related to lifestyle diseases. Results showed that, low-dose X-ray irradiation activated superoxide dismutase and inhibits oedema following ischaemia-reperfusion. To alleviate ischaemia-reperfusion injury with transplantation, the changes of the antioxidative function in liver graft using low-dose X-ray irradiation immediately after exenteration were examined. Results showed that liver grafts activate the antioxidative function as a result of irradiation. In addition, radon inhalation enhances the antioxidative function in some organs, and alleviates alcohol-induced oxidative damage of mouse liver. Moreover, in order to determine the most effective condition of radon inhalation, mice inhaled radon before or after carbon tetrachloride (CCl(4)) administration. Results showed that radon inhalation alleviates CCl(4)-induced hepatopathy, especially prior inhalation. It is highly possible that adequate activation of antioxidative functions induced by low-dose irradiation can contribute to preventing or reducing oxidative damages, which are related to lifestyle diseases.

Grafting Technique to Eliminate Rootstock Suckering of Grafted Tomatoes

USDA-ARS?s Scientific Manuscript database

Vegetable grafting has been proposed as a technique for avoiding disease problems in tomatoes in open field production. In this study we investigated the current use of grafting in an open field scenario and found a serious problem with the grafting techniques. In the Fall of 2007, commercially pr...

Nanofat grafting under a split-thickness skin graft for problematic wound management.

PubMed

Kemaloğlu, Cemal Alper

2016-01-01

Obesity and certain medical disorders make the reconstruction of skin defects challenging. Different kind of procedure can be used for these defect, besides, skin grafting is one of the most common and simplest procedure. Fat grafting and stem cells which are located in the adipose tissue have been commonly used in plastic surgery for regeneration and rejuvenation purposes. To decrease graft failure rate we performed nanofat grafting under an autologous split-thickness skin graft in our patient who had a problematic wound. The case of a 35-year-old female patient with a traumatic skin defect on her left anterior crural region is described herein. After subsequent flap reconstruction, the result was disappointing and the defect size was widened. The defect was treated with combined grafting (nanofat grafting under an autologous split-thickness skin graft). At the 6 months follow-up assessment after combined grafting, the integrity of the skin graft was good with excellent pliability. Combined grafting for problematic wounds seems to be a useful technique for cases requiring reconstruction. The potential existence of stem cells may be responsible for the successful result in our patient.

Impact of graft implantation order on graft survival in simultaneous pancreas-kidney transplantation.

PubMed

Niclauss, Nadja; Bédat, Benoît; Morel, Philippe; Andres, Axel; Toso, Christian; Berney, Thierry

2016-05-01

The optimal order of revascularization for pancreas and kidney grafts in simultaneous pancreas-kidney transplantation has not been established. In this study, we investigate the influence of graft implantation order on graft survival in SPK. 12 700 transplantations from the Scientific Registry of Transplant Recipients were analyzed retrospectively. Graft implantation order was determined based on the reported ischemia times of pancreas and kidney grafts. Pancreas and kidney graft survivals were analyzed depending on graft implantation order at 3 months and 5 years using Kaplan-Meier plots. Significance was tested with log-rank test and Cox regression model. In 8454 transplantations, the pancreas was implanted first (PBK), and in 4246 transplantations, the kidney was implanted first (KBP). The proportion of lost pancreas grafts at 3 months was significantly lower in PBK (9.4% vs. 10.8%, P = 0.011). Increasing time lag (>2 h) between kidney and pancreas graft implantation in KBP accentuated the detrimental impact on pancreas graft survival (12.5% graft loss at 3 months, P = 0.001). Technical failure rates were reduced in PBK (5.6 vs. 6.9%, P = 0.005). Graft implantation order had no impact on kidney graft survival. In summary, although observed differences are small, pancreas graft implantation first increases short-term pancreas graft survival and reduces rates of technical failure. © 2016 Steunstichting ESOT.

Effect of bidispersity in grafted chain length on grafted chain conformations and potential of mean force between polymer grafted nanoparticles in a homopolymer matrix.

PubMed

Nair, Nitish; Wentzel, Nathaniel; Jayaraman, Arthi

2011-05-21

In efforts to produce polymeric materials with tailored physical properties, significant interest has grown around the ability to control the spatial organization of nanoparticles in polymer nanocomposites. One way to achieve controlled particle arrangement is by grafting the nanoparticle surface with polymers that are compatible with the matrix, thus manipulating the interfacial interactions between the nanoparticles and the polymer matrix. Previous work has shown that the molecular weight of the grafted polymer, both at high grafting density and low grafting density, plays a key role in dictating the effective inter-particle interactions in a polymer matrix. At high grafting density nanoparticles disperse (aggregate) if the graft molecular weight is higher (lower) than the matrix molecular weight. At low grafting density the longer grafts can better shield the nanoparticle surface from direct particle-particle contacts than the shorter grafts and lead to the dispersion of the grafted particles in the matrix. Despite the importance of graft molecular weight, and evidence of non-trivial effects of polydispersity of chains grafted on flat surfaces, most theoretical work on polymer grafted nanoparticles has only focused on monodisperse grafted chains. In this paper, we focus on how bidispersity in grafted chain lengths affects the grafted chain conformations and inter-particle interactions in an implicit solvent and in a dense homopolymer polymer matrix. We first present the effects of bidispersity on grafted chain conformations in a single polymer grafted particle using purely Monte Carlo (MC) simulations. This is followed by calculations of the potential of mean force (PMF) between two grafted particles in a polymer matrix using a self-consistent Polymer Reference Interaction Site Model theory-Monte Carlo simulation approach. Monte Carlo simulations of a single polymer grafted particle in an implicit solvent show that in the bidisperse polymer grafted particles

Combined use of the latissimus dorsi musculocutaneous free flap and split-rib grafts for cranial vault reconstruction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stueber, K.; Salcman, M.; Spence, R.J.

1985-08-01

The patient described in this article had a large skull defect under the scalp which had been irradiated during treatment of a malignant brain tumor. The patient desired reconstruction of her defect. To provide good soft-tissue coverage for the bony reconstruction, a free latissimus dorsi musculocutaneous flap was used. The bony defect was partially reconstructed with split-rib grafts. The two parts of the reconstruction were combined into one operation, since it was felt that the well-vascularized muscle would ensure viability of the bone grafts.

Introduction of anticoagulation group to polypropylene film by radiation grafting and its blood compatibility

NASA Astrophysics Data System (ADS)

Mao, Chun; Zhang, Can; Qiu, Yongzhi; Zhu, Aiping; Shen, Jian; Lin, Sicong

2004-04-01

Based on in vitro tests for an improvement of the blood compatibility of polypropylene (PP) films by grafting O-butyrylchitosan (OBCS), we prepared a novel biocompatible film. The immobilization was accomplished by irradiating with ultraviolet light, OBCS being coated on the film surface to photolyze azide groups, thus cross-linking OBCS and PP together. The grafted sample films were verified by attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR), electron spectroscopy for chemical analysis (ESCA) and the water contact angle measurements. The blood compatibility of the OBCS-grafted PP films was evaluated by platelet rich plasma (PRP) contacting experiments and protein adsorption experiments using blank PP film as the control. It demonstrated that blood compatibility of the OBCS-grafted surfaces is better than that of the blank PP. The suitable modifications could be carried out to tailor PP biomaterial to meet the specific needs of different biomedical applications. These results suggest that the photocrosslinkable chitosan developed here has the potential of serving as a new biomaterial in medical use.

Proximal Tibial Bone Graft

MedlinePlus

... All Site Content AOFAS / FootCareMD / Treatments Proximal Tibial Bone Graft Page Content What is a bone graft? Bone grafts may be needed for various ... the proximal tibia. What is a proximal tibial bone graft? Proximal tibial bone graft (PTBG) is a ...

Outcomes of patients with a pretransplant history of early-stage melanoma.

PubMed

Puza, Charles J; Barbas, Andrew S; Mosca, Paul J

2018-06-25

A history of melanoma within the preceding 5 years is commonly considered a contraindication to solid organ transplantation. We investigated how a pretransplant history of melanoma impacts patient survival and melanoma recurrence. Institutional Review Board approval was obtained, and Duke's retrospective database was used to identify 4552 patients who underwent a solid organ transplant at Duke University from 1 January 2001 to 31 December 2016. Data with regard to the transplant, melanoma characteristics, rejection episodes, and survival were recorded. Of 4552 patients who underwent a solid organ transplant, 12 (0.3%) had a history of melanoma before transplant (six with melanoma in situ and six with stage I disease). The median time between melanoma diagnosis and transplant was 4.13 years (range: 1.1-13.3 years). The study cohort consisted of four liver transplants, four lung transplants, one kidney transplant, one heart transplant, one small bowel transplant, and one multivisceral transplant. At the median follow-up time of 2.8 years, 10 (83.3%) patients were alive. In nonmelanoma cohorts, the 3-year survival is 70% for thoracic transplants, 78% for liver transplants, and 88% for kidney transplants. In well-selected patients with a history of early-stage melanoma and an appropriate time interval between melanoma treatment and transplant, post-transplant outcomes are favorable.

Treatment of Venous Aortorenal Bypass Graft Aneurysm Using a Stent-Graft

DOE Office of Scientific and Technical Information (OSTI.GOV)

Novotny, Jiri, E-mail: jino@medicon.cz; Peregrin, Jan H.; Stribrna, Jarmila

2010-02-15

We present the case of a 77-year-old male patient who had undergone a bilateral venous aortorenal bypass graft 30 years previously. Thirteen years previously, the patient was shown to have a decrease in renal function, with mild shrinking of both kidneys; additionally, a stenosis was found in the left proximal anastomosis. At the most recent follow-up visit (1 year previously), ultrasound revealed an aneurysm (42 mm in diameter) of the left renal bypass graft; the finding was confirmed by CT angiography. A significant ostial stenosis of the left renal bypass graft was also confirmed. It was decided to place amore » self-expandable stent-graft into the aneurysm while also attempting to dilate the stenosis. Proximal endoleak after stent-graft placement necessitated the implantation of another, balloon-expandable stent-graft into the bypass graft ostium. Postprocedural angiography and follow-up by CT angiography at 3 months confirmed good patency of the stent-grafts and complete thrombosis of the aneurysmal sac, with preserved kidney perfusion. Renal function remained unaltered, while the hypertension is better controlled.« less

Degradation Behaviour of Gamma Irradiated Poly(Acrylic Acid)-graft-Chitosan Superabsorbent Hydrogel

NASA Astrophysics Data System (ADS)

Ria Barleany, Dhena; Ilhami, Alpin; Yusuf Yudanto, Dea; Erizal

2018-03-01

A series of superabsorbent hydrogels were prepared from chitosan and partially neutralized acrylic acid at room temperature by gamma irradiation technique. The effect of irradiation and chitosan addition to the degradation behaviour of polymer were investigated. The gel content, swelling capacity, Equillibrium Degree of Swelling (EDS), Fourier Transform Infra Red (FTIR), and Scanning Electron Microscopy (SEM) study were also performed. Natural degradation in soil and thermal degradation by using of TGA analysis were observed. The variation of chitosan compositions were 0.5, 1, 1.5, and 2 g and the total irradiation doses were 5, 10, 15, and 20 kGy. The highest water capacity of 583.3 g water/g dry hydrogel was resulted from 5 kGy total irradiation dose and 0,5 g addition of chitosan. From the thermal degradation evaluation by using of TGA analysis showed that irradiation dose did not give a significant influence to the degradation rate. The rate of thermal degradation was ranged between 2.42 to 2.55 mg/min. In the natural test of degradation behaviour by using of soil medium, the hydrogel product with chitosan addition was found to have better degradability compared with the poly(acrylic acid) polymer without chitosan.

Calcar bone graft

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bargar, W.L.; Paul, H.A.; Merritt, K.

1986-01-01

A canine model was developed to investigate the use of an autogeneic iliac bone graft to treat the calcar deficiency commonly found at the time of revision surgery for femoral component loosening. Five large male mixed-breed dogs had bilateral total hip arthroplasty staged at three-month intervals, and were sacrificed at six months. Prior to cementing the femoral component, an experimental calcar defect was made, and a bicortical iliac bone graft was fashioned to fill the defect. Serial roentgenograms showed the grafts had united with no resorption. Technetium-99 bone scans showed more uptake at three months than at six months inmore » the graft region. Disulfine blue injection indicated all grafts were perfused at both three and six months. Thin section histology, fluorochromes, and microradiographs confirmed graft viability in all dogs. Semiquantitative grading of the fluorochromes indicated new bone deposition in 20%-50% of each graft at three months and 50%-80% at six months. Although the calcar bone graft was uniformly successful in this canine study, the clinical application of this technique should be evaluated by long-term results in humans.« less

New CO2 adsorbent containing aminated poly(glycidyl methacrylate) grafted onto irradiated PE-PP nonwoven sheet

NASA Astrophysics Data System (ADS)

Mahmoud Nasef, Mohamed; Abbasi, Ali; Ting, T. M.

2014-10-01

A new CO2 adsorbent containing triethylamine (TEA) was prepared by radiation induced grafting of glycidyl methacrylate (GMA) onto polyethylene coated polypropylene (PE-PP) non-woven sheet followed by amination reaction. The degree of grafting (DOG%) was controlled by variation of monomer concentration and absorbed dose. The incorporation of aminated poly(GMA) was investigated by Fourier transform infrared (FTIR) and scanning electron microscope (SEM). The adsorbent with DOG of 350% and amination yield of 60% exhibited CO2 adsorption capacity of 4.52 mol/kg at ambient temperature and pressure.

Stable trichimerism after marrow grafting from 2 DLA-identical canine donors and nonmyeloablative conditioning

PubMed Central

Hogan, William; Kuhr, Christian S.; Diaconescu, Razvan; Harkey, Michael A.; Georges, George E.; Sale, George E.; Zellmer, Eustacia; Baran, Szczepan; Jochum, Christoph; Stone, Brad; Storb, Rainer

2007-01-01

Although hematopoietic cell transplantation (HCT) is generally accomplished using a single donor, multiple donors have been used to enhance the speed of engraftment, particularly in the case of umbilical cord blood grafts. Here we posed the question in the canine HCT model whether stable dual-donor chimerism could be established using 2 DLA-identical donors. We identified 8 DLA-identical littermate triplets in which the marrow recipients received 2 Gy total body irradiation followed by marrow infusions from 2 donors and postgrafting immunosuppression. All 8 dogs showed initial “trichimerism,” which was sustained in 5 dogs, while 2 dogs rejected one of the allografts and remained mixed chimeras, and 1 dog rejected both allografts. Immune function in one trichimeric dog, as tested by mixed leukocyte culture response and antibody response to sheep red blood cells, was found to be normal. Five dogs received kidney grafts from one of their respective marrow donors at least 6 months after HCT without immunosuppressive drugs, and grafts in 4 dogs are surviving without rejection. In summary, following nonmyeloablative conditioning, simultaneous administration of marrow grafts from 2 DLA-identical littermates could result in sustained trichimerism, and immunologic tolerance could include a kidney graft from one of the marrow donors. PMID:17369487

Bone Graft Alternatives

MedlinePlus

... Spine Treatment Spondylolisthesis BLOG FIND A SPECIALIST Treatments Bone Graft Alternatives Patient Education Committee Patient Education Committee ... procedure such as spinal fusion. What Types of Bone Grafts are There? Bone grafts that are transplanted ...

Evaluation of synthetic vascular grafts in a mouse carotid grafting model.

PubMed

Chan, Alex H P; Tan, Richard P; Michael, Praveesuda L; Lee, Bob S L; Vanags, Laura Z; Ng, Martin K C; Bursill, Christina A; Wise, Steven G

2017-01-01

Current animal models for the evaluation of synthetic grafts are lacking many of the molecular tools and transgenic studies available to other branches of biology. A mouse model of vascular grafting would allow for the study of molecular mechanisms of graft failure, including in the context of clinically relevant disease states. In this study, we comprehensively characterise a sutureless grafting model which facilitates the evaluation of synthetic grafts in the mouse carotid artery. Using conduits electrospun from polycaprolactone (PCL) we show the gradual development of a significant neointima within 28 days, found to be greatest at the anastomoses. Histological analysis showed temporal increases in smooth muscle cell and collagen content within the neointima, demonstrating its maturation. Endothelialisation of the PCL grafts, assessed by scanning electron microscopy (SEM) analysis and CD31 staining, was near complete within 28 days, together replicating two critical aspects of graft performance. To further demonstrate the potential of this mouse model, we used longitudinal non-invasive tracking of bone-marrow mononuclear cells from a transgenic mouse strain with a dual reporter construct encoding both luciferase and green fluorescent protein (GFP). This enabled characterisation of mononuclear cell homing and engraftment to PCL using bioluminescence imaging and histological staining over time (7, 14 and 28 days). We observed peak luminescence at 7 days post-graft implantation that persisted until sacrifice at 28 days. Collectively, we have established and characterised a high-throughput model of grafting that allows for the evaluation of key clinical drivers of graft performance.

Delayed grafting for banked skin graft in lymph node flap transfer.

PubMed

Ciudad, Pedro; Date, Shivprasad; Orfaniotis, Georgios; Dower, Rory; Nicoli, Fabio; Maruccia, Michele; Lin, Shu-Ping; Chuang, Chu-Yi; Chuang, Tsan-Yu; Wang, Gou-Jen; Chen, Hung-Chi

2017-02-01

Over the last decade, lymph node flap (LNF) transfer has turned out to be an effective method in the management of lymphoedema of extremities. Most of the time, the pockets created for LNF cannot be closed primarily and need to be resurfaced with split thickness skin grafts. Partial graft loss was frequently noted in these cases. The need to prevent graft loss on these iatrogenic wounds made us explore the possibility of attempting delayed skin grafting. We have herein reported our experience with delayed grafting with autologous banked split skin grafts in cases of LNF transfer for lymphoedema of the extremities. Ten patients with International Society of Lymphology stage II-III lymphoedema of upper or lower extremity were included in this study over an 8-month period. All patients were thoroughly evaluated and subjected to lymph node flap transfer. The split skin graft was harvested and banked at the donor site, avoiding immediate resurfacing over the flap. The same was carried out in an aseptic manner as a bedside procedure after confirming flap viability and allowing flap swelling to subside. Patients were followed up to evaluate long-term outcomes. Flap survival was 100%. Successful delayed skin grafting was done between the 4th and 6th post-operative day as a bedside procedure under local anaesthesia. The split thickness skin grafts (STSG) takes more than 97%. One patient needed additional medications during the bedside procedure. All patients had minimal post-operative pain and skin graft requirement. The patients were also reported to be satisfied with the final aesthetic results. There were no complications related to either the skin grafts or donor sites during the entire period of follow-up. Delayed split skin grafting is a reliable method of resurfacing lymph node flaps and has been shown to reduce the possibility of flap complications as well as the operative time and costs. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Tuberculosis after liver transplantation in a large center in New York City: QuantiFERON® -TB Gold-based pre-transplant screening performance and active tuberculosis post-transplant.

PubMed

Hand, Jonathan; Sigel, Keith; Huprikar, Shirish; Hamula, Camille; Rana, Meena

2018-04-01

Pre-transplant screening for latent tuberculosis infection (LTBI) is a complex consideration that varies by institution. Inconsistent performance of interferon-gamma release assay (IGRA) further complicates screening. Data regarding LTBI screening outcomes and test characteristics in a large, foreign-born pre-transplant population within the United States are limited. In this retrospective study, patients who received QuantiFERON ® -TB Gold (QFT) prior to liver transplantation (LT) were included. Characteristics of patients were compared by QFT result, and predictors of indeterminate results were evaluated. Similar comparisons were performed between patients who developed active TB and those who did not. Of 148 patients screened, the rate of positive, indeterminate, and negative testing was 13.5% (20/148), 27% (40/148), and 59% (88/148), respectively. An indeterminate QFT result was more than 16 times more likely in patients with a Model for End-stage Liver Disease score >25 (odds ratio [OR] 16.7; 95% confidence interval [CI], 2.1-132.0; P = .008) and more than 4 times when performed in our institution's lab compared with commercial lab (OR 4.1; 95% CI, 1.34-12.44; P = .013). The overall TB incidence was 1102/100 000 transplant cases. No patient who developed active TB had a positive QFT. All were born outside of the United States (P = .06) and had pre-transplantation chest imaging demonstrating granulomatous disease (P = .006). Our experience further highlights the challenges of LTBI screening prior to LT and suggests that QFT may be a poor predictor of active TB in higher risk pre-transplant populations. Candidates should be screened as early as possible to optimize QFT performance, and local epidemiological data should be used to create institution-specific screening protocols in areas with large populations from TB-endemic regions. Management should consider TB risk factors, QFT, and imaging instead of reliance on QFT testing alone. © 2018 John Wiley

Grafting of Ring-Opened Cyclopropylamine Thin Films on Silicon (100) Hydride via UV Photoionization.

PubMed

Tung, J; Ching, J Y; Ng, Y M; Tew, L S; Khung, Y L

2017-09-13

The grafting of cyclopropylamine onto a silicon (100) hydride (Si-H) surface via a ring-opening mechanism using UV photoionization is described here. In brief, radicals generated from the Si-H surface upon UV irradiation were found to behave in classical hydrogen abstraction theory manner by which the distal amine group was first hydrogen abstracted and the radical propagated down to the cyclopropane moiety. This subsequently liberated the strained bonds of the cyclopropane group and initiated the surface grafting process, producing a thin film approximately 10-15 nm in height. Contact angle measurements also showed that such photoionization irradiation had yielded an extremely hydrophilic surface (∼21.3°) and X-ray photoelectron spectroscopy also confirmed the coupling was through the Si-C linkage. However, when the surface underwent high-temperature hydrosilylation (>160 °C), the reaction proceeded predominantly through the nucleophilic NH 2 group to form a Si-N linkage to the surface. This rendered the surface hydrophobic and hence suggested that the Si-H homolysis model may not be the main process. To the best of our knowledge, this was the first attempt reported in the literature to use photoionization to directly graft cyclopropylamine onto a silicon surface and in due course generate a highly rich NH-terminated surface that was found to be highly bioactive in promoting cell viability on the basis of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide studies.

DIFFERENTIAL EFFECTS OF SPECIFIC ANTISERA ON THE REJECTION OF ALLOGENIC AND XENOGENIC SKIN GRAFTS BY SUBLETHALLY X-IRRADIATED MICE

DTIC Science & Technology

an allogenic skin graft can be significantly inhibited, in sublethally irrsdiated mice, by specific antisera, while the first-set response to a...xenogenic skin graft remains resistant to similar treatient. Specific antisera had no effect upon a pre-existing second-set response. The significance of these data is discussed.

NOTE: Blood irradiation with accelerator produced electron beams

NASA Astrophysics Data System (ADS)

Butson, M. J.; Cheung, T.; Yu, P. K. N.; Stokes, M. J.

2000-11-01

Blood and blood products are irradiated with gamma rays to reduce the risk of graft versus host disease (GVHD). A simple technique using electron beams produced by a medical linear accelerator has been studied to evaluate irradiation of blood and blood products. Variations in applied doses for a single field 20 MeV electron beam are measured in a phantom study. Doses have been verified with ionization chambers and commercial diode detectors. Results show that the blood product volume can be given a relatively homogeneous dose to within 6% using 20 MeV electrons without the need to rotate the blood bags or the beam entry point. The irradiation process takes approximately 6.5 minutes for 30 Gy applied dose to complete as opposed to 12 minutes for a dual field x-ray field irradiation at our centre. Electron beams can be used to satisfactorily irradiate blood and blood products in a minimal amount of time.

Post-plasma grafting of AEMA as a versatile tool to biofunctionalise polyesters for tissue engineering.

PubMed

Desmet, Tim; Billiet, T; Berneel, Elke; Cornelissen, Ria; Schaubroeck, David; Schacht, Etienne; Dubruel, Peter

2010-12-08

In the last decade, substantial research in the field of post-plasma grafting surface modification has focussed on the introduction of carboxylic acids on surfaces by grafting acrylic acid (AAc). In the present work, we report on an alternative approach for biomaterial surface functionalisation. Thin poly-ε-caprolactone (PCL) films were subjected to a dielectric barrier discharge Ar-plasma followed by the grafting of 2-aminoethyl methacrylate (AEMA) under UV-irradiation. X-ray photoelectron spectroscopy (XPS) confirmed the presence of nitrogen. The ninhydrin assay demonstrated, both quantitatively and qualitatively, the presence of free amines on the surface. Confocal fluorescence microscopy (CFM), atomic force microscopy (AFM) and scanning electron microscopy (SEM) were used to visualise the grafted surfaces, indicating the presence of pAEMA. Static contact angle (SCA) measurements indicated a permanent increase in hydrophilicity. Furthermore, the AEMA grafted surfaces were applied for comparing the physisorption and covalent immobilisation of gelatin. CFM demonstrated that only the covalent immobilisation lead to a complete coverage of the surface. Those gelatin-coated surfaces obtained were further coated using fibronectin. Osteosarcoma cells demonstrated better cell-adhesion and cell-viability on the modified surfaces, compared to the pure PCL films. Copyright © 2010 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Biodegradable metal adsorbent synthesized by graft polymerization onto nonwoven cotton fabric

NASA Astrophysics Data System (ADS)

Sekine, Ayako; Seko, Noriaki; Tamada, Masao; Suzuki, Yoshio

2010-01-01

A fibrous adsorbent for Hg ions was synthesized by radiation-induced emulsion graft polymerization of glycidyl methacrylate (GMA) onto a nonwoven cotton fabric and subsequent chemical modification. The optimal pre-irradiation dose for initiation of the graft polymerization of GMA, which minimized the effects of radiation damage on the mechanical strength of the nonwoven cotton fabric, was found to be 10 kGy. The GMA-grafted nonwoven cotton fabric was subsequently modified with ethylenediamine (EDA) or diethylenetriamine (DETA) to obtain a Hg adsorbent. The resulting amine-type adsorbents were evaluated for batch and continuous adsorption of Hg. In batch adsorption, the distribution coefficients of Hg reached 1.9×10 5 and 1.0×10 5 for EDA- and DETA-type adsorbents, respectively. A column packed with EDA-type adsorbent removed Hg from 1.8 ppm Hg solution at a space velocity of 100 h -1, which corresponds to 16,000 times the volume of the packed adsorbent. The adsorbed Hg on the EDA-type adsorbent could be completely eluted by 1 M HCl solution. A microbial oxidative degradation test revealed that the EDA-type adsorbent is biodegradable.

Homogeneous graft copolymerization of styrene onto cellulose in a sulfur dioxide-diethylamine-dimethyl sulfoxide cellulose solvent

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tsuzuki, M.; Hagiwara, I.; Shiraishi, N.

1980-12-01

Graft copolymerization of styrene onto cellulose was studied in a homogeneous system (SO/sub 2/(liquid)- diethylamine (DEA)-dimethyl sulfoxide (DMSO) medium)) by ..gamma..-ray mutual irradiation technique. At the same time, homopolymerization of styrene was also examined separately in DMSO, SO/sub 2/-DMSO, DEA-DMSO, and SO/sub 2/-DEA-DMSO media by the same technique. Polymerization of styrene hardly occurs on concentrations above 10 mole SO/sub 2/-DEA complex per mole glucose unit. Maximum percent grafting was obtained in concentrations of 4 mole, after which it decreased rapidly. Total conversion and percent grafting increased with the irradiation time. The value (=0.55) of the slope of the total conversionmore » rate plotted against the dose was only a little higher than the 1/2 which was expected from normal kinetics. No retardation in homopolymerization of styrene in DMSO, SO/sub 2/-DMSO, and DEA-DMSO was evident, while the retardation of homopolymerization in the SO/sub 2/-DEA-DMSO medium was measurable. Sulfur atoms were detected in the polymers obtained in both of SO/sub 2/-DMSO and SO/sub 2/-DEA-DMSO solutions. All of the molecular weights of polymers obtained in the present experiment were very low (3.9 x 10/sup 3/-1.75 x 10/sup 4/).« less

One-step synthesis of gene carrier via gamma irradiation and its application in tumor gene therapy

PubMed Central

Kim, Eun-Ji; Heo, Hun; Park, Jong-Seok; Gwon, Hui-Jeong; Lim, Youn-Mook; Jang, Mi-Kyeong

2018-01-01

Introduction Although numerous studies have been conducted with the aim of developing drug-delivery systems, chemically synthesized gene carriers have shown limited applications in the biomedical fields due to several problems, such as low-grafting yields, undesirable reactions, difficulties in controlling the reactions, and high-cost production owing to multi-step manufacturing processes. Materials and methods We developed a 1-step synthesis process to produce 2-aminoethyl methacrylate-grafted water-soluble chitosan (AEMA-g-WSC) as a gene carrier, using gamma irradiation for simultaneous synthesis and sterilization, but no catalysts or photoinitiators. We analyzed the AEMA graft site on WSC using 2-dimensional nuclear magnetic resonance spectroscopy (2D NMR; 1H and 13C NMR), and assayed gene transfection effects in vitro and in vivo. Results We revealed selective grafting of AEMA onto C6-OH groups of WSC. AEMA-g-WSC effectively condensed plasmid DNA to form polyplexes in the size range of 170 to 282 nm. AEMA-g-WSC polyplexes in combination with psi-hBCL2 (a vector expressing short hairpin RNA against BCL2 mRNA) inhibited tumor cell proliferation and tumor growth in vitro and in vivo, respectively, by inducing apoptosis. Conclusion The simple grafting process mediated via gamma irradiation is a promising method for synthesizing gene carriers. PMID:29416333

Properties of starch-polyglutamic acid (PGA) graft copolymer prepared by microwave irradiation - Fourier transform infrared spectroscopy (FTIR) and rheology studies

USDA-ARS?s Scientific Manuscript database

The rheological properties of waxy starch-'-polygutamic acid (PGA) graft copolymers were investigated. Grafting was confirmed by FTIR spectroscopy. The starch-PGA copolymers absorbed water and formed gels, which exhibited concentration-dependent viscoelastic solid properties. Higher starch-PGA conce...

Intestinal Helminths Regulate Lethal Acute Graft Versus Host Disease and Preserve Graft Versus Tumor Effect in Mice

PubMed Central

Li, Yue; Chen, Hung-lin; Bannick, Nadine; Henry, Michael; Holm, Adrian N.; Metwali, Ahmed; Urban, Joseph F.; Rothman, Paul B.; Weiner, George J.; Blazar, Bruce R.; Elliott, David E.; Ince, M. Nedim

2014-01-01

Donor T lymphocyte transfer with hematopoietic stem cells suppresses residual tumor growth (graft-versus-tumor; GVT) in cancer patients undergoing bone marrow transplantation (BMT). However, donor T cell reactivity to host organs causes severe and potentially lethal inflammation, called graft-versus-host disease (GVHD). High dose steroids or other immune suppressives are used to treat GVHD that have limited ability to control the inflammation while incurring long-term toxicity. Novel strategies are needed to modulate GVHD, preserve GVT and improve the outcome of BMT. Regulatory T cells (Tregs) control alloantigen-sensitized inflammation of GVHD, sustain GVT and prevent mortality in bone marrow transplantation. Helminths colonizing the alimentary tract dramatically increase the Treg activity, thereby modulating intestinal or systemic inflammatory responses. These observations led us to hypothesize that helminths can regulate GVHD and maintain GVT in mice. Acute GVHD was induced in helminth (Heligmosomoides polygyrus)-infected or uninfected Balb/C recipients of C57BL/6 donor grafts. Helminth infection suppressed donor T cell inflammatory cytokine generation along with reduction in GVHD lethality and maintenance of GVT. H. polygyrus colonization promoted the survival of TGFβ generating recipient Tregs after a conditioning regimen with total body irradiation and led to a TGFβ-dependent in vivo expansion/maturation of donor Tregs after BMT. Helminths did not control GVHD, when T cells unresponsive to TGFβ-mediated immune regulation were used as donor T lymphocytes. These results suggest that helminths suppress acute GVHD, employing regulatory T cells and TGFβ-dependent pathways in mice. Helminthic regulation of GVHD and GVT through intestinal immune conditioning may improve the outcome of BMT. PMID:25527786

Ethylene vinyl acetate based radiation grafted hydrophilic matrices: Process parameter standardization, grafting kinetics and characterization

NASA Astrophysics Data System (ADS)

Chaudhari, C. V.; Mondal, R. K.; Dubey, K. A.; Grover, V.; Panicker, L.; Bhardwaj, Y. K.; Varshney, L.

2016-08-01

A transparent, elastomeric, grafted matrix for several potential applications was synthesized by single-step simultaneous radiation grafting of methacrylic acid onto ethylene vinyl acetate (EVA). CuSO4 was found to be the most suitable homo-polymerization inhibitor among different inhibitors tried. The grafting kinetics was found to be a strong function of dose rate (D) and monomer content (M) and an equation relating grafting rate Rg=Kg [M]1.13D0.23 was deduced. Crystallinity of the grafted matrices as assessed from XRD and DSC measurements indicated decrease in crystalline content with increase in grafting yield, suggesting crystalline domain of EVA get disrupted on grafting. Elastic modulus increased linearly with the increase in grafting yield, though elongation at break decreased precipitously from 900% to 30% at even 9% grafting. Thermo-gravimetric analysis showed three step weight loss of the grafted EVA matrix. The grafting of MAA resulted in increase in surface energy mainly due to enhanced polar component.

Outcomes after heart transplantation in patients with and without pretransplant renal dysfunction.

PubMed

Molina, Ezequiel J; Sandusky, Matthew F; Gupta, Dipin; Gaughan, John P; McClurken, James B; Furukawa, Satoshi; Macha, Mahender

2010-06-01

To compare long-term survival and incidence of ESRD between patients with and without preoperative renal dysfunction following heart transplantation. Fifty consecutive patients with preoperative estimated GFR < or = than 50 ml/min were compared with 50 age-matched patients with estimated GFR > or = than 80 ml/min who underwent heart transplantation between 1994 and 1998. We investigated two primary outcomes: death and development of ESRD. We also analyzed risk factors. Eight patients (16%) developed ESRD and 19 (38%) died in the control group whereas 10 patients (20%) developed ESRD and 26 (52%) died in the renal failure group during a mean follow-up period of 6.74 +/- 3.31 years. Survival and time to ESRD were not significantly different. In univariate and multivariate analysis, waiting time was the only risk factor found to predict mortality but not ESRD. High cyclosporine levels were only found to be associated with lower estimated GFR (p < 0.009). Among the control group, mortality was significantly higher in the subgroup of patients that developed > or = 50% reduction of estimated GFR at the end of the first post transplant year (p < 0.05). This study suggests that low pre-transplant estimated GFR may not accurately predict long-term development of ESRD.

Surgical Outcomes of Porcine Acellular Dermis Graft in Anophthalmic Socket: Comparison with Oral Mucosa Graft.

PubMed

Teo, Livia; Woo, Young Jun; Kim, Dong Kyu; Kim, Chang Yeom; Yoon, Jin Sook

2017-02-01

We describe our experience with the Permacol graft in anophthalmic socket reconstruction, and compare it to the autologous buccal mucosal graft, emphasizing the postoperative vascularization and contraction of each graft. This was a retrospective comparative study. We measured the time necessary for the graft surface to be completely vascularized, as well as the fornix depth of the conjunctival sac in anophthalmic patients. Ten patients underwent Permacol graft reconstruction, with 44 undergoing buccal mucosal graft reconstruction. Seven eyelids (70%) in the Permacol group had a good outcome, with improvement in lower eyelid position and prosthesis retention. Nine out of 10 eyelids (90%) in this group showed complete vascularization of the graft at 2.6 ± 1.9 months postoperatively, while the grafted buccal mucosa was fully vascularized at 1.1 ± 0.3 months postoperatively ( p < 0.01). Postoperative fornix depth in the Permacol group was 9.1 ± 2.2 mm, compared to 14.9 ± 4.5 mm in the buccal mucosal graft group ( p < 0.01). Mean increases in fornix depth were 33.1% and 67.9% of the mean vertical length of the implanted graft. The Permacol graft can be useful as spacer graft material in anophthalmic socket patients. It takes longer to vascularize, and undergoes greater graft shrinkage with time, compared to the buccal mucosal graft.

Comparative study on gamma irradiation and cold plasma pretreatment for a cellulosic substrate modification with phenolic compounds

NASA Astrophysics Data System (ADS)

Irimia, Anamaria; Ioanid, Ghiocel Emil; Zaharescu, Traian; Coroabă, Adina; Doroftei, Florica; Safrany, Agnes; Vasile, Cornelia

2017-01-01

The efficiency of the activation of the cellulose/chitin mix substrate by cold plasma or γ-radiation exposure in order to modify it with bioactive compounds was studied. The eugenol or vegetable oils such as grape seed oil and rosehip seed oil have been grafted onto activated substrate. The examination of modified cellulose/chitin mix substrate by ATR-FTIR spectroscopy, X-ray photoelectron spectroscopy and scanning electron microscopy confirms that the structural and morphological changes took place in both cases. The grafting degrees of the surface layer estimated from XPS data varied from 31.1% to 58.7% for air cold plasma activation and from 9.7% to 22.8% for γ-irradiation treatment. They depend both on bioactive compound used and procedure of substrate activation. Higher grafting degree are obtain by using vegetable oils than in the case of modification with eugenol and the air cold plasma activation seems to be much efficient than γ-irradiation. By grafting the polymeric substrate with bioactive compounds, antimicrobial and antioxidant properties have been conferred. Such materials can be considered promising for food packaging applications and medical textiles and also the applied procedures are environmental friendly ones.

Deceased donor renal transplantation from older donors to increase the donor pool.

PubMed

Kute, Vivek B; Trivedi, Hargovind L; Vanikar, Aruna V; Shah, Pankaj R; Gumber, Manoj R; Patel, Himanshu V; Modi, Pranjal R; Shah, Veena R

2012-09-01

Use of kidneys from donors aged 70 years and older is controversial. Organ shortage has led many transplant centers to accept kidneys from old, suboptimal deceased donors and make increasing use of old-for-old allocation systems. We describe our institutional experience with outcomes from transplanting deceased-donor kidneys from older donors (=70 years). 20 deceased donor renal transplants (DDRTx) were performed at our center using grafts from deceased donors 70 years and older between June 2004 and September 2011. Kidneys were allocated to dual or single grafting according to pre-transplant biopsy. Mean age of recipients was 47.60 ± 11.38 years, 13 of whom were males. Mean donor age was 76.49 ± 4.9 years; 10 of whom were males. The most common cause of donor death was cerebrovascular/road traffic accidents. Mean dialysis duration pre-transplantation was 19.5 ± 6.5 months. Mean HLA (Human Leukocyte Antigens) match was 1 ± 0.8. Most common recipient diseases leading to ESRD were chronic glomerulonephritis (25%), diabetes (20%), and hypertension (20%). Post-transplant immunosuppression consisted of a calcineurin inhibitor-based regimen. Over a mean follow-up of 2.8 ± 1.7 years, patient and graft survival rates were 75% (n = 15) and 80% ( n = 16), respectively, with a mean serum creatinine of 1.78 ± 0.56 mg/dl; 20% of the patients had biopsy-proven acute rejection episodes. A total of 25% (n = 5) patients died, mainly due to infections. DDRTx from older donors achieves acceptable graft function with patient/graft survival, provided that organs are allocated to dual or single grafting according to pre-transplant biopsy. These findings encourage the use of this approach even in low-income countries.

Longitudinal trajectory of sexual functioning after hematopoietic cell transplantation: impact of chronic graft-versus-host disease and total body irradiation.

PubMed

Wong, F Lennie; Francisco, Liton; Togawa, Kayo; Kim, Heeyoung; Bosworth, Alysia; Atencio, Liezl; Hanby, Cara; Grant, Marcia; Kandeel, Fouad; Forman, Stephen J; Bhatia, Smita

2013-12-05

This prospective study described the trajectory of sexual well-being from before hematopoietic cell transplantation (HCT) to 3 years after in 131 allogeneic and 146 autologous HCT recipients using Derogatis Interview for Sexual Function and Derogatis Global Sexual Satisfaction Index. Sixty-one percent of men and 37% of women were sexually active pre-HCT; the prevalence declined to 51% (P = .01) in men and increased to 48% (P = .02) in women at 3 years post-HCT. After HCT, sexual satisfaction declined in both sexes (P < .001). All sexual function domains were worse in women compared with men (P ≤ .001). Orgasm (P = .002) and drive/relationship (P < .001) declined in men, but sexual cognition/fantasy (P = .01) and sexual behavior/experience (P = .01) improved in women. Older age negatively impacted sexual function post-HCT in both sexes (P < .01). Chronic graft-versus-host disease was associated with lower sexual cognition/fantasy (P = .003) and orgasm (P = .006) in men and sexual arousal (P = .05) and sexual satisfaction (P = .005) in women. All male sexual function domains declined after total body irradiation (P < .05). This study identifies vulnerable subpopulations that could benefit from interventional strategies to improve sexual well-being.

Photodynamic damage to cartilage and synovial tissue grafted on a chick's chorioallantoic membrane

NASA Astrophysics Data System (ADS)

Fisher, M.; Nahir, A. M.; Kimel, Sol

1997-09-01

Rheumatoid arthritis (RA) is a chronic inflammatory disease of the synovial joints causing pain deformities and disability. The highly vascular inflamed synovium has aggressive and destructive characteristics, it invades, erodes and gradually destroys cartilage and underlying bone. Photodynamic therapy (PDT) was performed using the chick chorioallantoic membrane (CAM) model to investigate the vitality of synovium and cartilage implanted on the CAM. Synovium, obtained from human patients, was grafted onto the CAM; gross microscopy and histology proved its vitality 7 days post grafting. Cartilage obtained from rabbit knee joint was also maintained on the CAM for 7 days. Its vitality was demonstrated by histology and by measuring metabolic and enzymatic activity of cartilage cells (chondrocytes) as well as the collagen and proteoglycans content. Selective PDT was performed using aluminum phthalocyanine tetrasulfonate (AlPcS4), a hydrophilic compound, soluble in biological solutions, as a photosensitizer. After irradiation with a diode laser (lambda equals 670 nm, 10 mW) damage was observed in vascularized synovium grafts, whereas avascular cartilage remained intact.

Graft union formation in artichoke grafting onto wild and cultivated cardoon: an anatomical study.

PubMed

Trinchera, Alessandra; Pandozy, Gianmarco; Rinaldi, Simona; Crinò, Paola; Temperini, Olindo; Rea, Elvira

2013-12-15

In order to develop a non-chemical method such as grafting effective against well-known artichoke soil borne diseases, an anatomical study of union formation in artichoke grafted onto selected wild and cultivated cardoon rootstocks, both resistant to Verticillium wilt, was performed. The cardoon accessions Belgio (cultivated cardoon) and Sardo (wild cardoon) were selected as rootstocks for grafting combinations with the artichoke cv. Romolo. Grafting experiments were carried out in the autumn and spring. The anatomical investigation of grafting union formation was conducted by scanning electron microscopy (SEM) on the grafting portions at the 3rd, 6th, 10th, 12th day after grafting. For the autumn experiment only, SEM analysis was also performed at 30 d after grafting. A high affinity between artichoke scion and cardoon rootstocks was observed, with some genotype differences in healing time between the two bionts. SEM images of scion/rootstock longitudinal sections revealed the appearance of many interconnecting structures between the two grafting components just 3d after grafting, followed by a vascular rearrangement and a callus development during graft union formation. De novo formation of many plasmodesmata between scion and rootstock confirmed their high compatibility, particularly in the globe artichoke/wild cardoon combination. Moreover, the duration of the early-stage grafting process could be influenced not only by the scion/rootstock compatibility, but also by the seasonal conditions, being favored by lower temperatures and a reduced light/dark photoperiod. Copyright © 2013 Elsevier GmbH. All rights reserved.

Predictors of early graft failure after coronary artery bypass grafting for chronic total occlusion.

PubMed

Oshima, Hideki; Tokuda, Yoshiyuki; Araki, Yoshimori; Ishii, Hideki; Murohara, Toyoaki; Ozaki, Yukio; Usui, Akihiko

2016-07-01

Little is known regarding the transit-time flow measurement (TTFM) variables in grafts anastomosed to chronically totally occluded vessels (CTOs). We aimed to establish the TTFM cut-off values for detecting graft failure in bypass grafts anastomosed to chronically totally occluded arteries and clarify the relationship between early graft failure and the grade of collateral circulation/regional wall motion of the CTO territory. Among 491 patients who underwent isolated coronary artery bypass grafting (CABG) from 2009 to 2015, 196 cases with CTOs underwent postoperative coronary angiography within 1 month after CABG. Two hundred and forty-one CTOs in all patients were examined. Thirty-two CTOs (13%) were not bypassed and 214 conduits were anastomosed to CTOs and underwent intraoperative TTFM. Arterial conduits and saphenous vein grafts (SVGs) were used in 102 and 112 cases, respectively. Among the arterial conduit procedures that were performed, 78 involved the left internal thoracic artery (LITA), 10 involved the right internal thoracic artery (RITA) and 14 involved the right gastroepiploic artery (rGEA). Any graft showing Fitzgibbon type B or O lesions on angiography was considered to be a failing graft. The insufficiency rates for LITA, RITA, rGEA and SVG procedures were 5.1, 10, 14.3 and 7.1%, respectively. The TTFM variables recorded in failing grafts had a significantly lower mean flow (Qmean) and higher pulsatility index (PI) compared with patent grafts. Furthermore, akinetic or dyskinetic wall motion in the territory of bypassed CTOs was observed at a significantly higher rate in failing grafts. A multivariable regression analysis and receiver operating characteristic analysis revealed good predictors of early graft failure as follows: a Qmean value of < 11.5 ml/min for arterial conduits, a PI value of >5.85 and akinetic/dyskinetic wall motion in the CTO territory for SVGs. The Rentrop collateral grade was not associated with early graft failure. The Qmean

Morphological Study of Poly(vinylbenzyl chloride)-Grafted Poly(ethylene-co-tetrafluoroethylene) [ETFE-g-PVBC] Films Using Small-Angle Neutron Scattering Analysis.

PubMed

Song, J M; Ko, B S; Sohn, J Y; Shin, J

2016-06-01

In this study, the effect of degree of the grafting and crosslinking on the morphology of the crystalline domain in poly(vinylbenzyl chloride)-grafted poly(ethylene-co-tetrafluoroethylene) [ETFE-g-PVBC] films was investigated using a SANS (small-angle neutron scattering) analysis. The grafted films can be used as a precursor for ion-exchange membrane. ETFE-g-PVBC films with various degrees of cross-linking were prepared by a simultaneous irradiation grafting of vinylbenzyl chloride (VBC) and divinylbenzene (DVB) onto an ETFE film. The SEM-EDX (scanning electron microscopy-energy dispersive X-ray spectroscopy) results of a cross-sectional distribution of ETFE-g-PVBC films showed that the chlorine atoms were well-distributed throughout the films. SANS profiles of the PVBC-grafted films in the absence of a DVB crosslinker showed that the crystalline domain peaks were observed and the peak maximum position shifted significantly from 0.032 Å-(-1) to 0.02 Å(-1) with an increase in the degree of grafting. However, peak maximum positions of the PVBC-grafted films in the presence of a DVB crosslinker shifted slightly from 0.02 Å(-1) to 0.024 Å(-1) with an increase in the amount of DVB monomer at same degree of grafting. These results indicate that the degree of grafting and crosslinking affect the morphology of the crystalline domain in the ETFE-g-PVBC films.

Effect of irradiation on the prevulcanized latex/low nitrosamines latex blends

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ibrahim, Pairu; Zin, Wan Manshol Wan; Daik, Rusli

2015-09-25

Radiation Prevulcanized Natural Rubber Latex (RVNRL) was blended with Low Nitrosamines Latex (LNL) at different composition ratio. Methyl Metachrylate (MMA) was added for grafting onto the blended latex. Blended latex was subjected to gamma irradiation at various doses up to 8kGy. The mechanical properties and FTIR analysis were investigated as a function of the blended composition and irradiation dose. It was found that blending at specific ratio and gamma irradiation at specific dose led to significant improvement on the properties of the latex. The optimum mechanical properties was attained at a total blending ratio of 70% RVNRL and 30% ofmore » LNL.« less

Intestinal helminths regulate lethal acute graft-versus-host disease and preserve the graft-versus-tumor effect in mice.

PubMed

Li, Yue; Chen, Hung-Lin; Bannick, Nadine; Henry, Michael; Holm, Adrian N; Metwali, Ahmed; Urban, Joseph F; Rothman, Paul B; Weiner, George J; Blazar, Bruce R; Elliott, David E; Ince, M Nedim

2015-02-01

Donor T lymphocyte transfer with hematopoietic stem cells suppresses residual tumor growth (graft-versus-tumor [GVT]) in cancer patients undergoing bone marrow transplantation (BMT). However, donor T cell reactivity to host organs causes severe and potentially lethal inflammation called graft-versus-host disease (GVHD). High-dose steroids or other immunosuppressive drugs are used to treat GVHD that have limited ability to control the inflammation while incurring long-term toxicity. Novel strategies are needed to modulate GVHD, preserve GVT, and improve the outcome of BMT. Regulatory T cells (Tregs) control alloantigen-sensitized inflammation of GVHD, sustain GVT, and prevent mortality in BMT. Helminths colonizing the alimentary tract dramatically increase the Treg activity, thereby modulating intestinal or systemic inflammatory responses. These observations led us to hypothesize that helminths can regulate GVHD and maintain GVT in mice. Acute GVHD was induced in helminth (Heligmosomoides polygyrus)-infected or uninfected BALB/c recipients of C57BL/6 donor grafts. Helminth infection suppressed donor T cell inflammatory cytokine generation and reduced GVHD-related mortality, but maintained GVT. H. polygyrus colonization promoted the survival of TGF-β-generating recipient Tregs after a conditioning regimen with total body irradiation and led to a TGF-β-dependent in vivo expansion/maturation of donor Tregs after BMT. Helminths did not control GVHD when T cells unresponsive to TGF-β-mediated immune regulation were used as donor T lymphocytes. These results suggest that helminths suppress acute GVHD using Tregs and TGF-β-dependent pathways in mice. Helminthic regulation of GVHD and GVT through intestinal immune conditioning may improve the outcome of BMT. Copyright © 2015 by The American Association of Immunologists, Inc.

A Highly Thermostable Ceramic-Grafted Microporous Polyethylene Separator for Safer Lithium-Ion Batteries.

PubMed

Zhu, Xiaoming; Jiang, Xiaoyu; Ai, Xinping; Yang, Hanxi; Cao, Yuliang

2015-11-04

The safety concern is a critical obstacle to large-scale energy storage applications of lithium-ion batteries. A thermostable separator is one of the most effective means to construct the safe lithium-ion batteries. Herein, we demonstrate a novel ceramic (SiO2)-grafted PE separator prepared by electron beam irradiation. The separator shows similar thickness and pore structure to the bare separator, while displaying strong dimensional thermostability, as the shrinkage ratio is only 20% even at an elevated temperature of 180 °C. Besides, the separator is highly electrochemically inert, showing no adverse effect on the energy and power output of the batteries. Considering the excellent electrochemical and thermal stability, the SiO2-grafted PE separator developed in this work is greatly beneficial for constructing safer lithium-ion batteries.

Percutaneous coronary intervention strategies and prognosis for graft lesions following coronary artery bypass grafting

PubMed Central

LIU, YIN; ZHOU, XIUJUN; JIANG, HUA; GAO, MINGDONG; WANG, LIN; SHI, YUTIAN; GAO, JING

2015-01-01

The purpose of this study was to compare the prognosis of graft-percutaneous coronary intervention (PCI) and native vessel (NV)-PCI, drug-eluting stents (DESs) and bare-metal stents (BMSs) for the treatment of graft lesions following coronary artery bypass grafting (CABG), and to determine the risk factors for major adverse cardiac events (MACEs). A total of 289 patients who underwent PCI following CABG between August 2005 and March 2010 were retrospectively analyzed. The effects on survival were compared among patients who underwent NV- and graft-PCI, and DES and BMS implantation. Additionally, the risk factors for MACEs following PCI for graft lesions were analyzed. The findings showed that MACE-free and revascularization-free survival rates were significantly higher in the NV-PCI group compared with those in the graft-PCI group. There were 63 cases (29.0%) of MACEs in the DES group and 25 cases (52.1%) in the BMS group. In patients undergoing NV-PCI, the DES group had significantly fewer MACEs and less target vessel revascularization (TVR) than the BMS group. In patients undergoing graft-PCI, the DES group showed a tendency for fewer MACEs and a lower incidence of cardiac mortality, myocardial infarction and TVR compared with the BMS group. Diabetes, an age of >70 years and graft-PCI were independent risk factors for MACEs in patients post-PCI. It is concluded that NV-PCI has superior long-term outcomes compared with graft-PCI, and should therefore be considered as the first-line treatment for graft disease following CABG. Despite this, graft-PCI remains a viable option. DESs are the first choice for graft-PCI due to their safety and efficacy and their association with reduced mortality and MACE rate. Diabetes, older age and graft-PCI are independent risk factors for MACEs in patients post-CABG who are undergoing revascularization. PMID:26136874

Radiation induced emulsion graft polymerization of 4-vinylpyridine onto PE/PP nonwoven fabric for As(V) adsorption

NASA Astrophysics Data System (ADS)

Akkaş Kavaklı, Pınar; Kavaklı, Cengiz; Seko, Noriaki; Tamada, Masao; Güven, Olgun

2016-10-01

A novel nonwoven fabric adsorbent having 4-vinylpyridine functional groups was prepared by using radiation-induced emulsion graft polymerization method and grafting 4-vinylpyridine monomer onto a polyethylene-coated polypropylene nonwoven fabric (NWF) in aqueous emulsion solution. The grafting conditions of the 4-vinylpyridine monomer onto the NWF were optimised and 150% Dg VP-g-NWF was prepared using 30 kGy pre-irradiation dose, 5% VP monomer concentration and 0.5% (w/w) Tween 20 in aqueous emulsion. Grafted 4-vinylpyridine chains on the NWF were then quaternized for the preparation of QVP-g-NWF adsorbent. All fabric structures were characterized by using Fourier-transform infrared spectrometer, x-ray photoelectron spectrometer and scanning electron microscope. QVP-g-NWF adsorbent was used in batch adsorption experiments for As(V) ions by studying the pH, contact time, and initial As(V) ion concentration parameters. Results showed that QVP-g-NWF adsorbent has significant As(V) adsorption and experimental As(V) adsorption capacity was 98.04 mg As(V)/g polymer from 500 mg/L initial As(V) concentration at pH 7.00.

A novel photo-grafting of acrylamide onto carboxymethyl starch. 1. Utilization of CMS-g-PAAm in easy care finishing of cotton fabrics.

PubMed

El-Sheikh, Manal A

2016-11-05

The photosensitized grafting of vinyl monomers onto a range of polymeric substrates has been the subject of particular interest in the recent past. Carboxymethyl starch (CMS)-poly acrylamide (PAAm) graft copolymer (CMS-g-PAAm) with high graft yield was successfully prepared by grafting of acrylamide onto CMS using UV irradiation in the presence of the water soluble 4-(trimethyl ammoniummethyl) benzophenone chloride photoinitiator. CMS-g-PAAm with nitrogen content of 8.3% and grafting efficiency up to 98.9% was obtained using 100% AAm, a material: liquor ratio of 1:14 and 1% photinitiator at 30°C for 1h of UV irradiation. The synthesis of CMS-g-PAAm was confirmed by FTIR and Nitrogen content (%). Surface morphology of CMS and surface morphological changes of CMS after grafting with AAm were studied using SEM. Thermal properties of both CMS and CMS-g-PAAm were studied using TGA and DSC. To impart easy care finishing to cotton fabrics, aqueous formulations of: CMS-g-PAAm, dimethylol dihydroxy ethylene urea (DMDHEU), CMS-g-PAAm-DMDHEU mixture or methylolated CMS-g-PAAm were used. Cotton fabrics were padded in these formulations, squeezed to a wet pick up 100%, dried at 100°C for 5min, cured at 150°C for 5min, washed at 50°C for 10min and air-dried. CRA (crease recovery angle) of untreated fabrics and fabrics finished with a mixture of 2% CMS-g-PAAm and 10% DMDHEU or methylolated CMS-g-PAAm (10% formaldehyde) were: 136°, 190°, 288° respectively. Increasing the number of washing cycles up to five cycles results in an insignificant decrease in the CRA and a significant decrease in RF (releasable formaldehyde) of finished fabric samples. The morphologies of the finished and unfinished cotton fabrics were performed by SEM. Copyright © 2016 Elsevier Ltd. All rights reserved.

Management of an infected aortic graft with endovascular stent grafting.

PubMed

Jamel, Sara; Attia, Rizwan; Young, Christopher

2013-01-01

Aortic graft infection, one of the most common fatal complications of aortovascular surgery, is managed mainly by the removal of infected graft material and re-establishment of vascular continuity using an extra-anatomical bypass or in situ graft replacement. Despite significant progress in perioperative, surgical, and medical treatments, the mortality and morbidity for this condition remain high. Here, we report the use of endograft implantation and prolonged intravenous antibiotics to successfully treat a life-threatening Dacron aortic tube graft infection and anastomotic leak. Although the gold standard is surgical removal of infected material and repair with a homograft, in certain extremely high-risk patients such as ours, an alternate strategy may be warranted when the risks associated with surgery are prohibitive. Endovascular repair of a surgical Dacron graft leak may provide a novel temporizing measure in the acute setting, allowing for delayed semi-urgent surgical intervention, or it may provide a definitive treatment, as in our case. At the four-year follow-up, our patient was well with a good quality of life and with no clinical, radiological, or biochemical evidence of infection.

Grafting of a reactive siloxane onto an alpha-olefin in the melt phase

NASA Astrophysics Data System (ADS)

Bekele, Solomon

1999-11-01

the grafted film was found to be lower than the base polymer film by 50% to 60%. This increased to 65% to 75% when both sets of film samples were subjected to 50 kGy of electron beam irradiation.

Preparation and characterization of the graft copolymer of chitosan with poly[rosin-(2-acryloyloxy)ethyl ester].

PubMed

Duan, Wengui; Chen, Chunhong; Jiang, Linbin; Li, Guang Hua

2008-09-05

Graft copolymerization of rosin-(2-acryloyloxy)ethyl ester (RAEE) onto chitosan (Cts) was carried out under microwave irradiation using potassium persulfate as an initiator. The structures, morphology, and thermal properties of the Cts graft copolymer (Cts-g-PRAEE) were characterized by means of FT-IR, XRD, SEM, and TG. Also, Cts and Cts-g-PRAEE copolymer were used as carriers of fenoprofen calcium (FC), and their controlled release behavior in artificial intestinal juice were studied. The results show that the rate of release of fenoprofen calcium from the carrier of Cts-g-PRAEE copolymer becomes very slower than that of Cts in artificial intestinal juice. Copyright © 2008. Published by Elsevier Ltd.

Accelerated cell-sheet recovery from a surface successively grafted with polyacrylamide and poly(N-isopropylacrylamide).

PubMed

Akiyama, Yoshikatsu; Kikuchi, Akihiko; Yamato, Masayuki; Okano, Teruo

2014-08-01

A double polymeric nanolayer consisting of poly(N-isopropylacrylamide) (PIPAAm) and hydrophilic polyacrylamide (PAAm) was deposited on tissue culture polystyrene (TCPS) surfaces using electron beam irradiation to form a new temperature-responsive cell culture surface in which the basal hydrophilic PAAm component in the double polymeric layer promotes the hydration of the upper PIPAAm layer and induces rapid cell detachment compared to a conventional temperature-responsive cell culture surface, PIPAAm-grafted TCPS (PIPAAm-TCPS). Take-off angle-dependent X-ray photoelectron spectroscopy spectral analysis demonstrated that the grafted PIPAAm and PAAm components were located in the upper and basal regions of the double polymeric layer, respectively, suggesting that the double polymeric layer forms an inter-penetrating-network-like structure with PAAm at the basal portion of the PIPAAm grafted chains. The wettability of the temperature-responsive cell culture surfaces with the double polymeric layer tended to be more hydrophilic, with an increase in the basal PAAm graft density at a constant PIPAAm graft density. However, when the graft densities of the upper PIPAAm and basal PAAm were optimized, the resulting temperature-responsive cell culture surface with the double polymeric layer exhibited rapid cell detachment while maintaining cell adhesive character comparable to that of PIPAAm-TCPS. The cell adhesive character was altered from cell-adhesive to cell-repellent with increasing PAAm or PIPAAm graft density. The cell adhesive character of the temperature-responsive cell culture surfaces was relatively consistent with their contact angles. These results strongly suggest that the basal PAAm surface properties affect the degree of hydration and dehydration of the subsequently grafted PIPAAm. In addition, the roles of the hydrophilic component in accelerating cell detachment are further discussed in terms of the mobility of the grafted PIPAAm chains. Applications of

Effects of LED phototherapy on bone defects grafted with MTA, bone morphogenetic proteins and guided bone regeneration: a Raman spectroscopic study.

PubMed

Pinheiro, Antonio L B; Soares, Luiz G P; Cangussú, Maria Cristina T; Santos, Nicole R S; Barbosa, Artur Felipe S; Silveira Júnior, Landulfo

2012-09-01

We studied peaks of calcium hydroxyapatite (CHA) and protein and lipid CH groups in defects grafted with mineral trioxide aggregate (MTA) treated or not with LED irradiation, bone morphogenetic proteins and guided bone regeneration. A total of 90 rats were divided into ten groups each of which was subdivided into three subgroups (evaluated at 15, 21 and 30 days after surgery). Defects were irradiated with LED light (wavelength 850 ± 10 nm) at 48-h intervals for 15 days. Raman readings were taken at the surface of the defects. There were no statistically significant differences in the CHA peaks among the nonirradiated defects at any of the experimental time-points. On the other hand, there were significant differences between the defects filled with blood clot and the irradiated defects at all time-points (p < 0.001, p = 0.02, p < 0.001). There were significant differences between the mean peak CHA in nonirradiated defects at all the experimental time-points (p < 0.01). The mean peak of the defects filled with blood clot was significantly different from that of the defects filled with MTA (p < 0.001). There were significant differences between the defects filled with blood clot and the irradiated defects (p < 0.001). The results of this study using Raman spectral analysis indicate that infrared LED light irradiation improves the deposition of CHA in healing bone grafted or not with MTA.

Reduced intensity haplo plus single cord transplant compared to double cord transplant: improved engraftment and graft-versus-host disease-free, relapse-free survival

PubMed Central

van Besien, Koen; Hari, Parameswaran; Zhang, Mei-Jie; Liu, Hong-Tao; Stock, Wendy; Godley, Lucy; Odenike, Olatoyosi; Larson, Richard; Bishop, Michael; Wickrema, Amittha; Gergis, Usama; Mayer, Sebastian; Shore, Tsiporah; Tsai, Stephanie; Rhodes, Joanna; Cushing, Melissa M.; Korman, Sandra; Artz, Andrew

2016-01-01

Umbilical cord blood stem cell transplants are commonly used in adults lacking HLA-identical donors. Delays in hematopoietic recovery contribute to mortality and morbidity. To hasten recovery, we used co-infusion of progenitor cells from a partially matched related donor and from an umbilical cord blood graft (haplo-cord transplant). Here we compared the outcomes of haplo-cord and double-cord transplants. A total of 97 adults underwent reduced intensity conditioning followed by haplo-cord transplant and 193 patients received reduced intensity conditioning followed by double umbilical cord blood transplantation. Patients in the haplo-cord group were more often from minority groups and had more advanced malignancy. Haplo-cord recipients received fludarabine-melphalan-anti-thymocyte globulin. Double umbilical cord blood recipients received fludarabine-cyclophosphamide and low-dose total body irradiation. In a multivariate analysis, haplo-cord had faster neutrophil (HR=1.42, P=0.007) and platelet (HR=2.54, P<0.0001) recovery, lower risk of grade II–IV acute graft-versus-host disease (HR=0.26, P<0.0001) and chronic graft-versus-host disease (HR=0.06, P<0.0001). Haplo-cord was associated with decreased risk of relapse (HR 0.48, P=0.001). Graft-versus-host disease-free, relapse-free survival was superior with haplo-cord (HR 0.63, P=0.002) but not overall survival (HR=0.97, P=0.85). Haplo-cord transplantation using fludarabine-melphalan-thymoglobulin conditioning hastens hematopoietic recovery with a lower risk of relapse relative to double umbilical cord blood transplantation using the commonly used fludarabine-cyclophosphamide-low-dose total body irradiation conditioning. Graft-versus-host disease-free and relapse-free survival is significantly improved. Haplo-cord is a readily available graft source that improves outcomes and access to transplant for those lacking HLA-matched donors. Trials registered at clinicaltrials.gov identifiers 00943800 and 01810588. PMID

Adoptive immunotherapy against allogeneic kidney grafts in dogs with stable hematopoietic trichimerism.

PubMed

Graves, Scott S; Hogan, William J; Kuhr, Christian; Diaconescu, Razvan; Harkey, Michael; Sale, George E; Stone, Brad; Georges, George E; Storb, Rainer

2008-11-01

Dogs given nonmyeloablative conditioning and marrow grafts from 2 dog leukocyte antigen (DLA)-identical littermate donors developed stable trichimerism and stably accepted a subsequent kidney graft from one of the marrow donors without the need for immunosuppression. In this study, we used trichimeras to evaluate strategies for adoptive immunotherapy to solid tumors, using the kidney as a tumor surrogate. Three DLA-identical trichimeric recipients were established by simultaneously infusing marrow from 2 DLA-identical donor dogs into a DLA-identical recipient conditioned with 2 Gy of total body irradiation (TBI) and given a short course of postgraft immunosuppression. After stable hematopoietic engraftment was confirmed, a kidney was transplanted from 1 of the 2 marrow donors into each respective trichimeric recipient. Peripheral blood lymphocytes from each kidney donor were then used to sensitize the alternate marrow donor. The trichimeric recipients were given donor lymphocyte infusions (DLIs) from the sensitized dogs and monitored for chimerism, graft-versus-host disease (GVHD), and kidney rejection. After DLI, we observed both prompt rejection of the transplanted marrow and donor kidney and disappearance of corresponding hematopoietic chimerism. Presumably due to shared minor histocompatibility antigens, host chimerism also disappeared, and GVHD in skin, gut, and liver developed. The native kidneys, although exhibiting lymphocytic infiltration, remained functionally normal. This study demonstrates that under certain experimental conditions, the kidney--an organ ordinarily not involved in graft-versus-host reactions--can be targeted by sensitized donor lymphocytes.

Adoptive Immunotherapy against Allogeneic Kidney Grafts in Dogs with Stable Hematopoietic Trichimerism

PubMed Central

Graves, Scott S.; Hogan, William J.; Kuhr, Christian; Diaconescu, Razvan; Harkey, Michael; Sale, George E.; Stone, Brad; Georges, George E.; Storb, Rainer

2008-01-01

Dogs given nonmyeloablative conditioning and marrow grafts from two dog leukocyte antigen- (DLA) identical littermate donors developed stable trichimerism and stably accepted a subsequent kidney graft from one of the marrow donors without the need for immunosuppression. Here, we used trichimeras to evaluate strategies of adoptive immunotherapy to solid tumors, using the kidney as a tumor surrogate. Three DLA-identical trichimeric recipients were established by simultaneously infusing marrow from two DLA-identical donor dogs into a DLA-identical recipient conditioned with 2 Gy total body irradiation and given a short course of postgrafting immunosuppression. After confirming stable hematopoietic engraftment, a kidney was transplanted from one of the two marrow donors into each respective trichimeric recipient. Peripheral blood lymphocytes (PBL) from each kidney donor were then used to sensitize the alternate marrow donor. Donor lymphocyte infusions (DLI) from the sensitized dogs were given to the trichimeric recipients, whereupon chimerism, graft-versus-host disease (GvHD), and kidney rejection were monitored. After DLI, we observed both prompt rejection of the transplanted marrow-donor kidney and disappearance of corresponding hematopoietic chimerism. Presumably, owing to shared minor histocompatibility antigens, host chimerism also disappeared and GvHD in skin, gut, and liver developed. The native kidneys, while showing lymphocytic infiltration, remained functionally normal. The current study demonstrated that under certain experimental conditions, the kidney, an organ ordinarily not involved in graft-versus-host reactions, can be targeted by sensitized donor lymphocytes. PMID:18940673

Plant grafting: new mechanisms, evolutionary implications.

PubMed

Goldschmidt, Eliezer E

2014-01-01

Grafting, an old plant propagation practice, is still widely used with fruit trees and in recent decades also with vegetables. Taxonomic proximity is a general prerequisite for successful graft-take and long-term survival of the grafted, composite plant. However, the mechanisms underlying interspecific graft incompatibility are as yet insufficiently understood. Hormonal signals, auxin in particular, are believed to play an important role in the wound healing and vascular regeneration within the graft union zone. Incomplete and convoluted vascular connections impede the vital upward and downward whole plant transfer routes. Long-distance protein, mRNA and small RNA graft-transmissible signals currently emerge as novel mechanisms which regulate nutritional and developmental root/top relations and may play a pivotal role in grafting physiology. Grafting also has significant pathogenic projections. On one hand, stock to scion mechanical contact enables the spread of diseases, even without a complete graft union. But, on the other hand, grafting onto resistant rootstocks serves as a principal tool in the management of fruit tree plagues and vegetable soil-borne diseases. The 'graft hybrid' historic controversy has not yet been resolved. Recent evidence suggests that epigenetic modification of DNA-methylation patterns may account for certain graft-transformation phenomena. Root grafting is a wide spread natural phenomenon; both intraspecific and interspecific root grafts have been recorded. Root grafts have an evolutionary role in the survival of storm-hit forest stands as well as in the spread of devastating diseases. A more fundamental evolutionary role is hinted by recent findings that demonstrate plastid and nuclear genome transfer between distinct Nicotiana species in the graft union zone, within a tissue culture system. This has led to the formation of alloploid cells that, under laboratory conditions, gave rise to a novel, alloploid Nicotiana species, indicating

Plant grafting: new mechanisms, evolutionary implications

PubMed Central

Goldschmidt, Eliezer E.

2014-01-01

Grafting, an old plant propagation practice, is still widely used with fruit trees and in recent decades also with vegetables. Taxonomic proximity is a general prerequisite for successful graft-take and long-term survival of the grafted, composite plant. However, the mechanisms underlying interspecific graft incompatibility are as yet insufficiently understood. Hormonal signals, auxin in particular, are believed to play an important role in the wound healing and vascular regeneration within the graft union zone. Incomplete and convoluted vascular connections impede the vital upward and downward whole plant transfer routes. Long-distance protein, mRNA and small RNA graft-transmissible signals currently emerge as novel mechanisms which regulate nutritional and developmental root/top relations and may play a pivotal role in grafting physiology. Grafting also has significant pathogenic projections. On one hand, stock to scion mechanical contact enables the spread of diseases, even without a complete graft union. But, on the other hand, grafting onto resistant rootstocks serves as a principal tool in the management of fruit tree plagues and vegetable soil-borne diseases. The ‘graft hybrid’ historic controversy has not yet been resolved. Recent evidence suggests that epigenetic modification of DNA-methylation patterns may account for certain graft-transformation phenomena. Root grafting is a wide spread natural phenomenon; both intraspecific and interspecific root grafts have been recorded. Root grafts have an evolutionary role in the survival of storm-hit forest stands as well as in the spread of devastating diseases. A more fundamental evolutionary role is hinted by recent findings that demonstrate plastid and nuclear genome transfer between distinct Nicotiana species in the graft union zone, within a tissue culture system. This has led to the formation of alloploid cells that, under laboratory conditions, gave rise to a novel, alloploid Nicotiana species

THE TREATMENT OF IRRADIATION FRACTURE OF THE FEMORAL NECK

DOE Office of Scientific and Technical Information (OSTI.GOV)

Leabhart, J.W.; Bonfiglio, M.

1961-10-01

Treatment of 44 patients with 56 postirradiation fractures of the femoral neck is reported. Of 2612 patients who received pelvic irradiation for carcinoma of the uterine cervix, 40 developed fractures of the femoral neck, an incidence of 1.5%. Sixteen of the 40 patients had bilateral fractures. The average age of the patients was 58.5 yr at the time of irradiation. The average irradiation dose was approximates 3600 r (parametrial dose), the largest dose being 4235 r. The average interval from irradiation to the onset of pain in the hip was 36.6 months (3 to 240 months) and from the onsetmore » of pain to diagnosis, 3 months. Forty-six surgical procedures were performed: 36 as primary treatment and 9 because of failure or complications of the first procedure. The average follow-up time of these patients was 6.9 yr. The presenting complaint was usually spontaneous onset of pain in the groin and medial portion of the thigh. Initially the physical examination often revealed only restriction of internal rotation of the affected hip, and the roentgenograms appeared normal in some instances. Subsequently, a change in bone density was noted at the inferior aspect of the femoral neck, denoting an adduction type of fracture. The displaced fractures resembled the traumatic adduction fractures of the femoral neck seen in patients who had not received irradiation. Acetabular changes were also noted, characterized by marked osteoporosis and occasionally fracture of the acetabulum. Seven methods of primary therapy were used to treat these patients: no treatment, nonsurgical measures (crutches or bedrest), internal fixation, bone- grafting (with and without additional fixation), osteotomy, arthroplasty, and the insertion of a prosthesis. Early in situ internal fixation or internal fixation with bone grafts was the procedure of choice in fractures of the femorai neck secondary to irradiation. Reconstructive procedures, such as cup arthroplasty or insertion of a prosthesis, were

Characterization of modified PVDF membrane by gamma irradiation for non-potable water reuse.

PubMed

Lim, Seung Joo; Kim, Tak-Hyun; Shin, In Hwan

2015-01-01

Poly(vinylidene fluorine) (PVDF) membranes were grafted by gamma-ray irradiation and were sulfonated by sodium sulfite to modify the surface of the membranes. The characteristics of the modified PVDF membranes were evaluated by the data of Fourier transform infrared (FT-IR), X-ray photoelectron spectroscopy (XPS), field-emission scanning electron microscope (FE-SEM), the contact angle of the membrane surface and the water permeability. From the results of FT-IR, XPS and FE-SEM, it was shown that the modified membranes were successfully grafted by gamma-ray irradiation and were sulfonated. The content of oxygen and sulfur increased with the monomer concentration, while the content of fluorine sharply decreased. The pore size of the modified membranes decreased after gamma-ray irradiation. The contact angle and the water permeability showed that the hydrophilicity of the modified membranes played a role in determining the membrane performance. The feasibility study of the modified PVDF membranes for using non-potable water reuse were carried out using a laboratory-scale microfiltration system. Grey wastewater was used as the influent in the filtration unit, and permeate quality satisfied non-potable water reuse guidelines in the Republic of Korea.

Differential growth of allogeneic bone marrow and leukemia cells in irradiated guinea pigs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bhan, A,K.; Kumar, V.; Bennett, M.

1979-11-01

Growth of normal bone marrow and L/sub 2/C leukemia cell grafts was studied in lethally irradiated strain 2 and strain 13 guinea pigs. Allogeneic bone marrow cells proliferated as well as syngeneic cells in both strain 2 and 13 animals. This observation indicates that Ia disparities are not relevant to marrow graft rejection in the guinea pig. Both Ia positive and Ia negative L/sub 2/C leukemia cells of strain 2 origin grew well in the spleen of irradiated strain 2 animals. However, irradiated strain 13 animals showed resistance to the growth of both leukemia cell lines. F/sub 1/ hybrids (2more » x 13) also showed resistance to the growth of the leukemia cells. These observations suggest the existence of an effector system capable of mediating natural resistance to L/sub 2/C cells in unimmunized strain 13 and F/sub 1/ guinea pigs. The nature of antigens recognized by these radiation resistant effector cells are not entirely clear. However, Ia antigens, or tumor-associated antigens dependent upon Ia antigens for immunogenicity, do not seem to be the primary targets in this phenomenon.« less

Successful disinfection of femoral head bone graft using high hydrostatic pressure.

PubMed

van de Sande, Michiel A J; Bovée, Judith V M G; van Domselaar, Mark; van Wijk, Marja J; Sanders, Ingrid; Kuijper, Ed

2017-12-20

The current standard for sterilization of potentially infected bone graft by gamma irradiation and thermal or chemical inactivation potentially deteriorates the biomechanical properties of the graft. We performed an in vitro experiment to evaluate the use of high hydrostatic pressure (HHP); which is widely used as a disinfection process in the food processing industry, to sterilize bone grafts. Four femoral heads were divided into five parts each, of which 16 were contaminated (in duplicate) with 10 5 -10 7  CFU/ml of Staphylococcus epidermidis, Bacillus cereus, or Pseudomonas aeruginosa or Candida albicans, respectively. Of each duplicate, one sample was untreated and stored similarly as the treated sample. The remaining four parts were included as sterile control and non-infected control. The 16 parts underwent HHP at the high-pressure value of 600 MPa. After HHP, serial dilutions were made and cultured on selective media and into enrichment media to recover low amounts of microorganism and spores. Three additional complete femoral heads were treated with 0, 300 and 600 MPa HHP respectively for histological evaluation. None of the negative-control bone fragments contained microorganisms. The measured colony counts in the positive-control samples correlated excellent with the expected colony count. None of the HHP treated bone fragments grew on culture plates or enrichment media. Histological examination of three untreated femoral heads showed that the bone structure remained unchanged after HHP. Sterilizing bone grafts by high hydrostatic pressure was successful and is a promising technique with the possible advantage of retaining biomechanical properties of bone tissue.

Immune Desensitization Allows Pediatric Blood Group Incompatible Kidney Transplantation.

PubMed

Stojanovic, Jelena; Adamusiak, Anna; Kessaris, Nicos; Chandak, Pankaj; Ahmed, Zubir; Sebire, Neil J; Walsh, Grainne; Jones, Helen E; Marks, Stephen D; Mamode, Nizam

2017-06-01

Blood group incompatible transplantation (ABOi) in children is rare as pretransplant conditioning remains challenging and concerns persist about the potential increased risk of rejection. We describe the results of 11 ABOi pediatric renal transplant recipients in the 2 largest centers in the United Kingdom, sharing the same tailored desensitization protocol. Patients with pretransplant titers of 1 or more in 8 received rituximab 1 month before transplant; tacrolimus and mycophenolate mofetil were started 1 week before surgery. Antibody removal was performed to reduce titers to 1 or less in 8 on the day of the operation. No routine postoperative antibody removal was performed. Death-censored graft survival at last follow-up was 100% in the ABOi and 98% in 50 compatible pediatric transplants. One patient developed grade 2A rejection successfully treated with antithymocyte globulin. Another patient had a titer rise of 2 dilutions treated with 1 immunoadsorption session. There was no histological evidence of rejection in the other 9 patients. One patient developed cytomegalovirus and BK and 2 others EBV and BK viremia. Tailored desensitization in pediatric blood group incompatible kidney transplantation results in excellent outcomes with graft survival and rejection rates comparable with compatible transplants.

Penile Inversion Vaginoplasty with or without Additional Full-Thickness Skin Graft: To Graft or Not to Graft?

PubMed

Buncamper, Marlon E; van der Sluis, Wouter B; de Vries, Max; Witte, Birgit I; Bouman, Mark-Bram; Mullender, Margriet G

2017-03-01

Penile inversion vaginoplasty is considered to be the gold standard for gender reassignment surgery in transgender women. The use of additional full-thickness skin graft as neovaginal lining is controversial. Some believe that having extra penile skin for the vulva gives better aesthetic results. Others believe that it gives inferior functional results because of insensitivity and skin graft contraction. Transgender women undergoing penile inversion vaginoplasty were studied prospectively. The option to add full-thickness skin graft is offered in patients where the penile skin length lies between 7 and 12 cm. Neovaginal depth was measured at surgery and during follow-up (3, 13, 26, and 52 weeks postoperatively). Satisfaction with the aesthetic result, neovaginal depth, and dilation regimen during follow-up were recorded. Satisfaction, sexual function, and genital self-image were assessed using questionnaires. A total of 100 patients were included (32 with and 68 without additional full-thickness skin graft). Patient-reported aesthetic outcome, overall satisfaction with the neovagina, sexual function, and genital self-image were not significantly associated with surgical technique. The mean intraoperative neovaginal depth was 13.8 ± 1.4 cm. After 1 year, this was 11.5 ± 2.5 cm. The largest decline (-15 percent) in depth is observed in the first 3 postoperative weeks (p < 0.01). The authors can confirm neither of the suggested arguments, for or against full-thickness skin graft use, in penile inversion vaginoplasty. The additional use of full-thickness skin graft does not influence neovaginal shrinkage, nor does it affect the patient- and physician-reported aesthetic or functional outcome. Therapeutic, IV.

Longitudinal trajectory of sexual functioning after hematopoietic cell transplantation: impact of chronic graft-versus-host disease and total body irradiation

PubMed Central

Wong, F. Lennie; Francisco, Liton; Togawa, Kayo; Kim, Heeyoung; Bosworth, Alysia; Atencio, Liezl; Hanby, Cara; Grant, Marcia; Kandeel, Fouad; Forman, Stephen J.

2013-01-01

This prospective study described the trajectory of sexual well-being from before hematopoietic cell transplantation (HCT) to 3 years after in 131 allogeneic and 146 autologous HCT recipients using Derogatis Interview for Sexual Function and Derogatis Global Sexual Satisfaction Index. Sixty-one percent of men and 37% of women were sexually active pre-HCT; the prevalence declined to 51% (P = .01) in men and increased to 48% (P = .02) in women at 3 years post-HCT. After HCT, sexual satisfaction declined in both sexes (P < .001). All sexual function domains were worse in women compared with men (P ≤ .001). Orgasm (P = .002) and drive/relationship (P < .001) declined in men, but sexual cognition/fantasy (P = .01) and sexual behavior/experience (P = .01) improved in women. Older age negatively impacted sexual function post-HCT in both sexes (P < .01). Chronic graft-versus-host disease was associated with lower sexual cognition/fantasy (P = .003) and orgasm (P = .006) in men and sexual arousal (P = .05) and sexual satisfaction (P = .005) in women. All male sexual function domains declined after total body irradiation (P < .05). This study identifies vulnerable subpopulations that could benefit from interventional strategies to improve sexual well-being. PMID:24159171

Treatment of aggressive multiple myeloma by high-dose chemotherapy and total body irradiation followed by blood stem cells autologous graft

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fermand, J.P.; Levy, Y.; Gerota, J.

1989-01-01

Eight patients with stage III aggressive multiple myeloma, refractory to current chemotherapy in six cases, were treated by high-dose chemotherapy (nitrosourea, etoposide, and melphalan) (HDC) and total body irradiation (TBI), followed by autografting with blood stem cells. These cells were previously collected by leukapheresis performed during hematologic recovery following cytotoxic drug-induced bone marrow aplasia. Seven patients were alive 9 to 17 months after HDC-TBI and graft. One died at day 40 from cerebral bleeding. All living patients achieved a 90% or greater reduction in tumor mass. In two cases, a complete remission (CR) has persisted at a follow-up of 15more » and 16 months. Three patients have been well and off therapy with stable minimal residual disease (RD) since 10, 11, and 17 months, respectively. A patient in apparent CR and another with RD have relapsed 9 to 12 months posttreatment. Autologous blood-derived hematopoietic stem cells induced successful and sustained engraftment in all living patients. These results, although still preliminary, indicate that HDC and TBI, followed by blood stem cells autograft, which has both practical and theoretical interest over allogeneic or autologous bone marrow transplantation, deserve consideration in selected patients with multiple myeloma.« less

Grafting in Arabidopsis.

PubMed

Bainbridge, Katherine; Bennett, Tom; Crisp, Peter; Leyser, Ottoline; Turnbull, Colin

2014-01-01

Grafting provides a simple way to generate chimeric plants with regions of different genotypes and thus to assess the cell autonomy of gene action. The technique of grafting has been widely used in other species, but in Arabidopsis, its small size makes the process rather more demanding. However, there are now several well-established grafting procedures available, which we described here, and their use has already contributed greatly to understanding of such processes as shoot branching control, flowering, disease resistance, and systemic silencing.

Effects of LED phototherapy on bone defects grafted with MTA, bone morphogenetic proteins, and guided bone regeneration in a rodent model: a description of the bone repair by light microscopy

NASA Astrophysics Data System (ADS)

Pinheiro, Antonio Luiz B.; Aciole, Gilberth T. S.; Soares, Luiz G. P.; Correia, Neandder A.; N. dos Santos, Jean

2011-03-01

We carried out a histological analysis on surgical bone defects grafted or not with MTA, treated or not with LED, BMPs and GBR. We have used several models to assess the effects of laser on bone. Benefits of the isolated or combined use them on bone healing has been suggested. There is no previous report on their association with LED light. 90 rats were divided into 10 groups. On Groups II and I the defect were filled with the clot. On Group II, were further irradiated. On groups III-VI, defect was filled with MTA + Collagen gel (III); animals of group IV were further irradiated. On groups V and VI, the defects filled with the MTA were covered with a membrane. Animals of Group VI were further irradiated. On Groups VII and VIII a pool of BMPs was added to the MTA and was further irradiated. On groups IX and X, the MTA + BMP graft was covered with a membrane. On group X, the defect was further irradiated. LED (λ850 +/- 10nm, 150mW, A= 0.5cm2, 54s, 0.3W/cm2, 16 J/cm2) was applied at 48 h intervals during 15 days. Specimens were taken, processed, cut and stained with H&E and Sirius red and underwent histological analysis. The results showed that MTA seemed not being affected by LED light. However, its use positively affected healing around the graft. It is concluded that MTA is not affected by the LED light due to it characteristics, but beneficial results with LED usage was found.

Gum Graft Surgery

MedlinePlus

... gum line and reduce sensitivity. What are the benefits of gum graft surgery? A gum graft can ... improve function or esthetics, patients often receive the benefits of both: a beautiful new smile and improved ...

Skin grafts: a rural general surgical perspective.

PubMed

Henderson, Nigel J; Fancourt, Michael; Gilkison, William; Kyle, Stephen; Mosquera, Damien

2009-05-01

Skin grafts are a common method of closing skin defects. The literature comparing methods of graft application and subsequent outcomes is poor, but reports indicate a graft failure rate between 2 and 30%. The aim of this study was to audit our current skin graft practice. Data were collected prospectively on all skin grafts performed by the general surgical department between 1st December 2005 and 1st December 2006. A standardized proforma on each patient included data on age, gender, graft indication, application method, comorbidities, length of stay, and graft outcomes including graft take at 1, 2 and 6 weeks post-operatively. There were 85 grafts performed on 74 patients, median age 72 years (9-102 years), with 10 (12%) acute admissions. Prophylactic antibiotics were given to 50% (38 of 74) of patients. Successful grafts (>80% take) were performed in 68 (80%) patients. The overall graft complication rate was 24.7% (22 of 85 grafts). Infection occurred in 13 of 17 graft failures. No patients underwent re-operation for graft failure. Patients who received prophylactic antibiotics had a reduced risk of graft failure (Fisher's exact test, P = 0.016). Skin grafts were performed successfully in the majority of patients. Graft complication and failure rates compare well with the world literature. The use of prophylactic antibiotics was the only predictor of successful graft take.

Preventive effect of ultraviolet radiation on murine chronic sclerodermatous graft-versus-host disease.

PubMed

Mermet, Isabelle; Kleinclauss, François; Marandin, Aliette; Guérrini, Jean Sébastien; Angonin, Régis; Tiberghien, Pierre; Saas, Philippe; Aubin, François

2007-12-27

Although previous studies have demonstrated the efficient modulatory effects of ultraviolet radiation B (UVB) on cutaneous graft-versus-host disease (GVHD), most animal research on GVHD has been performed in murine models of acute GVHD. Here, we studied the preventive effect of UVB radiation on the occurrence of chronic sclerodermatous (Scl) GVHD in a murine model. Scl GVHD was induced by transplanting lethally irradiated BALB/c mice with B10.D2 bone marrow and spleen cells. Recipient mice were exposed to UVB before or after bone marrow and spleen cell infusion. Histological and clinical evaluation of GVHD was performed, in association with the characterization of epidermal Langerhans cells. UVB irradiation of recipients after, and more remarkably before, transplantation induced a decrease of Scl GVHD severity associated with epidermal Langerhans cells depletion. We conclude that UVB irradiation of recipient before or after transplantation has a preventive effect on cutaneous Scl GVHD and may represent an effective strategy for prevention of Scl GVHD.

Microwave induced synthesis of graft copolymer of binary vinyl monomer mixtures onto delignified Grewia optiva fiber: application in dye removal

PubMed Central

Gupta, Vinod Kumar; Pathania, Deepak; Priya, Bhanu; Singha, Amar Singh; Sharma, Gaurav

2014-01-01

Grafting method, through microwave radiation technique is very effective in terms of time consumption, cost effectiveness and environmental friendliness. Via this method, delignified Grewia optiva identified as a waste biomass, was graft copolymerized with methylmethacrylate (MMA) as an principal monomer in a binary mixture of ethyl methacrylate (EMA) and ethyl acrylate (EA) under microwave irradiation (MWR) using ascorbic acid/H2O2 as an initiator system. The concentration of the comonomer was optimized to maximize the graft yield with respect to the primary monomer. Maximum graft yield (86.32%) was found for dGo-poly(MMA-co-EA) binary mixture as compared to other synthesized copolymer. The experimental results inferred that the optimal concentrations for the comonomers to the optimized primary monomer was observed to be 3.19 mol/L × 10−1 for EMA and 2.76 mol/L × 10−1 for EA. Delignified and graft copolymerized fiber were subjected to evaluation of physicochemical properties such as swelling behavior and chemical resistance. The synthesized graft copolymers were characterized with Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), thermogravimetric analysis (TGA) and X-ray diffraction techniques. Thermal stability of dGo-poly(MMA-co-EA) was found to be more as compared to the delignified Grewia optiva fiber and other graft copolymers. Although the grafting technique was found to decrease percentage crystallinity and crystallinity index among the graft copolymers but there was significant increase in their acid/base and thermal resistance properties. The grafted samples have been explored for the adsorption of hazardous methylene dye from aqueous system. PMID:25157348

Vein Graft Preservation Solutions, Patency, and Outcomes After Coronary Artery Bypass Graft Surgery

PubMed Central

Harskamp, Ralf E.; Alexander, John H.; Schulte, Phillip J.; Brophy, Colleen M.; Mack, Michael J.; Peterson, Eric D.; Williams, Judson B.; Gibson, C. Michael; Califf, Robert M.; Kouchoukos, Nicholas T.; Harrington, Robert A.; Ferguson, T. Bruce; Lopes, Renato D.

2015-01-01

IMPORTANCE In vitro and animal model data suggest that intraoperative preservation solutions may influence endothelial function and vein graft failure (VGF) after coronary artery bypass graft (CABG) surgery. Clinical studies to validate these findings are lacking. OBJECTIVE To evaluate the effect of vein graft preservation solutions on VGF and clinical outcomes in patients undergoing CABG surgery. DESIGN, SETTING, AND PARTICIPANTS Data from the Project of Ex-Vivo Vein Graft Engineering via Transfection IV (PREVENT IV) study, a phase 3, multicenter, randomized, double-blind, placebo-controlled trial that enrolled 3014 patients at 107 US sites from August 1, 2002, through October 22, 2003, were used. Eligibility criteria for the trial included CABG surgery for coronary artery disease with at least 2 planned vein grafts. INTERVENTIONS Preservation of vein grafts in saline, blood, or buffered saline solutions. MAIN OUTCOMES AND MEASURES One-year angiographic VGF and 5-year rates of death, myocardial infarction, and subsequent revascularization. RESULTS Most patients had grafts preserved in saline (1339 [44.4%]), followed by blood (971 [32.2%]) and buffered saline (507 [16.8%]). Baseline characteristics were similar among groups. One-year VGF rates were much lower in the buffered saline group than in the saline group (patient-level odds ratio [OR], 0.59 [95% CI, 0.45-0.78; P < .001]; graft-level OR, 0.63 [95% CI, 0.49-0.79; P < .001]) or the blood group (patient-level OR, 0.62 [95% CI, 0.46-0.83; P = .001]; graft-level OR, 0.63 [95% CI, 0.48-0.81; P < .001]). Use of buffered saline solution also tended to be associated with a lower 5-year risk for death, myocardial infarction, or subsequent revascularization compared with saline (hazard ratio, 0.81 [95% CI, 0.64-1.02; P = .08]) and blood (0.81 [0.63-1.03; P = .09]) solutions. CONCLUSIONS AND RELEVANCE Patients undergoing CABG whose vein grafts were preserved in a buffered saline solution had lower VGF rates and trends

Skin graft - slideshow

MedlinePlus

... this page: //medlineplus.gov/ency/presentations/100100.htm Skin graft - series—Normal anatomy To use the sharing features ... entire body, and acts as a protective barrier. Skin grafts may be recommended for: Extensive wounds Burns Specific ...

Post-transplant increased levels of serum sCD30 is a marker for prediction of kidney allograft loss in a 5-year prospective study.

PubMed

Delgado, Julio C; Pavlov, Igor Y; Shihab, Fuad S

2009-12-01

Levels of sCD30 represent a biomarker for early outcome in kidney transplantation. The purpose of this study was to determine the role of sCD30 levels for prediction of graft loss in the late post-transplant period. Sera were collected immediately pre-transplant and yearly thereafter for up to 5-year post-transplant in 37 primary renal transplant recipients. Levels of serum sCD30 were tested using a fluorescent microsphere assay. Levels of sCD30 significantly decreased after transplantation and remained normal in 34 patients without graft loss up to 5-year post-transplant. Elevated levels of serum sCD30 preceded the increase of serum creatinine in patients with subsequent graft loss. Elevated levels of serum sCD30 post-transplant might be a marker for predicting subsequent graft loss in the post-transplant period.

Upper limb grafts for hemodialysis access.

PubMed

Shemesh, David; Goldin, Ilya; Verstandig, Anthony; Berelowitz, Daniel; Zaghal, Ibrahim; Olsha, Oded

2015-01-01

Arteriovenous (AV) grafts are required for hemodialysis access when options for native fistulas have been fully exhausted, where they continue to play an important role in hemodialysis patients, offering a better alternative to central vein catheters. When planning autogenous accesses using Doppler ultrasound, adequate arterial inflow and venous outflow must be consciously preserved for future access creation with grafts. Efforts to improve graft patency include changing graft configuration, graft biology and hemodynamics. Industry offers early cannulation grafts to reduce central catheter use and a bioengineered graft is undergoing clinical studies. Although the outcome of AV grafts is inferior to fistulas, grafts can provide long-term hemodialysis access that is a better alternative to central venous catheters. AV grafts have significant drawbacks, mainly poor patency, infection and cost but also have some advantages: early maturation, ease of creation and needling and widespread availability. The outcome of AV graft surgery is variable from center to center. The primary patency rate for AV grafts is 58% at 6 months and the secondary patency rate is 76% at 6 months and 55% at 18 months. There are centers of excellence that report a 1 year secondary patency rate of up to 91%. In this review of the use of AV grafts for hemodialysis access in the upper extremities, technical issues involved in planning the access and performing the surgery in its different configurations are discussed and the role of surveillance and maintenance with their attendant surgical and radiological interventions is described.

Xenon Treatment Protects Against Cold Ischemia Associated Delayed Graft Function and Prolongs Graft Survival in Rats

PubMed Central

Zhao, H; Watts, H R; Chong, M; Huang, H; Tralau-Stewart, C; Maxwell, P H; Maze, M; George, A J T; Ma, D

2013-01-01

Prolonged hypothermic storage causes ischemia-reperfusion injury (IRI) in the renal graft, which is considered to contribute to the occurrence of the delayed graft function (DGF) and chronic graft failure. Strategies are required to protect the graft and to prolong renal graft survival. We demonstrated that xenon exposure to human proximal tubular cells (HK-2) led to activation of range of protective proteins. Xenon treatment prior to or after hypothermia–hypoxia challenge stabilized the HK-2 cellular structure, diminished cytoplasmic translocation of high-mobility group box (HMGB) 1 and suppressed NF-κB activation. In the syngeneic Lewis-to-Lewis rat model of kidney transplantation, xenon exposure to donors before graft retrieval or to recipients after engraftment decreased caspase-3 expression, localized HMGB-1 within nuclei and prevented TLR-4/NF-κB activation in tubular cells; serum pro-inflammatory cytokines IL-1β, IL-6 and TNF-α were reduced and renal function was preserved. Xenon treatment of graft donors or of recipients prolonged renal graft survival following IRI in both Lewis-to-Lewis isografts and Fischer-to-Lewis allografts. Xenon induced cell survival or graft functional recovery was abolished by HIF-1α siRNA. Our data suggest that xenon treatment attenuates DGF and enhances graft survival. This approach could be translated into clinical practice leading to a considerable improvement in long-term graft survival. PMID:23710625

Growth in children following irradiation for bone marrow transplantation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bushhouse, S.; Ramsay, N.K.; Pescovitz, O.H.

Longitudinal height data from 46 pediatric bone marrow transplant (BMT) patients, including 18 with aplastic anemia (AA), 19 with acute nonlymphoblastic leukemia (ANLL), and 9 with acute lymphoblastic leukemia (ALL), were analyzed to assess growth posttransplantation. Patients were prepared for BMT with high-dose cyclophosphamide followed by 7.5 Gy single-dose irradiation; AA patients received total lymphoid irradiation (TLI), and leukemia patients received total body irradiation (TBI). AA patients demonstrated reduced height posttransplant as reflected in a negative mean standard deviation score. The observed reduction was statistically significant only at 3 years following transplant. In contrast, leukemia patients showed a significant lossmore » in relative height that was first visible at 1 year post-BMT and continued until at least 4 years post-BMT. Mean growth velocities in the leukemia patients were significantly below median for the 3 years following transplant. With a median follow-up of 4 years, antithymocyte globulin plus steroids in combination with methotrexate as graft vs. host prophylaxis was associated with less severe growth suppression than methotrexate alone, while there were no significant associations between growth during the first 2 years following transplant and prepubertal status at transplant (as defined by age), graft vs. host disease, thyroid or gonadal function, or previous therapies received by the leukemia patients. Children undergoing marrow transplantation, particularly those receiving TBI, are at significant risk of subsequent growth suppression.« less

A new grafting technique for tympanoplasty: tympanoplasty with a boomerang-shaped chondroperichondrial graft (TwBSCPG).

PubMed

Dündar, Rıza; Soy, Fatih Kemal; Kulduk, Erkan; Muluk, Nuray Bayar; Cingi, Cemal

2014-10-01

The aim of this study was to introduce a new grafting technique in tympanoplasty that involves use of a boomerang-shaped chondroperichondrial graft (BSCPG). The anatomical and functional results were evaluated. A new tympanoplasty with boomerang-shaped chondroperichondrial graft (TwBSCPG) technique was used in 99 chronic otitis media patients with central or marginal perforation of the tympanic membrane and a normal middle ear mucosa. All 99 patients received chondroperichondrial cartilage grafts with a boomerang-shaped cartilage island left at the anterior and inferior parts. Postoperative follow-ups were conducted at months 1, 6, and 12. Preoperative and postoperative audiological examinations were performed and air-bone gaps were calculated according to the pure-tone averages (PTAs) of the patients. In the preoperative period, most (83.8%) air-bone gaps were ≥ 16 dB; after operating using the TwBSCPG technique, the air-bone gaps decreased to 0-10 dB in most patients (77.8%). In the TwBSCPG patients, the mean preoperative air-bone gap was 22.02 ± 6.74 dB SPL. Postoperatively, the mean postoperative air-bone gap was 8.70 ± 5.74 dB SPL. The TwBSCPG technique therefore decreased the postoperative air-bone gap compared to that preoperatively (p = 0.000, z = -8.645). At the 1-month follow-up, there were six graft perforations and one graft retraction. At the 6-month follow-up, there were nine graft perforations and three graft retractions. At 12 months, there were seven graft perforations and four graft retractions. During the first year after the boomerang tympanoplasty surgery, graft lateralization was not detected in any patient. Retractions were grade 1 according to the Sade classification and were localized to the postero-superior quadrant of the tympanic membrane. The TwBSCPG technique has benefits with respect to postoperative anatomical and audiological results. It prevents perforation of the tympanic membrane at the anterior quadrant and avoids graft

Adolescent External Iliac Artery Trauma: Recurrent Aneurysmal Dilatation of an Iliofemoral Saphenous Vein Graft Treated by Stent-Grafting

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lenton, James, E-mail: jlenton@doctors.org.u; Davies, John; Homer-Vanniasinkam, S.

An adolescent male sustained a severe penetrating injury to the external iliac artery. Emergency surgical revascularization was with a reversed long saphenous vein interposition graft. The primary graft and the subsequent revision graft both became aneurysmal. The second graft aneurysm was successfully excluded by endovascular stent-grafts with medium-term primary patency. A venous graft was used initially rather than a synthetic graft to reduce the risk of infection and the potential problems from future growth. Aneurysmal dilatation of venous grafts in children and adolescents is a rare but recognized complication. To the best of our knowledge, exclusion of these aneurysms withmore » stent-grafts has not been previously reported in the adolescent population.« less

Compliance Study of Endovascular Stent Grafts Incorporated with Polyester and Polyurethane Graft Materials in both Stented and Unstented Zones

PubMed Central

Guan, Ying; Wang, Lu; Lin, Jing; King, Martin W.

2016-01-01

Compliance mismatch between stent graft and host artery may induce complications and blood flow disorders. However, few studies have been reported on stent graft compliance. This study aims to explore the deformation and compliance of stent graft in stented and unstented zones under three pressure ranges. Compliance of two stent grafts incorporated with polyurethane graft (nitinol-PU) and polyester graft (nitinol-PET) materials respectively were tested; the stents used in the two stent grafts were identical. For the circumferential deformation of the stent grafts under each pressure range, the nitinol-PET stent graft was uniform in both zones. The nitinol-PU stent graft was circumferentially uniform in the stented zone, however, it was nonuniform in the unstented zone. The compliance of the PU graft material was 15 times higher than that of the PET graft. No significant difference in compliance was observed between stented and unstented zones of the nitinol-PET stent graft regardless of the applied pressure range. However, for the nitinol-PU stent graft, compliance of the unstented PU region was approximately twice that of the stented region; thus, compliance along the length of the nitinol-PU stent graft was not constant and different from that of the nitinol-PET stent graft. PMID:28773781

Xenon treatment protects against cold ischemia associated delayed graft function and prolongs graft survival in rats.

PubMed

Zhao, H; Watts, H R; Chong, M; Huang, H; Tralau-Stewart, C; Maxwell, P H; Maze, M; George, A J T; Ma, D

2013-08-01

Prolonged hypothermic storage causes ischemia-reperfusion injury (IRI) in the renal graft, which is considered to contribute to the occurrence of the delayed graft function (DGF) and chronic graft failure. Strategies are required to protect the graft and to prolong renal graft survival. We demonstrated that xenon exposure to human proximal tubular cells (HK-2) led to activation of range of protective proteins. Xenon treatment prior to or after hypothermia-hypoxia challenge stabilized the HK-2 cellular structure, diminished cytoplasmic translocation of high-mobility group box (HMGB) 1 and suppressed NF-κB activation. In the syngeneic Lewis-to-Lewis rat model of kidney transplantation, xenon exposure to donors before graft retrieval or to recipients after engraftment decreased caspase-3 expression, localized HMGB-1 within nuclei and prevented TLR-4/NF-κB activation in tubular cells; serum pro-inflammatory cytokines IL-1β, IL-6 and TNF-α were reduced and renal function was preserved. Xenon treatment of graft donors or of recipients prolonged renal graft survival following IRI in both Lewis-to-Lewis isografts and Fischer-to-Lewis allografts. Xenon induced cell survival or graft functional recovery was abolished by HIF-1α siRNA. Our data suggest that xenon treatment attenuates DGF and enhances graft survival. This approach could be translated into clinical practice leading to a considerable improvement in long-term graft survival. © Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.

Similar Outcomes in Diabetes Patients After Coronary Artery Bypass Grafting With Single Internal Thoracic Artery Plus Radial Artery Grafting and Bilateral Internal Thoracic Artery Grafting.

PubMed

Raza, Sajjad; Blackstone, Eugene H; Houghtaling, Penny L; Koprivanac, Marijan; Ravichandren, Kirthi; Javadikasgari, Hoda; Bakaeen, Faisal G; Svensson, Lars G; Sabik, Joseph F

2017-12-01

The purpose of this study was to determine in patients with diabetes mellitus whether single internal thoracic artery (SITA) plus radial artery (RA) grafting yields outcomes similar to those of bilateral internal thoracic artery (BITA) grafting. From January 1994 to January 2011, 1,325 diabetic patients underwent primary isolated coronary artery bypass graft surgery with either (1) SITA plus RA with or without saphenous vein (SV) grafts (n = 965) or (2) BITA with or without SV grafts (n = 360); an internal thoracic artery was used in all patients to graft the left anterior descending coronary artery. Endpoints were in-hospital outcomes and time-related mortality. Median follow-up was 7.4 years, with a total follow-up of 9,162 patient-years. Propensity score matching was performed to identify 282 well-matched pairs for adjusted comparisons. Unadjusted in-hospital mortality was 0.52% for SITA plus RA with or without SV grafts and 0.28% for BITA with or without SV grafts, and prevalence of deep sternal wound infection was 3.2% and 1.7%, respectively. Unadjusted survival at 1, 5, 10, and 14 years was 97%, 88%, 68%, and 51% for SITA plus RA with or without SV grafts, and 97%, 95%, 80%, and 66% for BITA with or without SV grafts, respectively. Among propensity-matched patients, in-hospital mortality (0.35% versus 0.35%) and prevalence of deep sternal wound infection (1.4% versus 1.4%) were similar (p > 0.9) in the two groups, as was 1-, 5-, 10-, and 14-year survival: 97%, 90%, 70%, and 58% for SITA plus RA with or without SV grafting versus 97%, 93%, 79%, and 64% for BITA with or without SV grafting, respectively (early p = 0.8, late p = 0.2). For diabetic patients, SITA plus RA with or without SV grafting and BITA with or without SV grafting yield similar in-hospital outcomes and long-term survival after coronary artery bypass graft surgery. Therefore, both SITA plus RA and BITA plus SV grafting should be considered for these patients. Copyright © 2017 The Society

Donor Indocyanine Green Clearance Test Predicts Graft Quality and Early Graft Prognosis After Liver Transplantation.

PubMed

Tang, Yunhua; Han, Ming; Chen, Maogen; Wang, Xiaoping; Ji, Fei; Zhao, Qiang; Zhang, Zhiheng; Ju, Weiqiang; Wang, Dongping; Guo, Zhiyong; He, Xiaoshun

2017-11-01

Transplantation centers have given much attention to donor availability. However, no reliable quantitative methods have been employed to accurately assess graft quality before transplantation. Here, we report that the indocyanine green (ICG) clearance test is a valuable index for liver grafts. We performed the ICG clearance test on 90 brain-dead donors within 6 h before organ procurement between March 2015 and November 2016. We also analyzed the relationship between graft liver function and early graft survival after liver transplantation (LT). Our results suggest that the ICG retention rate at 15 min (ICGR15) of donors before procurement was independently associated with 3-month graft survival after LT. The best donor ICGR15 cutoff value was 11.0%/min, and we observed a significant increase in 3-month graft failure among patients with a donor ICGR15 above this value. On the other hand, a donor ICGR15 value of ≤ 11.0%/min could be used as an early assessment index of graft quality because it provides additional information to the transplant surgeon or organ procurement organization members who must maintain or improve organ function to adapt the LT. An ICG clearance test before liver procurement might be an effective quantitative method to predict graft availability and improve early graft prognosis after LT.

Graft selection strategy in adult-to-adult living donor liver transplantation: When both hemiliver grafts meet volumetric criteria.

PubMed

Kurihara, Takeshi; Yoshizumi, Tomoharu; Yoshida, Yoshihiro; Ikegami, Toru; Itoh, Shinji; Harimoto, Norifumi; Ninomiya, Mizuki; Uchiyama, Hideaki; Okabe, Hirohisa; Kimura, Koichi; Kawanaka, Hirofumi; Shirabe, Ken; Maehara, Yoshihiko

2016-07-01

To ensure donor safety in living donor liver transplantation (LDLT), the left and caudate lobe (LL) is the preferred graft choice. However, patient prognosis may still be poor even if graft volume (GV) selection criteria are met. Our aim was to evaluate the effects of right lobe (RL) donation when the LL graft selection criteria are met. Consecutive donors (n = 135) with preoperative LL graft volumetric GV/standard liver volume (SLV) of ≥35% and RL remnant of ≥35% were retrospectively studied. Patients were divided into 2 groups: LL graft and RL graft. Recipient's body surface area (BSA), Model for End-Stage Liver Disease (MELD) score, and the donor's age were higher in the RL group. The donor's BSA and preoperative volumetric GV/SLV of the LL graft were smaller in the RL group. The predicted score (calculated using data for graft size, donor age, MELD score, and the presence of portosystemic shunt, which correlated well with graft function and with 6-month graft survival) of the RL group, was significantly lower if the LL graft were used, but using the actual RL graft improved the score equal to that of the LL group. Six-month and 12-month graft survival rates did not differ between the 2 groups. In patients with a poor prognosis, a larger RL graft improved the predicted score and survival was equal to that of patients who received LL grafts. In conclusion, graft selection by GV, donor age, and recipient MELD score improves outcomes in LDLT. Liver Transplantation 22 914-922 2016 AASLD. © 2016 American Association for the Study of Liver Diseases.

Segmental pancreatic allograft survival in baboons treated with combined irradiation and cyclosporine: a preliminary report

DOE Office of Scientific and Technical Information (OSTI.GOV)

du Toit, D.F.; Heydenrych, J.J.; Smit, B.

1985-04-01

The present study was undertaken to evaluate the effectiveness of cyclosporine (CS) alone, total lymphoid irradiation (TLI) alone, and CS in combination with total body irradiation (TBI) in suppressing segmental pancreatic allograft rejection in totally pancreatectomized outbred chacma baboons. The administration of CS 25 mg/kg/day and 50 mg/ kg/day resulted in mean graft survival of 21.5 days and 24.5 days, respectively. CS 85 mg/kg/day resulted in median graft survival of 9 days. There was a wide daily fluctuation of CS serum trough levels exhibited between primates receiving the same oral dose. TBI in excess of 300 rads resulted in irreversiblemore » bone marrow suppression. Modest results were achieved in recipients of TBI-76 rads (38 x 2 rads), with median graft survival of 21 days, results not different from recipients treated with CS. TLI recipients of 600 rads (150 x 4 rads) resulted in median pancreatic graft survival of 16 days. TBI together with oral CS administration exhibited no synergistic or additive effect and a single peroperative donor-specific blood transfusion did not enhance pancreatic allograft survival in this model. However, of 10 primates receiving TBI 100 rads (50 x 2 rads) and CS 25 mg/kg/day administered orally indefinitely, four remained normoglycemic for more than 60 days. TBI 100 rads (50 x 2 rads) together with oral and parenteral CS resulted in necrotizing enterocolitis in four of six recipients.« less

Separation of copper ions from iron ions using PVA-g-(acrylic acid/N-vinyl imidazole) membranes prepared by radiation-induced grafting.

PubMed

Ajji, Zaki; Ali, Ali M

2010-01-15

Acrylic acid (AAc), N-vinyl imidazole (Azol) and their binary mixtures were graft copolymerized onto poly(vinyl alcohol) membranes using gamma irradiation. The ability of the grafted membranes to separate Cu ions from Fe ions was investigated with respect to the grafting yield and the pH of the feed solution. The data showed that the diffusion of copper ions from the feed compartment to the receiver compartment depends on the grafting yield of the membranes and the pH of the feed solution. To the contrary, iron ions did not diffuse through the membranes of all grafting yields. However, a limited amount of iron ions diffused in strong acidic medium. This study shows that the prepared membranes could be considered for the separation of copper ions from iron ions. The temperature of thermal decomposition of pure PVA-g-AAc/Azol membrane, PVA-g-AAc/Azol membrane containing copper ions, and PVA-g-AAc/Azol membrane containing iron ions were determined using TGA analyzer. It was shown that the presence of Cu and Fe ions increases the decomposition temperature, and the membranes bonded with iron ions are more stable than those containing copper ions.

Recurrent Urinary Tract Infection Among Renal Transplant Recipients: Risk Factors and Long-Term Outcome.

PubMed

Tawab, Khaled Abdel; Gheith, Osama; Al Otaibi, Torki; Nampoory, Naryanam; Mansour, Hany; Halim, Medhat A; Nair, Prasad; Said, Tarek; Abdelmonem, Mohamed; El-Sayed, Ayman; Awadain, Waleed

2017-04-01

Urinary tract infection is the most common type of bacterial infection in kidney transplant procedures, with adverse effects on graft and patient survival. We aimed to evaluate the risk factors of recurrent urinary tract infection in renal transplant recipients and its impact on patient and graft survival. In a cohort of 1019 patients who were transplanted between 2000 and 2010 at Hamed Al-Essa Organ Transplant Center in Kuwait, 86% developed at least 1 episode of urinary tract infection, with only 6.2% of patients having recurrent infections. We compared patients with recurrent urinary tract infections (group 1) with those who had no recurrence (group 2) regarding their risk factors. Patients in group 1 were significantly younger than those in group 2 (34.9 ± 23 vs 42.8 ± 16 y; P < .001), with female preponderance (P < .001). The percentage of patients with thymoglobulin induction (21.5%) was significantly higher in group 1. Patients with pretransplant urologic problems experienced significantly more recurrent urinary tract infections (P < .001). Hepatitis C infections were significantly more prevalent among group 1 (10.8% vs 3.8%; P = .008). Long-term graft outcome (functioning and failed) were 78.5% and 21.5% in group 1 versus 85.1% and 13.9% in group 2 (P = .18). Patient outcomes (living and deceased donors) were 98.4% and 1.6% in group 1 versus 95.7% and 4.3% in group 2 (P = .187). Adult females, thymoglobulin induction, pretransplant urologic problems, and hepatitis C infection were the risk factors of recurrent urinary tract infection among our renal transplant patients. However, recurrence did not adversely affect graft or patient survival.

Influence of preformed donor-specific antibodies and C4d on early liver allograft function.

PubMed

Perera, M T; Silva, M A; Murphy, N; Briggs, D; Mirza, D F; Neil, D A H

2013-12-01

INTRODUCTION. The impact of preformed donor-specific antibodies (DSA) is incompletely understood in liver transplantation. The incidence and impact of preformed DSA on early post liver transplant were assessed and these were correlated with compliment fragment C4d on allograft biopsy. METHODS. Pretransplant serum from 41 consecutive liver transplant recipients (brain dead donors; DBD = 27 and cardiac death donors; DCD = 14) were tested for class-specific anti-human leukocyte antigen (HLA) and compared against donor HLA types. Liver biopsies were taken during cold storage (t-1) and post-reperfusion (t0) stained with C4d and graded for preservation-reperfusion injury (PRI). RESULTS. Of the 41 recipients, 8 (20%) had anti-HLA class I/II antibodies pretransplant, 3 (7%) were confirmed preformed DSA; classes I and II (n=1) and class I only (n=2). No biopsies showed definite evidence of antibody-mediated rejection. Graft biopsies in overall showed only mild PRI with ischemic hepatocyte C4d pattern similar in both positive and negative DSA patients. One DSA-positive (33%) compared with four DSA-negative patients (10%) had significant early graft dysfunction; severe PRI causing graft loss from primary nonfunction was seen only in DSA-negative group. Allograft biopsy of preformed DSA-positive patient demonstrated only minimal PRI; however, no identifiable cause could be attributed to graft dysfunction other than preformed DSA. CONCLUSION. Preformed DSA are present in 5-10% liver transplant recipients. There is no association between anti-HLA DSA and PRI and C4d, but preformed DSA may cause early morbidity. Larger studies on the impact of DSA with optimization of C4d techniques are required.

Biodegradability of poly(3-hydroxybutyrate) film grafted with vinyl acetate: Effect of grafting and saponification

NASA Astrophysics Data System (ADS)

Wada, Yuki; Seko, Noriaki; Nagasawa, Naotsugu; Tamada, Masao; Kasuya, Ken-ichi; Mitomo, Hiroshi

2007-06-01

Radiation-induced graft polymerization of vinyl acetate (VAc) onto poly(3-hydroxybutyrate) (PHB) film was carried out. At a degree of grafting higher than 5%, the grafted films (PHB-g-VAc) completely lost the enzymatic degradability that is characteristic of PHB due to the grafted VAc covering the surface of the PHB film. However, the biodegradability of the PHB-g-VAc films was recovered when the films were saponified in alkali solution under optimum conditions. Graft chains of the PHB-g-VAc film reacted selectively to become biodegradable polyvinyl alcohol (PVA). The biodegradability of the saponified PHB-g-VAc film increased rapidly with time.

Causes of corneal graft failure in India.

PubMed

Dandona, L; Naduvilath, T J; Janarthanan, M; Rao, G N

1998-09-01

The success of corneal grafting in visual rehabilitation of the corneal blind in India depends on survival of the grafts. Understanding the causes of graft failure may help reduce the risk of failure. We studied these causes in a series of 638 graft failures at our institution. Multivariate logistic regression analysis was used to evaluate the association of particular causes of graft failure with indications for grafting, socioeconomic status, age, sex, host corneal vascularization, donor corneal quality, and experience of surgeon. The major causes of graft failure were allograft rejection (29.2%), increased intraocular pressure (16.9%), infection excluding endophthalmitis (15.4%), and surface problems (12.7%). The odds of infection causing graft failure were significantly higher in patients of lower socioeconomic status (odds ratio 2.45, 95% CI 1.45-4.15). Surface problems as a cause of graft failure was significantly associated with grafts done for corneal scarring or for regrafts (odds ratio 3.36, 95% CI 1.80-6.30). Increased intraocular pressure as a cause of graft failure had significant association with grafts done for aphakic or pseudophakic bullous keratopathy, congenital conditions or glaucoma, or regrafts (odds ratio 2.19, 95% CI 1.25-3.84). Corneal dystrophy was the indication for grafting in 12 of the 13 cases of graft failure due to recurrence of host disease. Surface problems, increased intraocular pressure, and infection are modifiable risk factors that are more likely to cause graft failure in certain categories of patients in India. Knowledge about these associations can be helpful in looking for and aggressively treating these modifiable risk factors in the at-risk categories of corneal graft patients. This can possibly reduce the chance of graft failure.

Development of a water purifier for radioactive cesium removal from contaminated natural water by radiation-induced graft polymerization

NASA Astrophysics Data System (ADS)

Seko, Noriaki; Hoshina, Hiroyuki; Kasai, Noboru; Shibata, Takuya; Saiki, Seiichi; Ueki, Yuji

2018-02-01

Six years after the Fukushima-nuclear accident, the dissolved radioactive cesium (Cs) is now hardly detected in environmental natural waters. These natural waters are directly used as source of drinking and domestic waters in disaster-stricken areas in Fukushima. However, the possibility that some radioactive Cs adsorbed on soil or leaves will contaminate these natural waters during heavy rains or typhoon is always present. In order for the returning residents to live with peace of mind, it is important to demonstrate the safety of the domestic waters that they will use for their daily life. For this purpose, we have synthesized a material for selective removal of radioactive Cs by introducing ammonium 12-molybdophosphate (AMP) onto polyethylene nonwoven fabric through radiation-induced emulsion graft polymerization technique. Water purifiers filled with the grafted Cs adsorbent were installed in selected houses in Fukushima. The capability of the grafted adsorbent to remove Cs from domestic waters was evaluated for a whole year. The results showed that the tap water filtered through the developed water purifier contained no radioactive Cs, signifying the very effective adsorption performance of the developed grafted adsorbent. From several demonstrations, we have commercialized the water purifier named "KranCsair®". Furthermore, we have also developed a method for the mass production of the grafted nonwoven fabric. Using a 30 L grafting reactor, it was possible to produce the grafted nonwoven fabric with a suitable range of degree of grafting. When an irradiated roll of nonwoven trunk fabric with a length of 10 m and a width of 30 cm was set in the reactor filled with glycidyl methacrylate (GMA), AMP, Tween 80 monomer emulsion solution at 40 °C for 1 h, the difference of Dgs in the length and the width on roll of fabrics was negligible.

Plant grafting: insights into tissue regeneration.

PubMed

Melnyk, Charles W

2017-02-01

For millennia, people have cut and joined different plants together through a process known as grafting. The severed tissues adhere, the cells divide and the vasculature differentiates through a remarkable process of regeneration between two genetically distinct organisms as they become one. Grafting is becoming increasingly important in horticulture where it provides an efficient means for asexual propagation. Grafting also combines desirable roots and shoots to generate chimeras that are more vigorous, more pathogen resistant and more abiotic stress resistant. Thus, it presents an elegant and efficient way to improve plant productivity in vegetables and trees using traditional techniques. Despite this horticultural importance, we are only beginning to understand how plants regenerate tissues at the graft junction. By understanding grafting better, we can shed light on fundamental regeneration pathways and the basis for self/non-self recognition. We can also better understand why many plants efficiently graft whereas others cannot, with the goal of improving grafting so as to broaden the range of grafted plants to create even more desirable chimeras. Here, I review the latest findings describing how plants graft and provide insight into future directions in this emerging field.

One-pot synthesis of iniferter-bound polystyrene core nanoparticles for the controlled grafting of multilayer shells

NASA Astrophysics Data System (ADS)

Marchyk, Nataliya; Maximilien, Jacqueline; Beyazit, Selim; Haupt, Karsten; Sum Bui, Bernadette Tse

2014-02-01

A novel approach using one-pot synthesis for the production of uniform, iniferter-bound polystyrene core nanoparticles of size 30-40 nm is described. Conventional oil-in-water emulsion polymerisation of styrene and divinylbenzene, combining a hybrid initiation system (thermal and UV), triggered sequentially, was employed to form the surface-bound thiocarbamate iniferters in situ. The iniferter cores were then used as seeds for re-initiating further polymerisation by UV irradiation to produce water-compatible core-shell nanoparticles. Grafting of various shell-types is demonstrated: linear polymers of poly(N-isopropylacrylamide) brushes, crosslinked polymers bearing different surface charges and molecularly imprinted polymers. The shell thickness was readily tuned by varying the monomers' concentration and polymerisation time. Our method is straightforward and in addition, gives access to the preparation of fluorescent seeds and the possibility of grafting nanosized multiple shells. The core-shell nanoparticles were fully characterised by dynamic light scattering, transmission electron microscopy, Fourier transform infrared spectroscopy and microelemental analysis.A novel approach using one-pot synthesis for the production of uniform, iniferter-bound polystyrene core nanoparticles of size 30-40 nm is described. Conventional oil-in-water emulsion polymerisation of styrene and divinylbenzene, combining a hybrid initiation system (thermal and UV), triggered sequentially, was employed to form the surface-bound thiocarbamate iniferters in situ. The iniferter cores were then used as seeds for re-initiating further polymerisation by UV irradiation to produce water-compatible core-shell nanoparticles. Grafting of various shell-types is demonstrated: linear polymers of poly(N-isopropylacrylamide) brushes, crosslinked polymers bearing different surface charges and molecularly imprinted polymers. The shell thickness was readily tuned by varying the monomers' concentration and

Graft union formation in Douglas-fir.

Treesearch

D.L. Copes

1969-01-01

Greenhouse-grown Douglas-fir (Pseudotsuga menziesii [Mirb.] Franco) graft unions were examined between 2 and 84 days after grafting. Room temperature was maintained at 60-70 F throughout the growing season. In most respects grafts of Douglas-fir followed development patterns previously reported for spruce and pine grafts, but specific differences...

Novel Ceramic-Grafted Separator with Highly Thermal Stability for Safe Lithium-Ion Batteries.

PubMed

Jiang, Xiaoyu; Zhu, Xiaoming; Ai, Xinping; Yang, Hanxi; Cao, Yuliang

2017-08-09

The separator is a critical component of lithium-ion batteries (LIBs), which not only allows ionic transport while it prevents electrical contact between electrodes but also plays a key role for thermal safety performance of LIBs. However, commercial separators for LIBs are typically microporous polyolefin membranes that pose challenges for battery safety, due to shrinking and melting at elevated temperature. Here, we demonstrate a strategy to improve the thermal stability and electrolyte affinity of polyethylene (PE) separators. By simply grafting the vinylsilane coupling reagent on the surface of the PE separator by electron beam irradiation method and subsequent hydrolysis reaction into the Al 3+ solution, an ultrathin Al 2 O 3 layer is grafted on the surface of the porous polymer microframework without sacrificing the porous structure and increasing the thickness. The as-synthesized Al 2 O 3 ceramic-grafted separator (Al 2 O 3 -CGS) shows almost no shrinkage at 150 °C and decreases the contact angle of the conventional electrolyte compared with the bare PE separator. Notably, the full cells with the Al 2 O 3 -CGSs exhibit better cycling performance and rate capability and also provide stable open circuit voltage even at 170 °C, indicating its promising application in LIBs with high safety and energy density.

FAS grafted superhydrophobic ceramic membrane

NASA Astrophysics Data System (ADS)

Lu, Jun; Yu, Yun; Zhou, Jianer; Song, Lixin; Hu, Xingfang; Larbot, Andre

2009-08-01

The hydrophobic properties of γ-Al 2O 3 membrane have been obtained by grafting fluoroalkylsilane (FAS) on the surface of the membrane. The following grafting parameters were studied: the eroding time of the original membrane, the grafting time, the concentration of FAS solution and the multiplicity of grafting. Hydrophobicity of the membranes was characterized by contact angle (CA) measurement. The thermogravimetric analysis (TGA) was used to investigate the weight loss process (25-800 °C) of the fluoroalkylsilane grafted on Al 2O 3 powders under different grafting conditions. The morphologies of the membranes modified under different parameters were examined by field emission scanning electron microscopy (FE-SEM) and the surface roughness (Ra) was measured using white light interferometers. A needle-like structure was observed on the membrane surface after modification, which causes the change of Ra. On the results above, we speculated a model to describe the reaction between FAS and γ-Al 2O 3 membrane surface as well as the formed surface morphology.

Comparison of endothelial function of coronary artery bypass grafts in diabetic and nondiabetic patients: Which graft offers the best?

PubMed Central

Gür, Demet Özkaramanlı; Gür, Özcan; Gürkan, Selami; Cömez, Selcem; Gönültaş, Aylin; Yılmaz, Murat

2016-01-01

Objective: Diabetes associated endothelial dysfunction, which determines both long and short term graft patency, is not uniform in all coronary artery bypass surgery (CABG) grafts. Herein this study, we aimed to investigate the degree of endothelial dysfunction in diabetic radial artery (RA), internal mammarian artery (IMA) and saphenous vein (SV) grafts in vitro tissue bath system. Methods: This is a prospective experimental study. Fifteen diabetic and 15 non-diabetic patients were included to the study. A total number of 96 graft samples were collected; 16 graft samples for each graft type from both diabetic and non-diabetic patients. Arterial grafts were harvested with pedicles and SV grafts were harvested by ‘no touch’ technique. Vasodilatation response of vascular rings to carbachol, which induces nitric oxide (NO) mediated vasodilatation, was designated as the measure of endothelial function. Results: The IMA grafts had the most prominent NO mediated vasodilatation in both diabetic and non-diabetic patients, concluding a better preserved endothelial function than SV and RA. The ‘no-touch’ SV and RA grafts had similar vasodilatation responses in non-diabetic patients. In diabetic patients, on the other hand, RA grafts exhibited the least vasodilatation response (ie. worst endothelial function), even less vasodilatation than ‘no touch’ SV grafts (p<0.0001). Conclusion: Deteriorated function of RA grafts in diabetic patients, even worse than SV grafts made evident by this study, encourages the use of ‘no touch’ technique as the method of SV harvesting and more meticulous imaging of RA before its use as a graft in diabetic patients. PMID:26301347

Correlation between sinus and lung cultures in lung transplant patients with cystic fibrosis.

PubMed

Choi, Kevin J; Cheng, Tracy Z; Honeybrook, Adam L; Gray, Alice L; Snyder, Laurie D; Palmer, Scott M; Abi Hachem, Ralph; Jang, David W

2018-03-01

Lung transplantation has revolutionized the treatment of end-stage pulmonary disease due to cystic fibrosis. However, infection of the transplanted lungs can lead to serious complications, including graft failure and death. Although many of these patients have concurrent sinusitis, it is unclear whether bacteria from the sinuses can infect the allograft. This is a single-institution retrospective study of all patients who underwent lung transplantation for cystic fibrosis from 2005 to 2015 at Duke University Hospital. Pre- and posttransplant nasal and pulmonary cultures obtained via nasal endoscopy and bronchoalveolar lavage (BAL), respectively, were analyzed. A total of 141 patients underwent 144 lung transplants. Sinus cultures were available for 76 patients (12 pretransplant, 42 posttransplant, 22 both pre- and posttransplant). Pretransplant BAL cultures were available for 139 patients, and posttransplant BAL cultures were available for all patients. Pseudomonas aeruginosa (PsA) and methicillin-resistant Staphylococcus aureus (MRSA) were the most common organisms cultured. There was a significant correlation between pretransplant sinus and posttransplant BAL cultures for PsA (p = 0.003), MRSA (p = 0.013), and Burkholderia cepacia (p = 0.001). There was a high correlation between pretransplant sinus cultures and posttransplant BAL cultures for PsA, MRSA, and Burkholderia sp. This suggests that the paranasal sinuses may act as a reservoir for allograft colonization in patients with cystic fibrosis. Further studies are needed to determine whether treatment of sinusitis affects allograft colonization and transplant outcomes. © 2017 ARS-AAOA, LLC.

Novel expansion techniques for skin grafts

PubMed Central

Kadam, Dinesh

2016-01-01

The quest for skin expansion is not restricted to cover a large area alone, but to produce acceptable uniform surfaces, robust engraftment to withstand mechanical shear and infection, with a minimal donor morbidity. Ease of the technique, shorter healing period and reproducible results are essential parameters to adopt novel techniques. Significant advances seen in four fronts of autologous grafting are: (1) Dermal–epidermal graft expansion techniques, (2) epidermal graft harvests technique, (3) melanocyte-rich basal cell therapy for vitiligo and (4) robust and faster autologous cell cultures. Meek's original concept that the sum of perimeter of smaller grafts is larger than the harvested graft, and smaller the graft size, the greater is the potential for regeneration is witnessed in newer modification. Further, as graft size becomes smaller or minced, these micrografts can survive on the wound bed exudate irrespective of their dermal orientation. Expansion produced by 4 mm × 4 mm sized Meek micrografts is 10-folds, similarly 0.8 mm × 0.8 mm size micrografts produce 100-fold expansion, which becomes 700-fold with pixel grafts of 0.3 mm × 0.3 mm size. Fractional skin harvest is another new technique with 700 μ size full thickness graft. These provide instant autologous non-cultured graft to cover extensive areas with similar quality of engraftment surface as split skin grafts. Newer tools for epidermal blister graft harvest quickly, with uniform size to produce 7-fold expansions with reproducible results. In addition, donor area heals faster with minimal scar. Melanocyte-rich cell suspension is utilised in vitiligo surgery tapping the potential of hair root melanocytes. Further advances in the cell culture to reduce the cultivation time and provide stronger epidermal sheets with dermal carrier are seen in trials. PMID:27274117

Prognostic values of soluble CD30 and CD30 gene polymorphisms in heart transplantation.

PubMed

Frisaldi, Elisa; Conca, Raffaele; Magistroni, Paola; Fasano, Maria Edvige; Mazzola, Gina; Patanè, Francesco; Zingarelli, Edoardo; Dall'omo, Anna M; Brusco, Alfredo; Amoroso, Antonio

2006-04-27

Pretransplant soluble CD30 (sCD30) is a predictor of kidney graft outcome. Its status as a predictor of heart transplant (HT) outcome has not been established. We have studied this question by assessing sCD30 levels and the number of (CCAT)n repeats of the microsatellite in the CD30 promoter region, which is able alone to repress gene transcription, in the sera of 83 HT patients and 77 of their donors. sCD30 was non-significantly increased in the patients, whereas there were no differences in the CD30 microsatellite allele frequencies. A negative correlation between the number of (CCAT)n and sCD30 levels was evident in the donors. Patients with pretransplant sCD30

KIR and HLA-C Interactions Promote Differential Dendritic Cell Maturation and Is a Major Determinant of Graft Failure following Kidney Transplantation

PubMed Central

Hanvesakul, Raj; Kubal, Chandrashekhar; Moore, Jason; Neil, Desley; Cook, Mark; Ball, Simon; Briggs, David; Moss, Paul; Cockwell, Paul

2011-01-01

Background HLA-C is an important ligand for killer immunoglobulin like receptors (KIR) that regulate natural killer (NK) cell function. Based on KIR specificity HLA-C molecules are allocated into two groups, HLA-C1 or HLA-C2; HLA-C2 is more inhibiting to NK cell function than HLA-C1. We studied the clinical importance of HLA-C genotypes on the long-term graft survival of 760 kidney transplants performed at our centre utilising a population based genetic study and cell culture model to define putative mechanisms. Methods and Findings Genotyping was performed using conventional DNA PCR techniques and correlations made to clinical outcomes. We found that transplant recipients with HLA-C2 had significantly better long-term graft survival than transplant recipients with HLA-C1 (66% versus 44% at 10 years, log-rank p = 0.002, HR = 1.51, 95%CI = 1.16–1.97). In in-vitro NK and dendritic cell (DC) co-culture model we made several key observations that correlated with the population based genetic study. We observed that donor derived NK cells, on activation with IL-15, promoted differential HLA-C genotype dependent DC maturation. In NK-DC co-culture, the possession of HLA-C2 by DC was associated with anti-inflammatory cytokine production (IL-1RA/IL-6), diminished DC maturation (CD86, HLA-DR), and absent CCR7 expression. Conversely, possession of HLA-C1 by DC was associated with pro-inflammatory cytokine synthesis (TNF-α, IL-12p40/p70), enhanced DC maturation and up-regulation of CCR7 expression. By immunohistochemistry the presence of donor NK cells was confirmed in pre-transplant kidneys. Conclusions We propose that after kidney transplantation IL-15 activated donor derived NK cells interact with recipient DC with less activation of indirect allo-reactivity in HLA-C2 positive recipients than HLA-C1 positive recipients; this has implications for long-term graft survival. Early events following kidney transplantation involving NK-DC interaction via KIR and HLA

Radiation-assisted grafting of vinylidene chloride onto high-density polyethylene

NASA Astrophysics Data System (ADS)

Nagesh, N.; Dokhale, P. A.; Bhoraskar, V. N.

1999-06-01

6 MeV electrons and Co-60 icons/Journals/Common/gamma" ALT="gamma" ALIGN="TOP"/>-rays were used for grafting vinylidene chloride (VDC) onto high-density polyethylene (HDPE) samples. The HDPE samples were immersed in vinylidene chloride and irradiated either with Co-60 icons/Journals/Common/gamma" ALT="gamma" ALIGN="TOP"/>-rays or with 6 MeV electrons. In both cases, the radiation dose was varied in the range 1.25-7.5 kGy. The grafted samples were characterized by IR spectroscopy to obtain information about the chemical bonds and with the 14 MeV neutron activation analysis technique for estimating the number of chlorine atoms. The formation of stable bonds between the VDC molecules and the polymer chains could be achieved either with 6 MeV electrons or with Co-60 icons/Journals/Common/gamma" ALT="gamma" ALIGN="TOP"/>-rays. Both the number of chlorine atoms and the sample-surface conductivity increased with the radiation dose but the increases achieved with 6 MeV electrons were greater than those achieved with Co-60 icons/Journals/Common/gamma" ALT="gamma" ALIGN="TOP"/>-rays.

One Year Outcomes of 101 BeGraft Stent Grafts used as Bridging Stents in Fenestrated Endovascular Repairs.

PubMed

Spear, Rafaelle; Sobocinski, Jonathan; Hertault, Adrien; Delloye, Matthieu; Azzauiu, Richard; Fabre, Dominique; Haulon, Stéphan

2018-04-01

To evaluate the outcomes of the second generation BeGraft balloon expandable covered stent Graft System (Bentley InnoMed, Hechingen, Germany) implanted as bridging stent grafts during fenestrated endovascular aortic repair (FEVAR) of complex aneurysms. This was a single centre prospective study including all consecutive patients treated by FEVAR performed with second generation BeGraft stent grafts as bridging stents. Demographics of patients, diameter and length of the bridging stent grafts, technical success, re-interventions, occlusions, post-operative events, and imaging (Cone Beam CT and/or CT scan, and contrast enhanced ultrasound) were prospectively collected in an electronic database. Duplex ultrasound was performed before discharge and at 6 month follow-up. At 1 year, patients were evaluated clinically and by imaging (CT and ultrasound). Between November 2015 and September 2016, 39 consecutive patients (one woman) were treated with custom made fenestrated endografts (2-5 fenestrations) for complex aneurysms or type 1 endoleak after EVAR, using a variety of bridging stents including the BeGraft. All 101 BeGraft stent grafts were successfully delivered and deployed. There was no in hospital mortality. Early fenestration patency rate was 99% (96/97); the sole target vessel post-operative occlusion was secondary to a dissection of the renal artery distal to the stent. Complementary stenting was unsuccessful in recovering renal artery patency; bilateral renal stent occlusion was observed in the same patient on a CT scan performed 2 months after the procedure. He required post-operative dialysis. No additional renal impairment was observed. During follow-up (median 13 months [11-15]), all fenestrations stented with BeGraft stent grafts remained patent (95/97, 98%). One type 1b endoleak was detected and treated (2.6%). BeGraft stent grafts used as bridging stents during FEVAR are associated with favourable outcomes at 1 year follow-up. Long-term follow-up is

Bilateral internal mammary artery grafting: in situ versus Y-graft. Similar 20-year outcome.

PubMed

Di Mauro, Michele; Iacò, Angela L; Allam, Ahmed; Awadi, Mohammed O; Osman, Ahmed A; Clemente, Daniela; Calafiore, Antonio M

2016-10-01

The aim of this study was to evaluate the 20-year clinical outcome of patients undergoing coronary artery bypass grafting with bilateral internal mammary arteries (BIMAs) using two different configurations, in situ versus Y-graft. From September 1991 to December 2002, 2150 patients with multivessel coronary artery disease underwent isolated myocardial revascularization with BIMA grafting. BIMA was used as an in situ or Y-configuration in 1332 and 818 cases, respectively. A propensity score model was applied to calculate a standardized difference of ≤10% between groups (BIMA in situ vs BIMA Y-graft), and a cohort of 1468 matched patients was identified (734 in each group). Death, non-fatal myocardial infarction and the need for repeat revascularization were defined as 'major adverse cardiac events'. Late mortality was 24.3% (n = 357) [BIMA in situ vs BIMA Y-graft: 26.9% (n = 197) vs 21.8% (n = 160)]; in 11.6% (n = 170) of cases death was due to cardiac causes [11.9% (n = 87) vs 11.3% (n = 83)]. The rate of major adverse cardiac events was 37.1% (n = 545) [40.8% (n = 299) vs 33.5% (n = 246)]. The 20-year survival was 59 ± 6% and the event-free survival was 45 ± 7%. The clinical outcome of BIMA grafting is independent of surgical configuration. Y-grafting increases the flexibility of BIMA grafting and should be taken into account when a surgical strategy for myocardial revascularization needs to be planned. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Transient engraftment of syngeneic bone marrow after conditioning with high-dose cyclophosphamide and thoracoabdominal irradiation in a patient with aplastic anemia

DOE Office of Scientific and Technical Information (OSTI.GOV)

Matsue, K.; Niki, T.; Shiobara, S.

1990-01-01

We describe the clinical course of a 16 year old girl with aplastic anemia who was treated by syngeneic bone marrow transplantation. Engraftment was not obtained by simple infusion of bone marrow without immunosuppression. The patient received a high-dose cyclophosphamide and thoracoabdominal irradiation, followed by second marrow transplantation from the same donor. Incomplete but significant hematologic recovery was observed; however, marrow failure recurred 5 months after transplantation. Since donor and recipient pairs were genotypically identical, graft failure could not be attributed to immunological reactivity of recipient cells to donor non-HLA antigens. This case report implies that graft failure in somemore » cases of aplastic anemia might be mediated by inhibitory cells resistant to cyclophosphamide and irradiation.« less

Graft-versus-host disease

MedlinePlus

GVHD; Bone marrow transplant - graft-versus-host disease; Stem cell transplant - graft-versus-host disease; Allogeneic transplant - ... GVHD may occur after a bone marrow, or stem cell, transplant in which someone receives bone marrow ...

Posterior repair with perforated porcine dermal graft.

PubMed

Taylor, G Bernard; Moore, Robert D; Miklos, John R; Mattox, T Fleming

2008-01-01

To compare postoperative vaginal incision separation and healing in patients undergoing posterior repair with perforated porcine dermal grafts with those that received grafts without perforations. Secondarily, the tensile properties of the perforated and non-perforated grafts were measured and compared. This was a non-randomized retrospective cohort analysis of women with stage II or greater rectoceles who underwent posterior repair with perforated and non-perforated porcine dermal grafts (Pelvicol(TM) CR Bard Covington, GA USA). The incidence of postoperative vaginal incision separation (dehiscence) was compared. A secondary analysis to assess graft tensile strength, suture pull out strength, and flexibility after perforation was performed using standard test method TM 0133 and ASTM bending and resistance protocols. Seventeen percent of patients (21/127) who received grafts without perforations developed vaginal incision dehiscence compared to 7% (5/71) of patients who received perforated grafts (p = 0.078). Four patients with vaginal incision dehiscence with non-perforated grafts required surgical revision to facilitate healing. Neither tensile strength or suture pull out strength were significantly different between perforated and non-perforated grafts (p = 0.81, p = 0.29, respectively). There was no difference in the flexibility of the two grafts (p = 0.20). Perforated porcine dermal grafts retain their tensile properties and are associated with fewer vaginal incision dehiscences.

Emerging concepts in liver graft preservation

PubMed Central

Bejaoui, Mohamed; Pantazi, Eirini; Folch-Puy, Emma; Baptista, Pedro M; García-Gil, Agustín; Adam, René; Roselló-Catafau, Joan

2015-01-01

The urgent need to expand the donor pool in order to attend to the growing demand for liver transplantation has obliged physicians to consider the use of suboptimal liver grafts and also to redefine the preservation strategies. This review examines the different methods of liver graft preservation, focusing on the latest advances in both static cold storage and machine perfusion (MP). The new strategies for static cold storage are mainly designed to increase the fatty liver graft preservation via the supplementation of commercial organ preservation solutions with additives. In this paper we stress the importance of carrying out effective graft washout after static cold preservation, and present a detailed discussion of the future perspectives for dynamic graft preservation using MP at different temperatures (hypothermia at 4 °C, normothermia at 37 °C and subnormothermia at 20 °C-25 °C). Finally, we highlight some emerging applications of regenerative medicine in liver graft preservation. In conclusion, this review discusses the “state of the art” and future perspectives in static and dynamic liver graft preservation in order to improve graft viability. PMID:25593455

Donor Cell Composition and Reactivity Predict Risk of Acute Graft-versus-Host Disease after Allogeneic Hematopoietic Stem Cell Transplantation.

PubMed

Sairafi, Darius; Stikvoort, Arwen; Gertow, Jens; Mattsson, Jonas; Uhlin, Michael

2016-01-01

Background . Graft-versus-host disease (GVHD) is a serious complication after allogeneic hematopoietic stem cell transplantation (HSCT). We designed a functional assay for assessment of individual risk for acute GVHD. Study Design and Methods . Blood samples were collected from patients and donors before HSCT. Two groups of seven patients each were selected, one in which individuals developed acute GVHD grades II-IV and one in which none showed any clinical signs of GVHD. Peripheral blood mononuclear cells (PBMCs) isolated from donors were incubated in mixed lymphocyte cultures (MLCs) with recipient PBMCs. The cells were characterized by flow cytometry before and after MLC. Results . Samples from donors in the GVHD group contained significantly lower frequencies of naïve γδ T-cells and T-cells expressing NK-cell markers CD56 and CD94. Donor samples in this group also exhibited lower frequencies of naïve CD95 + T-cells compared to controls. After MLC, there were dissimilarities in the CD4/CD8 T-cell ratio and frequency of CD69 + T-cells between the two patient groups, with the non-GVHD group showing higher frequencies of CD8 + and CD69 + T-cells. Conclusion . We conclude that a thorough flow cytometric analysis of donor cells for phenotype and allogeneic reactivity may be of value when assessing pretransplant risk for severe acute GVHD.

A grafting from approach to graft polystyrene chains at the surface of graphene nanolayers by RAFT polymerization: Various graft densities from hydroxyl groups

NASA Astrophysics Data System (ADS)

Roghani-Mamaqani, Hossein; Khezri, Khezrollah

2016-01-01

(3-Aminopropyl) triethoxysilane was grafted at the surface of GO in low and high different graft densities to yield GOHAL and GOHAH, respectively. Subsequently, 2-(dodecylthiocarbonothioylthio)-2-methylpropionic acid (RA) was attached at the surface of GOHAL and GOHAH by an amidation reaction to yield GOHRL and GOHRH, respectively. Then, GOHRL and GOHRH were used in grafting from RAFT polymerization of styrene. Grafting of APTES and RA was approved by Fourier transform infrared spectroscopy, X-ray photo electron spectroscopy, and Raman spectroscopy. Expansion of graphene interlayer by oxidation and functionalization processes was evaluated by X-ray diffraction. Conversion values of styrene were calculated using gas chromatography. Molecular weight and PDI values of attached polystyrene (PS) chains were studied by size exclusion chromatography. Thermogravimetric analysis was also used to investigate the degradation temperatures, char contents, and graft contents of modifiers and PS chains. GOHRH and GOHRL reach to char content of 55.3 and 45.2% at 600 °C, which shows that weight ratio of modifier (APTES and RA moieties) is 15.3 and 5.2%, respectively. Scanning and transmission electron microscopies show that graphite layers with flat and smooth surface wrinkled after oxidation and turned to opaque layers by grafting PS.

Coralline hydroxyapatite bone graft substitutes.

PubMed

Elsinger, E C; Leal, L

1996-01-01

The authors present a review of the various bone grafts currently available with special attention to coral bone grafts. Several of the benefits of coralline hydroxyapatite bone graft substitutes, such as safety and biocompatibility, will be addressed in this article, part of an ongoing investigation of coral bone grafts used in triple arthrodesis procedures. To date, eight cases have been performed. In seven cases, granular chips were employed to pack the subtalar joint. The final case, presented in this article, represents a 26-year-old male who, 2 years previously, sustained a calcaneal fracture with resultant shortening along the lateral column. A coralline hydroxyapatite block was used at the calcaneocuboid joint to achieve distraction. Clinically, the patient is progressing well at 10 months postoperatively. Radiographically, one can still clearly appreciate the margins of the bone graft at 5 months.

Organosiloxane-grafted natural polymer coatings

DOEpatents

Sugama, Toshifumi

1998-01-01

A new family of polysaccharide graft polymers are provided as corrosion resistant coatings having antimicrobial properties which are useful on light metals such as aluminum, magnesium, zinc, steel and their alloys. Methods of making the polysaccharide graft polymers are also included. The methods of making the polysaccharide graft polymers involve reacting a polysaccharide source with an antimicrobial agent under conditions of hydrolysis-condensation.

Microwave-Assisted Synthesis and Physicochemical Characterization of Tetrafuranylporphyrin-Grafted Reduced-Graphene Oxide.

PubMed

Bosca, Federica; Orio, Laura; Tagliapietra, Silvia; Corazzari, Ingrid; Turci, Francesco; Martina, Katia; Pastero, Linda; Cravotto, Giancarlo; Barge, Alessandro

2016-01-26

This work describes the design of a modified porphyrin that bears four furan rings linked by 1,2-bis-(2-aminoethoxy)ethane spacers. This unit is a well-suited scaffold for a Diels-Alder reaction with commercial reduced-graphene oxide, which is also described in this paper. A new hybrid material is obtained, thanks to efficient grafting under microwave irradiation, and fully characterized in terms of structure (UV, TGA, Raman) and morphology (HR-TEM and AFM). Potential applications in photo- and sonodynamic therapy are envisaged. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Vascularized bone graft for scaphoid nonunions.

PubMed

Mih, Alexander D

2004-09-01

Scaphoid fracture nonunion remains a challenging problem that may persist despite traditional methods of bone grafting and internal fixation. The alteration of wrist mechanics created by nonunion as well as the development of avascular necrosis leads to degenerative change of the radiocarpal joint accompanied by loss of motion and pain. The use of a vascularized bone graft has the theoretical benefit of increased blood flow that exceeds that of nonvascularized grafts. Numerous sources of vascularized bone graft have been described, including those from remote sites as well as from the carpus and distal radius. Knowledge of the blood supply to the distal radius has allowed for development of several vascularized bone graft harvest sites. The results of vascularized bone grafting from the distal radius have been encouraging, with numerous authors reporting the successful treatment of scaphoid nonunions.

[Surgical overview on kidney and pancreas transplantation].

PubMed

Capocasale, Enzo; Berardinelli, Luisa; Beretta, Claudio; Berloco, Pasquale; Boggi, Ugo; Boschiero, Luigino; Bretto, Piero; Carmellini, Mario; Citterio, Franco; Concone, Giacomo; De Carlis, Luciano; De Rosa, Paride; Del Gaudio, Massimo; Di Sandro, Stefano; Di Tonno, Pasquale; Faenza, Alessandro; Famulari, Antonio; Giacomoni, Alessandro; Giovannoni, Massimo; Iaria, Maurizio; Lauterio, Andrea; Lasaponara, Fedele; Mazzoni, Maria Patrizia; Nicita, Giulio; Orsenigo, Elena; Parolini, Danilo Carlo; Pietrabissa, Andrea; Pinna, Antonio Daniele; Pisani, Franco; Ravaioli, Matteo; Rigotti, Paolo; Romagnoli, Jacopo; Rossetti, Ornella; Secchi, Antonio; Socci, Carlo; Vistoli, Fabio

2016-01-01

The main purpose of this paper, written by a group of Italian expert transplant surgeons, is to provide clinical support and to help through the decision-making process over pre-transplant surgical procedures in potential kidney recipients, as well as selection of pancreas transplant candidates and perioperative management of kidney recipient. Current topics such as different approaches in minimally invasive donor nephrectomy, methods of graft preservation and treatment of failed allograft were addressed.

Rib Bone Graft Adjusted to Fit the Facial Asymmetry: A Frame Structure Graft.

PubMed

Lee, Yoon Ho; Choi, Jong Hwan; Hwang, Kun; Choi, Jun Ho

2015-10-01

The authors introduce the concept of a "frame structure graft" in which a harvested rib bone was adjusted to fit facial asymmetry. On the costochondral junction of the sixth or seventh rib, a 5 cm incision was made. Through a subperiosteal dissection, the rib bone was harvested. Using a reciprocating saw, the harvested rib was scored on its anterior surface as well as its posterior surface with a partial depth at different intervals. The harvested rib bone was placed on the skin surface of the unaffected side of the face and a curvature was created exactly matching that of the unaffected side by bending the bone using a greenstick fracture. Thereafter, the graft was adjusted to conceal the asymmetry of the deficient side. The adjusted "frame structure" was transferred to the defect through the incisions on the affected side, and the "frame structure" graft was placed on the mandible or zygoma. The graft fixation was done externally with at least 2 Kirschner wires (K-wires). From January 2005 to August 2013, a total of 30 patients (13 men, 17 women, mean age 25.6 years) received a frame structure graft. All 30 patients achieved good healing at the operation site without complications. Donor-site morbidity as pneumothorax from the rib bone harvest was not found. Merits of this frame structure graft, the authors think, are that this method could allow a similar curvature to the normal side. In addition, the procedure itself is easy.

A comparative study on the graft copolymerization of acrylic acid onto rayon fibre by a ceric ion redox system and a γ-radiation method.

PubMed

Kaur, Inderjeet; Kumar, Raj; Sharma, Neelam

2010-10-13

Functionalization of rayon fibre has been carried out by grafting acrylic acid (AAC) both by a chemical method using a Ce(4+)-HNO(3) redox initiator and by a mutual irradiation (γ-rays) method. The reaction conditions affecting the grafting percentage have been optimized for both methods, and the results are compared. The maximum percentage of grafting (50%) by the chemical method was obtained utilizing 18.24 × 10(-3) moles/L of ceric ammonium nitrate (CAN), 39.68 × 10(-2) moles/L of HNO(3), and 104.08 × 10(-2) moles/L of AAc in 20 mL of water at 45°C for 120 min. For the radiation method, the maximum grafting percentage (60%) was higher, and the product was obtained under milder reaction conditions using a lower concentration of AAc (69.38 × 10(-2) moles/L) in 10 mL of water at an optimum total dose of 0.932 kGy. Swelling studies showed higher swelling for the grafted rayon fibre in water (854.54%) as compared to the pristine fibre (407%), while dye uptake studies revealed poor uptake of the dye (crystal violet) by the grafted fibre in comparison with the pristine fibre. The graft copolymers were characterized by IR, TGA, and scanning electron micrographic methods. Grafted fibre, prepared by the radiation-induced method, showed better thermal behaviour. Comparison of the two methods revealed that the radiation method of grafting of acrylic acid onto rayon fibre is a better method of grafting in comparison with the chemical method. Copyright © 2010 Elsevier Ltd. All rights reserved.

Biologic activity of irradiated, autologous, GM-CSF-secreting leukemia cell vaccines early after allogeneic stem cell transplantation

PubMed Central

Ho, Vincent T.; Vanneman, Matthew; Kim, Haesook; Sasada, Tetsuro; Kang, Yoon Joong; Pasek, Mildred; Cutler, Corey; Koreth, John; Alyea, Edwin; Sarantopoulos, Stefanie; Antin, Joseph H.; Ritz, Jerome; Canning, Christine; Kutok, Jeffery; Mihm, Martin C.; Dranoff, Glenn; Soiffer, Robert

2009-01-01

Through an immune-mediated graft-versus-leukemia effect, allogeneic hematopoietic stem cell transplantation (HSCT) affords durable clinical benefits for many patients with hematologic malignancies. Nonetheless, subjects with high-risk acute myeloid leukemia or advanced myelodysplasia often relapse, underscoring the need to intensify tumor immunity within this cohort. In preclinical models, allogeneic HSCT followed by vaccination with irradiated tumor cells engineered to secrete GM-CSF generates a potent antitumor effect without exacerbating the toxicities of graft-versus-host disease (GVHD). To test whether this strategy might be similarly active in humans, we conducted a Phase I clinical trial in which high-risk acute myeloid leukemia or myelodysplasia patients were immunized with irradiated, autologous, GM-CSF-secreting tumor cells early after allogeneic, nonmyeloablative HSCT. Despite the administration of a calcineurin inhibitor as prophylaxis against GVHD, vaccination elicited local and systemic reactions that were qualitatively similar to those previously observed in nontransplanted, immunized solid-tumor patients. While the frequencies of acute and chronic GVHD were not increased, 9 of 10 subjects who completed vaccination achieved durable complete remissions, with a median follow-up of 26 months (range 12–43 months). Six long-term responders showed marked decreases in the levels of soluble NKG2D ligands, and 3 demonstrated normalization of cytotoxic lymphocyte NKG2D expression as a function of treatment. Together, these results establish the safety and immunogenicity of irradiated, autologous, GM-CSF-secreting leukemia cell vaccines early after allogeneic HSCT, and raise the possibility that this combinatorial immunotherapy might potentiate graft-versus-leukemia in patients. PMID:19717467

Viability of full-thickness skin grafts used for correction of cicatricial ectropion of lower eyelid in previously irradiated field in the periocular region

PubMed Central

Kim, Hee Joon; Hayek, Brent; Nasser, Qasiem; Esmaeli, Bita

2013-01-01

Purpose To evaluate the viability of skin grafts used for correction of cicatricial ectropion resulting from previous ablative surgery and radiotherapy for head and neck cancer and to report overall outcomes of cicatricial ectropion repair. Methods This is a retrospective, non-comparative case series of all consecutive head and neck cancer patients who had been exposed to high-dose radiation therapy in their periocular region and had surgical correction of their lower eyelid cicatricial ectropion through placement of a full-thickness skin graft and a lower eyelid tightening procedure by the same surgeon. The primary outcome measure was skin graft viability. Secondary outcome measures comprised of post-operative complications, the overall outcome of ectropion repair as judged by improvement in symptoms of exposure keratopathy and dependence on lubricating eye drops and ointments, as well as cosmetic improvement measured through a grading scale determined based on the degree of inferior scleral show and/or tarsal conjunctival eversion. Results 25 patients were eligible for the study. 19 men and 6 women had a median age of 63 years (range: 20–84 years). All 25 patients had high-dose radiation therapy for their head and neck cancer. All but 1 patient had major cancer ablative surgery performed prior to radiation therapy. Thirteen of 25 patients also received chemotherapy. There was 100% viability of the skin grafts used for the repair of lower eyelid cicatricial ectropion. There were a few post-operative complications including the need for revision surgery to correct residual ectropion in the lower eyelid in 2 patients and a third patient required a revision surgery due to upper lid retraction and lagophthalmos after harvest of skin graft from the upper eyelid. Improvement was noted in the subjective symptoms in 22 of 25 patients (88%) while 17 patients (68%) were noted to have improvement in their clinical findings on slit lamp examination. All 20 patients for whom

Stent-Graft Treatment of Late Stenosis of the Left Common Carotid Artery Following Thoracic Graft Placement

DOE Office of Scientific and Technical Information (OSTI.GOV)

Medda, Massimo; Lioupis, Christos, E-mail: lioupisC@vodafone.net.gr; Mollichelli, Nadia

2008-03-15

We report the case of a patient with subtotal occlusion of the origin of the left common carotid artery (CCA) following thoracic graft placement. Retrograde endovascular placement of a stent-graft by minimal cervical access was undertaken to repair the occlusive lesion of the left CCA and prevent future complications of endoluminal thoracic reconstruction. The retrograde endovascular repair of CCA lesions, as other authors have already suggested, may be the treatment of choice in 'high-surgical-risk' patients. In these cases where the ostium of supra-aortic trunks is compromised following thoracic aorta stent-graft migration, endoluminal placement of a stent-graft in the CCA canmore » guarantee both maintenance of carotid flow and thoracic stent-graft fixation.« less

Organosiloxane-grafted natural polymer coatings

DOEpatents

Sugama, Toshifumi

1998-12-01

A new family of polysaccharide graft polymers are provided as corrosion resistant coatings having antimicrobial properties which are useful on light metals such as aluminum, magnesium, zinc, steel and their alloys. Methods of making the polysaccharide graft polymers are also included. The methods of making the polysaccharide graft polymers involve reacting a polysaccharide source with an antimicrobial agent under conditions of hydrolysis-condensation. 17 figs.

Magnesium inference screw supports early graft incorporation with inhibition of graft degradation in anterior cruciate ligament reconstruction

PubMed Central

Cheng, Pengfei; Han, Pei; Zhao, Changli; Zhang, Shaoxiang; Zhang, Xiaonong; Chai, Yimin

2016-01-01

Patients after anterior cruciate ligament (ACL) reconstruction surgery commonly encounters graft failure in the initial phase of rehabilitation. The inhibition of graft degradation is crucial for the successful reconstruction of the ACL. Here, we used biodegradable high-purity magnesium (HP Mg) screws in the rabbit model of ACL reconstruction with titanium (Ti) screws as a control and analyzed the graft degradation and screw corrosion using direct pull-out tests, microCT scanning, and histological and immunohistochemical staining. The most noteworthy finding was that tendon graft fixed by HP Mg screws exhibited biomechanical properties substantially superior to that by Ti screws and the relative area of collagen fiber at the tendon-bone interface was much larger in the Mg group, when severe graft degradation was identified in the histological analysis at 3 weeks. Semi-quantitative immunohistochemical results further elucidated that the MMP-13 expression significantly decreased surrounding HP Mg screws with relatively higher Collagen II expression. And HP Mg screws exhibited uniform corrosion behavior without displacement or loosening in the femoral tunnel. Therefore, our results demonstrated that Mg screw inhibited graft degradation and improved biomechanical properties of tendon graft during the early phase of graft healing and highlighted its potential in ACL reconstruction. PMID:27210585

Magnesium inference screw supports early graft incorporation with inhibition of graft degradation in anterior cruciate ligament reconstruction

NASA Astrophysics Data System (ADS)

Cheng, Pengfei; Han, Pei; Zhao, Changli; Zhang, Shaoxiang; Zhang, Xiaonong; Chai, Yimin

2016-05-01

Patients after anterior cruciate ligament (ACL) reconstruction surgery commonly encounters graft failure in the initial phase of rehabilitation. The inhibition of graft degradation is crucial for the successful reconstruction of the ACL. Here, we used biodegradable high-purity magnesium (HP Mg) screws in the rabbit model of ACL reconstruction with titanium (Ti) screws as a control and analyzed the graft degradation and screw corrosion using direct pull-out tests, microCT scanning, and histological and immunohistochemical staining. The most noteworthy finding was that tendon graft fixed by HP Mg screws exhibited biomechanical properties substantially superior to that by Ti screws and the relative area of collagen fiber at the tendon-bone interface was much larger in the Mg group, when severe graft degradation was identified in the histological analysis at 3 weeks. Semi-quantitative immunohistochemical results further elucidated that the MMP-13 expression significantly decreased surrounding HP Mg screws with relatively higher Collagen II expression. And HP Mg screws exhibited uniform corrosion behavior without displacement or loosening in the femoral tunnel. Therefore, our results demonstrated that Mg screw inhibited graft degradation and improved biomechanical properties of tendon graft during the early phase of graft healing and highlighted its potential in ACL reconstruction.

Developments in parallel grafts for aortic arch lesions.

PubMed

Kolvenbach, Ralf R; Rabin, Asaf; Karmeli, Ron; Alpaslan, Alper; Schwierz, Elizabeth

2016-06-01

Due to the shortage of commercially available off the shelf aortic arch grafts since the last years parallel grafts or chimney grafts have played an increasing role in the treatment of patients with aortic arch lesions. Although there are still issues with type endoleaks and gutters between the chimney graft and the aortic stent-graft remaining. We report our results with the Medtronic thoracic graft in combination with long self-expanding parallel grafts, to ensure an overlapping zone of more than 7 cm between the different grafts. Alternatively, sandwich configurations are used where a direct contact between the parallel graft and the aortic wall is avoided. We have placed a total of 65 parallel grafts into supra-aortic branches. In 21 cases chimney grafts were placed into the carotid artery, in most cases into the left common carotid artery. In 36 cases chimney grafts were placed into left subclavian artery. A maximum number of 4 parallel grafts were placed for total endovascular debranching. In addition, in 8 patients a parallel graft had to be placed into the innominate artery. There was a patency of 69% for all subclavian artery chimney grafts versus 73% for carotid artery parallel grafts. Of note is a stroke rate of 5.2% in all these cases. Only 2 of the patients with an occluded left subclavian artery chimney graft required a bypass procedure for arm claudication or ischemia. We had a primary type I endoleak rate of 28%. In almost 25% secondary interventions were required mainly to treat type I leaks, in those cases where the leak did not resolve spontaneously. The overall mortality rate was 3.5%. The results of parallel graft in the aortic arch are promising, but of major concern is still the high rate of type I endoleaks as well as the neurological complication rate, most probably due to catheter manipulation in patients with severe atherosclerotic arch lesions.

Inheritance of graft compatibility in Douglas fir.

Treesearch

D.L. Copes

1973-01-01

Graft compatibility of genetically related and unrelated rootstock-scion combinations was compared. Scion clones were 75% compatible when grafted on half-related rootstocks but only 56% compatible when grafted on unrelated rootstocks. Most variance associated with graft incompatibility in Douglas-fir appears to be caused by multiple genes.

Results of liver transplantation in patients with acute liver failure due to Amanita phalloides and paracetamol (acetaminophen) intoxication

PubMed Central

Grąt, Michał; Hołówko, Wacław; Masior, Łukasz; Wronka, Karolina M.; Grąt, Karolina; Stypułkowski, Jan; Patkowski, Waldemar; Krawczyk, Marek

2015-01-01

Introduction Amanita phalloides and paracetamol intoxications are responsible for the majority of acute liver failures. Aim To assess survival outcomes and to analyse risk factors affecting survival in the studied group. Material and methods Of 1369 liver transplantations performed in the Department of General, Transplant, and Liver Surgery, Medical University of Warsaw before December 2013, 20 (1.46%) patients with Amanita phalloides (n = 13, 0.95%) and paracetamol (n = 7, 0.51%) intoxication were selected for this retrospective study. Overall and graft survival at 5 years were set as primary outcome measures. Results Five-year overall survival after liver transplantation in the studied group was 53.57% and 53.85% in patients with paracetamol and Amanita phalloides poisoning, respectively (p = 0.816). Five-year graft survival was 26.79% for patients with paracetamol and 38.46% with Amanita phalloides intoxication (p = 0.737). Risk factors affecting patient survival were: pre-transplant bilirubin concentration (p = 0.023) and higher number of red blood cells (p = 0.013) and fresh frozen plasma (p = 0.004) transfused intraoperatively. Likewise, higher number of red blood cells (p = 0.012) and fresh frozen plasma (p = 0.007) transfused were risk factors affecting 5-year graft survival. Surprisingly, donor and recipient blood type incompatibility was neither the risk factor for 5-year overall survival (p = 0.939) nor the risk factor for 5-year graft survival (p = 0.189). Conclusions In selected intoxicated patients urgent liver transplantation is the only successful modality of treatment. Risk factors affecting survival are in correspondence with the patient's pre-transplant status (bilirubin level in serum) and intraoperative status (number of red blood cells and fresh frozen plasma transfused). PMID:27350835

Mixed donor chimerism in non-malignant haematological diseases after allogeneic bone marrow transplantation.

PubMed

Shamshad, Ghassan Umair; Ahmed, Suhaib; Bhatti, Farhat Abbas; Ali, Nadir

2012-12-01

To determine the frequency of mixed donor chimerism in patients of non-malignant haematological diseases after allogeneic bone marrow transplant. A cross-sectional, observational study. Department of Haematology, Armed Forces Institute of Pathology (AFIP), Rawalpindi, from July 2010 to June 2011. Donor chimerism was assessed in patients of aplastic anaemia and beta-thalassaemia major who underwent allogeneic bone marrow transplantation (BMT). Peripheral blood samples were used to assess chimerism status by analysis of short tandem repeats (STR). In patients where pre-transplant blood sample was not available, swab of buccal mucosa was used for pre-transplant STR profile. A standard set of primers for STR markers were used and the amplified DNA was resolved by gel electrophoresis and stained with silver nitrate. The percentage of donor origin DNA was estimated by densitometer. Out of 84 patients, 52 (62%) were males, while 32 (38%) were females. In patients of beta-thalassaemia major, 31 (62%) developed mixed donor chimerism (MC), 13 (26%) developed complete donor chimerism (CC) and 6 (12%) had graft failure. In aplastic anaemia, 17 patients (50%) achieved MC, 13 (38.2%) had CC and 4 (11.8%) developed graft failure. The combined frequency of mixed donor chimerism for both the diseases was 58.3%. D3S1358 was the most informative STR marker in these patients. Majority of the studied patients developed mixed donor chimerism following bone marrow transplantation, whereas only a minor percentage of the patients had graft failure. Analysis of D3S1358 was the most informative in assessing donor chimerism in patients who underwent BMT.

Uncontrolled non-heartbeating donors (types i-ii) with normothermic recirculation vs. heartbeating donors: evaluation of functional results and survival.

PubMed

Miranda-Utrera, N; Medina-Polo, J; Pamplona-Casamayor, M; Passas-Martínez, J B; Rodríguez-Antolín, A; de la Rosa Kehrmann, F; Duarte-Ojeda, J M; Tejido-Sánchez, A; Villacampa Aubá, F; Andrés Belmonte, A

2015-09-01

Non-heartbeating donors (NHBD) are an alternative to heartbeating donors (HBD). Our objective was to compare functional results and kidney survival from NHBDs and HBDs. A retrospective study comparing the results of 236 normothermically preserved kidneys from type i and ii type NHBDs with the results of 250 from HBDs that were transplanted in our center between 2005 and 2012. Homogeneity between groups was tested and we evaluated the presence of delayed graft function (DGF) associated with pretransplant variables of the donor and recipient. Both groups show homogeneity in pretransplant characteristics in terms of: age, HLA incompatibilities, and recipient hemodialysis time. Average follow-up time was 33 months (range 0-87) for NHBDs and 38 months (range 0-90) for HBDs. 5.5% of NHBDs showed primary non-function (PNF) vs. 4% of HBDs (P=.42) and 80.9% of DGF vs. 46.8% of HBDs (P<.001). At the end of the follow-up, there were no statistically significant differences in the survival of grafts (92.8% for NHBD vs. 93.6% for HBD, P=.71) and recipients (99.1% NHBD vs. 98.6% HBD, P=.28). Although the DGF percentage was greater for NHBDs, final creatinine as well as graft and recipient survival were similar for both groups. Therefore, in our experience, kidneys from NHBDs have similar results to those from HBDs and are an excellent source of organs for transplantation. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Cranial Bone Graft Donor Site Reconstruction.

PubMed

Çelik, Muzaffer

2017-01-01

My most important concern, in my entire experience with cranial bone grafting procedures, is managing the bone graft donor site such as donor site cavity from harvesting and weakness of the cranium. The most common patient complaint, following cranial bone grafting for aesthetic indications, is the presence of a cavity at the donor site. The authors have managed more than 200 patients since 2001, wherein the cranial bone graft-donor sites were reconstructed with tiny bone chip lamellae harvested from the area adjacent to the donor site. This procedure was associated with a low incidence of patient complaints, thereby suggesting higher patient satisfaction. This approach for cranial bone grafting appears to have a high patient acceptance.

Biofunctionalization of multiwalled carbon nanotubes by irradiation of electropolymerized poly(pyrrole-diazirine) films.

PubMed

Papper, Vladislav; Gorgy, Karine; Elouarzaki, Kamal; Sukharaharja, Ayrine; Cosnier, Serge; Marks, Robert S

2013-07-15

A photoactivatable poly(pyrrole-diazirine) film was synthesized and electropolymerized as a versatile tool for covalent binding of laccase and glucose oxidase on multiwalled carbon nanotube coatings and Pt, respectively. Irradiation of the functionalized nanotubes allowed photochemical grafting of laccase and its subsequent direct electrical wiring, as illustrated by the electrocatalytic reduction of oxygen. Moreover, covalent binding of glucose oxidase as model enzyme, achieved by UV activation of electropolymerized pyrrole-diazirine, allowed a glucose biosensor to be realized. This original method to graft biomolecules combines electrochemical and photochemical techniques. The simplicity of this new method allows it to be extended easily to other biological systems. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Radiation graft modification of EPDM rubber

NASA Astrophysics Data System (ADS)

Katbab, A. A.; Burford, R. P.; Garnett, J. L.

N-Vinyl pyrrolidone (NVP), 2-hydroxyethylmethacrylate (HEMA) and acrylamide (AAm) have been grafted to the surface of rubber vulcanizates based on ethylene-propylene-terpolymer (EPDM) using the simultaneous radiation method to alter surface properties such as wettability and therefore biocompatibility. The effect of monomer concentration, solvent and EPDM structural factors on the grafting behavior have been investigated. The inhibitory effect upon homopolymerization of various salts has also been evaluated for the three monomers. NVP and HEMA could be grafted onto EPDM rubber in the presence of aqueous solutions of cupric nitrate at 0.005 M and 1.0 M concentrations respectively. Aqueous solutions of Mohr's salt (ammonium ferrous sulphate) at 0.05 M not only suppressed the homopolymerization of AAm but also increased grafting yield. The percentage grafting also increased with increasing AAm concentration. A mechanism has been proposed to explain the behaviour of these monomers. The inclusion of multifunctional acrylates in additive amounts (1.0 vol%) enhanced the graft degree. Modified samples were able to be efficiently stained, allowing the depth of the graft copolymerization to be determined by light microscopy. Water was found to have an accelerating effect on the polymerization of these monomers, but methanol prevented their polymerization completely. The effect of EPDM structural factors upon degree of grafting was found to vary, depending upon the monomer type.

Influence of low-level laser therapy on the healing process of autogenous bone block grafts in the jaws of systemically nicotine-modified rats: A histomorphometric study.

PubMed

de Almeida, Juliano Milanezi; de Moraes, Ricardo Oliveira; Gusman, David Jonathan Rodrigues; Faleiros, Paula Lazilha; Nagata, Maria José Hitomi; Garcia, Valdir Gouveia; Theodoro, Letícia Helena; Bosco, Alvaro Francisco

2017-03-01

To analyze the influence of low-level laser therapy (LLLT) on the bone healing process of autogenous bone block grafts installed in nicotine systemically modified rats. Seventy-two rats (Wistar) were randomly assigned into 4 groups (n=18). SS-BG: saline application+bone graft. SS-BG/LLLT: saline application+bone graft+LLLT. NIC-BG: nicotine application+bone graft. NIC-BG/LLLT: nicotine application+bone graft+LLLT. After 30days of application of solutions, all animals received autogenous bone block graft in the jaw, with the donation from the parietal bone's calvarial area. Treatment with LLLT was in bed-graft interface, after accommodation of the graft. The animals in each group were sacrificed at 7, 14, and 28days after graft surgery. The histologic analyses of NIC-BG group depicted a delay of osteogenic activity in the recipient bed-graft interface and the irradiation of tissue with LLLT provided better bone healing. The histometric analysis revealed that SS-BG/LLLT and NIC-BG/LLLT groups showed increased bone formation compared to BG-SS and NIC-BG groups, after 14days (SS-BG 24.94%±13.06% versus SS-BG/LLLT 27.53%±19.07% and NIC-BG 14.27%±2.22% versus NIC-BG/LLLT 24.37%±11.93%) and 28days (SS-BG 50.31%±2.69% versus SS-BG/LLLT 58 19%±12.32% and NIC-BG 36.89%±8.40% versus NIC-BG/LLLT 45.81%±6.03%). Nicotine harms bone formation in the bed-graft interface and LLLT action can mitigate this. Copyright © 2016 Elsevier Ltd. All rights reserved.

Synthesis and characterization of polypyrrole grafted chitin

NASA Astrophysics Data System (ADS)

Ramaprasad, A. T.; Latha, D.; Rao, Vijayalakshmi

2017-05-01

Synthesis and characterization of chitin grafted with polypyrrole (PPy) is reported in this paper. Chitin is soaked in pyrrole solution of various concentrations for different time intervals and polymerized using ammonium peroxy disulphate (APS) as an initiator. Grafting percentage of polypyrrole onto chitin is calculated from weight of chitin before and after grafting. Grafting of polymer is further verified by dissolution studies. The grafted polymer samples are characterized by FTIR, UV-Vis absorption spectrum, XRD, DSC, TGA, AFM, SEM and conductivity studies.

Central nervous system transplantation benefited by low-level laser irradiation

NASA Astrophysics Data System (ADS)

Rochkind, S.; Lubart, Rachel; Wollman, Yoram; Simantov, Rabi; Nissan, Moshe; Barr-Nea, Lilian

1990-06-01

Effect of low-level laser irradiation on the central nervous system transplantation is reported. Ernbryonal brain allografts were transplanted into the brain of 20 adult rats and peripheral nerve graft transplanted into the severely injured spinal cord of 16 dogs. The operated wound of 10 rats and 8 dogs were exposed daily for 21 days to lowpower laser irradiation CW HeNe laser (35 mW, 632.8 run, energy density of 30 J/cm2 at each point for rats and 70 J/cm2 at each point for dogs). This study shows that (i) the low-level laser irradiation prevents extensive glial scar formation (a limiting factor in CNS regeneration) between embryonal transplants and host brain; (ii) Dogs made paraplegic by spinal cord injury were able to walk 3-6 months later. Recovery of these dogs was effected by the implantation of a fragment of autologous sciatic nerve at the site of injury and subsequently exposing the dogs to low-level laser irradiation. The effect of laser irradiation on the embryonal nerve cells grown in tissue culture was also observed. We found that low-level laser irradiation induced intensive migration of neurites outward of the aggregates 15-22 The results of the present study and our previous investigations suggest that low-level laser irradiation is a novel tool for treatment of peripheral and central nervous system injuries.

Graft failure after allogeneic hematopoietic stem cell transplantation.

PubMed

Ozdemir, Zehra Narli; Civriz Bozdağ, Sinem

2018-04-18

Graft failure is a serious complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT) defined as either lack of initial engraftment of donor cells (primary graft failure) or loss of donor cells after initial engraftment (secondary graft failure). Successful transplantation depends on the formation of engrafment, in which donor cells are integrated into the recipient's cell population. In this paper, we distinguish two different entities, graft failure (GF) and poor graft function (PGF), and review the current comprehensions of the interactions between the immune and hematopoietic compartments in these conditions. Factors associated with graft failure include histocompatibility locus antigen (HLA)-mismatched grafts, underlying disease, type of conditioning regimen and stem cell source employed, low stem cell dose, ex vivo T-cell depletion, major ABO incompatibility, female donor grafts for male recipients, disease status at transplantation. Although several approaches have been developed which aimed to prevent graft rejection, establish successful engraftment and treat graft failure, GF remains a major obstacle to the success of allo-HSCT. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) still remains to be the curative treatment option for various non-malignant and malignant hematopoietic diseases. The outcome of allo-HSCT primarily depends on the engraftment of the graft. Graft failure (GF), is a life-threatening complication which needs the preferential therapeutic manipulation. In this paper, we focused on the definitions of graft failure / poor graft function and also we reviewed the current understanding of the pathophysiology, risk factors and treatment approaches for these entities. Copyright © 2018. Published by Elsevier Ltd.

Immunoregulation of GVHD by triggering the innate immune system with CpG.

PubMed

Morecki, Shoshana; Slavin, Shimon

2009-08-01

Stimulation of Toll-like receptors by oligodeoxynucleotide sequences containing a CpG motif provides signals capable of triggering the innate and adaptive immune systems, thereby leading either to stimulation or suppression of immunoreactivities. Similar immunoregulatory capabilities are necessary for achieving the fine balance between engraftment and graft-versus-host disease required in the setup of allogeneic cell therapy. Ligation of CpG to its Toll-like receptors can be accomplished by treatment of the host or pretransplant treatment of the donor in vivo. These different strategies are presented in this review, which summarizes the attempts to maximize beneficial alloreactivity against malignant or other undesirable host cells, while controlling graft-versus-host disease.

Elaboration of nano-structured grafted polymeric surface.

PubMed

Vrlinic, Tjasa; Debarnot, Dominique; Mozetic, Miran; Vesel, Alenka; Kovac, Janez; Coudreuse, Arnaud; Legeay, Gilbert; Poncin-Epaillard, Fabienne

2011-10-15

The surface grafting of multi-polymeric materials can be achieved by grafting as components such as polymers poly(N-isopropylacrylamide) and/or surfactant molecules (hexatrimethylammonium bromide, polyoxyethylene sorbitan monolaurate). The chosen grafting techniques, i.e. plasma activation followed by coating, allow a large spectrum of functional groups that can be inserted on the surface controlling the surface properties like adhesion, wettability and biocompatibility. The grafted polypropylene surfaces were characterized by contact angle analyses, XPS and AFM analyses. The influence of He plasma activation, of the coating parameters such as concentrations of the various reactive agents are discussed in terms of hydrophilic character, chemical composition and morphologic surface heterogeneity. The plasma pre-activation was shown inevitable for a permanent polymeric grafting. PNIPAM was grafted alone or with a mixture of the surfactant molecules. Depending on the individual proportion of each component, the grafted surfaces are shown homogeneous or composed of small domains of one component leading to a nano-structuration of the grafted surface. Copyright © 2011 Elsevier Inc. All rights reserved.

Facile synthesis of a conjugation-grafted-TiO2 nanohybrid with enhanced visible-light photocatalytic properties from nanotube titanic acid precursors

NASA Astrophysics Data System (ADS)

Guo, Yanru; Zhang, Min; Zhang, Zhihua; Li, Qiuye; Yang, Jianjun

2016-08-01

A conjugation-grafted-TiO2 nanohybrid was synthesized by chemically grafting conjugated structures on the surface of nanotube titanic acid (NTA) precursor-based TiO2 through the controlled thermal degradation of a coacervated polymer layer of polyvinyl alcohol (PVA). The interfacial interactions between the NTA precursor-based TiO2 and conjugated structures were characterized using Fourier transform infrared spectroscopy and X-ray photoelectron spectroscopy. Moreover, the effects of the NTA's pretreatment temperature and the weight ratio of NTA to PVA on the photocatalytic degradation of methyl orange were also investigated. A higher NTA pretreatment temperature and a lower NTA to PVA weight ratio were found to enhance photogenerated electron-hole separation efficiency and photocatalytic activity. Moreover, the conjugation-grafted-TiO2 nanohybrid synthesized from the NTA precursor displayed a much higher visible-light photocatalytic activity than that of the sample obtained from the P25 precursor. The origin of the enhanced photocatalytic activity under visible-light irradiation is also discussed in detail.

PRFM enhance wound healing process in skin graft.

PubMed

Reksodiputro, Mirta; Widodo, Dini; Bashiruddin, Jenny; Siregar, Nurjati; Malik, Safarina

2014-12-01

Facial plastic and reconstructive surgery often used skin graft on defects that cannot be covered primarily by a local flap. However, wound healing using skin graft is slow, most of the time the graft is contractured and the take of graft is not optimal. Platelet rich fibrin matrix (PRFM) is a new generation of concentrated platelets that produce natural fibrin and reported to speed up the healing process. Application of PRFM in the skin graft implants is expected to increase the survival of the graft. We used porcine as animal models to elucidate the effect of autologous PRFM on wound healing in full-thickness (FTSG) and split-thickness (STSG) skin grafts. Survival level of the skin graft was determined by using ImageJ software based on the formation of collagen type 1 and graft take. We observed that the use of PRFM in FTSG and STSG increased type 1 collagen formation. We also found that PRFM addition in STSG gave the best skin graft take. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Design and development of multilayer vascular graft

NASA Astrophysics Data System (ADS)

Madhavan, Krishna

2011-07-01

Vascular graft is a widely-used medical device for the treatment of vascular diseases such as atherosclerosis and aneurysm as well as for the use of vascular access and pediatric shunt, which are major causes of mortality and morbidity in this world. Dysfunction of vascular grafts often occurs, particularly for grafts with diameter less than 6mm, and is associated with the design of graft materials. Mechanical strength, compliance, permeability, endothelialization and availability are issues of most concern for vascular graft materials. To address these issues, we have designed a biodegradable, compliant graft made of hybrid multilayer by combining an intimal equivalent, electrospun heparin-impregnated poly-epsilon-caprolactone nanofibers, with a medial equivalent, a crosslinked collagen-chitosan-based gel scaffold. The intimal equivalent is designed to build mechanical strength and stability suitable for in vivo grafting and to prevent thrombosis. The medial equivalent is designed to serve as a scaffold for the activity of the smooth muscle cells important for vascular healing and regeneration. Our results have shown that genipin is a biocompatible crosslinker to enhance the mechanical properties of collagen-chitosan based scaffolds, and the degradation time and the activity of smooth muscle cells in the scaffold can be modulated by the crosslinking degree. For vascular grafting and regeneration in vivo, an important design parameter of the hybrid multilayer is the interface adhesion between the intimal and medial equivalents. With diametrically opposite affinities to water, delamination of the two layers occurs. Physical or chemical modification techniques were thus used to enhance the adhesion. Microscopic examination and graft-relevant functional characterizations have been performed to evaluate these techniques. Results from characterization of microstructure and functional properties, including burst strength, compliance, water permeability and suture

The treatment of peripheral nerve injuries using irradiated allografts and temporary host immunosuppression (in a rat model)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Easterling, K.J.; Trumble, T.E.

1990-10-01

Irradiation of allografts prior to transplantation and host immunosuppression with cyclosporin-A were studied separately and in combination as means of lessening the rejection of transplanted peripheral nerve tissue. Lewis and Brown Norway rats were used in the animal model, as they differ at both major and minor histocompatibility loci. Sciatic nerve grafts (2.5 cm) were used and the animals were followed for 16 weeks after nerve grafting. The outcome was studied by functional measurements (sensory testing, gait analysis, joint flexion contracture, and muscle weight), as well as by measurements of biochemical and histologic parameters (hydroxyproline concentration and axon counts, respectively).more » Sensory testing was not reliable because of crossover innervation by the saphenous nerve. Evaluation by standard gait-testing techniques was found to be unsatisfactory. However, the allografted animals receiving cyclosporin-A had significantly smaller flexion contractures, compared to the allografted animals without immunosuppression (17 degrees +/- 12 degrees vs. 44 degrees +/- 13 degrees and 51 degrees +/- 13 degrees, p less than 0.005). Allografted animals receiving short-term cyclosporin-A had contractures that were not significantly different from those seen in isografted control animals (17 degrees +/- 12 degrees vs. 22 degrees +/- 15 degrees, NS). Muscle hydroxyproline concentration analysis revealed a lower hydroxyproline concentration among the allografted groups that received irradiated allografts, compared to groups receiving nonirradiated allogeneic grafts. The studies of muscle hydroxyproline concentration and muscle weight both showed substantial reinnervation, even in allografted animals without pretreatment of the grafts or immunosuppression of the recipient animal.« less

Half-peroneus-longus-tendon graft augmentation for unqualified hamstring tendon graft of anterior cruciate ligament reconstruction.

PubMed

Liu, Chung-Ting; Lu, Yung-Chang; Huang, Chang-Hung

2015-09-01

In some situations, harvested hamstring tendon grafts are not qualified for anterior cruciate ligament (ACL) reconstruction. This study aimed to present a reinforcing method with additional half peroneus longus tendon (half-PLT) graft augmentation. Eight cases underwent ACL reconstruction with unqualified hamstring tendon grafts (diameter <7 mm) and were salvaged by additional half-PLT graft augmentation. The pivot shift test and KT-1000 tests were performed 3 years after surgery. Functional evaluation of subjective International Knee Documentation Committee (IKDC) and Lysholm scores was also done. In addition, Foot and Ankle Disability Index (FADI) scores were used to evaluate the function of the ankle donor site. The diameter of unqualified four-strand hamstring tendon grafts was 6.2 mm on average (range, 6.0-6.5 mm). The average diameter of hamstring grafts with half-PLT augmentation was 9.6 mm (range, 9.5-10.0 mm). The pivot shift test was negative in all patients. No significant differences between normal and abnormal knees were found by KT-1000. The average IKDC score was 86.0 (range, 83 to 89), and the average Lysholm score was 84.4 (range, 80-90). The average FADI score for the donor sites of half-PLT was 135.8 (range, 134-136). Additional half-PLT can successfully and safely reinforce unqualified hamstring tendon grafts for ACL reconstruction.

Simultaneous pancreas and kidney transplantation for liver transplant recipients with diabetes and uremia.

PubMed

Tam, Ngalei; Zhang, Chuanzhao; Lin, Jianwei; Wu, Chenglin; Deng, Ronghai; Liao, Bing; Hu, Shuiqing; Wang, Dongping; Zhu, Xiaofeng; Wu, Linwei; He, Xiaoshun

2015-06-01

Chronic kidney disease (CKD) has become a critical problem due to immunosuppressant related nephrotoxicity in liver transplant (LTx) recipients, especially in patients with pre-transplant risk factors. LTx recipients with uraemia and diabetes have poor prognosis even when treated with dialysis and insulin. Simultaneous pancreas and kidney transplantation (SPK) has been proven to be an effective treatment for patients with diabetic uraemia, but rarely performed in patients after LTx. Two cases of SPK after LTx were performed in our centre and we present our experience here. Two patients received LTx because of HBV related liver cirrhosis; both of them had pre-transplant diabetes mellitus (DM), which worsened after the administration of immunosuppressive drugs. These two patients suffered from CKD and developed uraemia due to diabetic nephropathy and immunosuppressive drugs induced renal toxicity years after LTx. They relied on dialysis and insulin injection. SPK were performed years after LTx and the clinical data was retrospectively analyzed. SPK was successfully performed in these two patients. Pancreatic fluid drainage was achieved via a side-to-side duodenojejunostomy into the proximal jejunum. No serious surgical complications, including pancreatitis or pancreatic fistula were observed postoperatively. In both cases, kidney and pancreatic grafts were functioning well as evidenced by euglycemia without the need for insulin injections and normal serum-creatinine level 7days after the operation. One of the patients presented with renal graft impairment 1week after the operation. FK506 was tapered and rapamycin was used when the renal graft biopsy indicated drug toxicity. The patient's kidney graft function recovered gradually after the adjustment. Both patients have good function of liver, kidney and pancreas grafts during a 60-month and 30-month period of follow up. SPK could serve as an effective option for patients with diabetes and uremia after LTx

Maximal blood flow acceleration analysis in the early diastolic phase for aortocoronary artery bypass grafts: a new transit-time flow measurement predictor of graft failure following coronary artery bypass grafting.

PubMed

Handa, Takemi; Orihashi, Kazumasa; Nishimori, Hideaki; Yamamoto, Masaki

2016-11-01

Maximal graft flow acceleration (max df/dt) determined using transit-time flowmetry (TTFM) in the diastolic phase was assessed as a potential predictor of graft failure for aortocoronary artery (AC) bypass grafts in coronary artery bypass patients. Max df/dt was retrospectively measured in 114 aortocoronary artery bypass grafts. TTFM data were fitted to a 9-polynomial curve, which was derived from the first-derivative curve, to measure max df/dt (9-polynomial max df/dt). Abnormal TTFM was defined as a mean flow of <15 ml/min, a pulsatility index of >5 or a diastolic filling ratio of <50 %. Postoperative assessments were routinely performed by coronary artery angiography (CAG) at 1 year after surgery. Using TTFM, 68 grafts were normal, 4 of which were failing on CAG, and 46 grafts were abnormal, 21 of which were failing on CAG. 9-polynomial max df/dt was significantly lower in abnormal TTFM/failing by the CAG group compared with abnormal TTFM/patent by the CAG group (1.08 ± 0.89 vs. 2.05 ± 1.51 ml/s(2), respectively; P < 0.01, Mann-Whitney U test, Holm adjustment). TTFM 9-polynomial max df/dt in the early diastolic phase may be a promising predictor of future graft failure for AC bypass grafts, particularly in abnormal TTFM grafts.

Physical properties of agave cellulose graft polymethyl methacrylate

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rosli, Noor Afizah; Ahmad, Ishak; Abdullah, Ibrahim

2013-11-27

The grafting polymerization of methyl methacrylate and Agave cellulose was prepared and their structural analysis and morphology were investigated. The grafting reaction was carried out in an aqueous medium using ceric ammonium nitrate as an initiator. The structural analysis of the graft copolymers was carried out by Fourier transform infrared and X-ray diffraction. The graft copolymers were also characterized by field emission scanning electron microscopy (FESEM). An additional peak at 1732 cm{sup −1} which was attributed to the C=O of ester stretching vibration of poly(methyl methacrylate), appeared in the spectrum of grafted Agave cellulose. A slight decrease of crystallinity indexmore » upon grafting was found from 0.74 to 0.68 for cellulose and grafted Agave cellulose, respectively. Another evidence of grafting showed in the FESEM observation, where the surface of the grafted cellulose was found to be roughed than the raw one.« less

The effect of graft strength on knee laxity and graft in-situ forces after posterior cruciate ligament reconstruction.

PubMed

Lai, Yu-Shu; Chen, Wen-Chuan; Huang, Chang-Hung; Cheng, Cheng-Kung; Chan, Kam-Kong; Chang, Ting-Kuo

2015-01-01

Surgical reconstruction is generally recommended for posterior cruciate ligament (PCL) injuries; however, the use of grafts is still a controversial problem. In this study, a three-dimensional finite element model of the human tibiofemoral joint with articular cartilage layers, menisci, and four main ligaments was constructed to investigate the effects of graft strengths on knee kinematics and in-situ forces of PCL grafts. Nine different graft strengths with stiffness ranging from 0% (PCL rupture) to 200%, in increments of 25%, of an intact PCL's strength were used to simulate the PCL reconstruction. A 100 N posterior tibial drawer load was applied to the knee joint at full extension. Results revealed that the maximum posterior translation of the PCL rupture model (0% stiffness) was 6.77 mm in the medial compartment, which resulted in tibial internal rotation of about 3.01°. After PCL reconstruction with any graft strength, the laxity of the medial tibial compartment was noticeably improved. Tibial translation and rotation were similar to the intact knee after PCL reconstruction with graft strengths ranging from 75% to 125% of an intact PCL. When the graft's strength surpassed 150%, the medial tibia moved forward and external tibial rotation greatly increased. The in-situ forces generated in the PCL grafts ranged from 13.15 N to 75.82 N, depending on the stiffness. In conclusion, the strength of PCL grafts have has a noticeable effect on anterior-posterior translation of the medial tibial compartment and its in-situ force. Similar kinematic response may happen in the models when the PCL graft's strength lies between 75% and 125% of an intact PCL.

Enhancement of the grafting performance and of the water absorption of cassava starch graft copolymer by gamma radiation

NASA Astrophysics Data System (ADS)

Kiatkamjornwong, Suda; Meechai, Nispa

1997-06-01

Enhancement of the gamma radiation grafting of acrylonitrile onto gelatinized cassava starch was investigated. Infrared spectrometry was used to follow the chemical changes in the grafting reaction and from saponification. The saponified starch- g-PAN (HSPAN) was then characterized in terms of grafting parameters to provide a guide for the optimum total dose (kGy) and the appropriate ratio of starch/acrylonitrile for a fixed dose rate of 2.5 × 10 -1 kGy/min. Other dose rates were also carried out to obtain the appropriate result of grafting copolymerization and of water absorption. A thin aluminium foil, covering the inner wall of the reaction vessel, was found to be far more effective than any other metal films in the enhancement of the grafting reaction and the water absorption as well. Nitric acid in the medium increases the grafting yield and the water absorption. Methyl ether hydroquinone inhibitor was evaluated for its ability to increase homopolymerization and decrease graft reaction. When styrene was used as a comonomer, it hampered the grafting of acrylonitrile onto starch backbone. The water absorption capacity was improved by freeze-drying the HSPAN. The treatment of the HSPAN with aluminium trichloride hexahydrate was found to enhance the degree of wicking, but to decrease the water absorbency.

Bypass grafting to the anterior tibial artery.

PubMed

Armour, R H

1976-01-01

Four patients with severe ischaemia of a leg due to atherosclerotic occlusion of the tibial and peroneal arteries had reversed long saphenous vein grafts to the patent lower part of the anterior tibial artery. Two of these grafts continue to function 19 and 24 months after operation respectively. One graft failed on the fifth postoperative day and another occluded 4 months after operation. The literature on femorotibial grafting has been reviewed. The early failure rate of distal grafting is higher than in the case of femoropopliteal bypass, but a number of otherwise doomed limbs can be salvaged. Contrary to widely held views, grafting to the anterior tibial artery appears to give results comparable to those obtained when the lower anastomosis is made to the posterior tibial artery.

Hydrogen, a potential safeguard for graft-versus-host disease and graft ischemia-reperfusion injury?

PubMed Central

Yuan, Lijuan; Shen, Jianliang

2016-01-01

Post-transplant complications such as graft-versus-host disease and graft ischemia-reperfusion injury are crucial challenges in transplantation. Hydrogen can act as a potential antioxidant, playing a preventive role against post-transplant complications in animal models of multiple organ transplantation. Herein, the authors review the current literature regarding the effects of hydrogen on graft ischemia-reperfusion injury and graft-versus-host disease. Existing data on the effects of hydrogen on ischemia-reperfusion injury related to organ transplantation are specifically reviewed and coupled with further suggestions for future work. The reviewed studies showed that hydrogen (inhaled or dissolved in saline) improved the outcomes of organ transplantation by decreasing oxidative stress and inflammation at both the transplanted organ and the systemic levels. In conclusion, a substantial body of experimental evidence suggests that hydrogen can significantly alleviate transplantation-related ischemia-reperfusion injury and have a therapeutic effect on graft-versus-host disease, mainly via inhibition of inflammatory cytokine secretion and reduction of oxidative stress through several underlying mechanisms. Further animal experiments and preliminary human clinical trials will lay the foundation for hydrogen use as a drug in the clinic. PMID:27652837

Autologous patch graft in tube shunt surgery.

PubMed

Aslanides, I M; Spaeth, G L; Schmidt, C M; Lanzl, I M; Gandham, S B

1999-10-01

To evaluate an alternate method of covering the subconjunctival portion of the tube in aqueous shunt surgery. Evidence of tube erosion, graft-related infection, graft melting, or other associated intraocular complications were evaluated. A retrospective study of 16 patients (17 eyes) who underwent tube shunt surgery at Wills Eye Hospital between July 1991 and October 1996 was conducted. An autologous either "free" or "rotating" scleral lamellar graft was created to cover the subconjunctival portion of the tube shunt. All patients were evaluated for at least 6 months, with a mean follow-up of 14.8 months (range 6-62 months). All eyes tolerated the autologous graft well, with no clinical evidence of tube erosion, or graft-related or intraocular complications. Autologous patch graft in tube shunt surgery appears--in selected cases--to be an effective, safe and inexpensive surgical alternative to allogenic graft materials. It also offers ease of availability, and eliminates the risk of transmitting infectious disease.

Fabrication of TiO2-modified polytetrafluoroethylene ultrafiltration membranes via plasma-enhanced surface graft pretreatment

NASA Astrophysics Data System (ADS)

Qian, Yingjia; Chi, Lina; Zhou, Weili; Yu, Zhenjiang; Zhang, Zhongzhi; Zhang, Zhenjia; Jiang, Zheng

2016-01-01

Surface hydrophilic modification of polymer ultrafiltration membrane using metal oxide represents an effective yet highly challenging solution to improve water flux and antifouling performance. Via plasma-enhanced graft of poly acryl acid (PAA) prior to coating TiO2, we successfully fixed TiO2 functional thin layer on super hydrophobic polytetrafluoroethylene (PTFE) ultrafiltration (UF) membranes. The characterization results evidenced TiO2 attached on the PTFE-based UF membranes through the chelating bidentate coordination between surface-grafted carboxyl group and Ti4+. The TiO2 surface modification may greatly reduce the water contact angle from 115.8° of the PTFE membrane to 35.0° without degradation in 30-day continuous filtration operations. The novel TiO2/PAA/PTFE membranes also exhibited excellent antifouling and self-cleaning performance due to the intrinsic hydrophilicity and photocatalysis properties of TiO2, which was further confirmed by the photo-degradation of MB under Xe lamp irradiation.

Radioprotection provides functional mechanics but delays healing of irradiated tendon allografts after ACL reconstruction in sheep.

PubMed

Seto, Aaron U; Culp, Brian M; Gatt, Charles J; Dunn, Michael

2013-12-01

Successful protection of tissue properties against ionizing radiation effects could allow its use for terminal sterilization of musculoskeletal allografts. In this study we functionally evaluate Achilles tendon allografts processed with a previously developed radioprotective treatment based on (1-ethyl-3-(3-dimethylaminopropyl)carbodiimide) crosslinking and free radical scavenging using ascorbate and riboflavin, for ovine anterior cruciate ligament reconstruction. Arthroscopic anterior cruciate ligament (ACL) reconstruction was performed using double looped allografts, while comparing radioprotected irradiated and fresh frozen allografts after 12 and 24 weeks post-implantation, and to control irradiated grafts after 12 weeks. Radioprotection was successful at preserving early subfailure mechanical properties comparable to fresh frozen allografts. Twelve week graft stiffness and anterior-tibial (A-T) translation for radioprotected and fresh frozen allografts were comparable at 30 % of native stiffness, and 4.6 and 5 times native A-T translation, respectively. Fresh frozen allograft possessed the greatest 24 week peak load at 840 N and stiffness at 177 N/mm. Histological evidence suggested a delay in tendon to bone healing for radioprotected allografts, which was reflected in mechanical properties. There was no evidence that radioprotective treatment inhibited intra-articular graft healing. This specific radioprotective method cannot be recommended for ACL reconstruction allografts, and data suggest that future efforts to improve allograft sterilization procedures should focus on modifying or eliminating the pre-crosslinking procedure.

Bovine and PTFE vascular graft results in hemodialysis patients.

PubMed

Sert, S; Demirogullari, B; Ziya Anadol, A; Guvence, N; Dalgic, A

2000-01-01

Purpose. There are many reports of patency periods, failure rates, thrombosis and infection attacks connected with vascular grafts. In this article, the results of polytetrafluoroethylene (PTFE) and Bovine grafts were compared in a forty-four month period. Methods. 61 vascular grafts (29 PTFE, 32 bovine) were placed in 49 patients. The grafts were compared in different ways, such as survival, complication rates and placement area using life survey analysis. Results. Mean survival time was 17 mo (SE +/- 2.8) for PTFE grafts and 11 mo (SE +/- 1.1) for bovine grafts. A failure rate of 34% due only to graft complications were found in PTFE and 25% in bovine grafts. All graft complications were seen in the first year. Comparison of the cumulative survival rates of the groups were found to be insignificant during the study period and the first year ( p>0.05). Regardless of the type, there was no signif-icant difference between the grafts placed in the forearm and the grafts in the thigh (p>0.05). Conclusions. There is no survival difference between PTFE and bovine grafts. First year of the grafts is important for developing complications.

Pretransplant nutritional habits and clinical outcome in children undergoing hematopoietic stem cell transplant.

PubMed

Tavil, Betul; Koksal, Eda; Yalcin, S Songul; Uckan, Duygu

2012-02-01

This study sought to investigate the effects of pretransplant nutrient content, nutritional status, and nutritional habits on the clinical outcome of children undergoing hematopoietic stem cell transplant. Forty-one children were enrolled in this study. Dietary assessment was based on a semiquantitative food frequency questionnaire, consisting of 47 food items (including all commonly used prebiotic and probiotic foods in the Turkish cuisine), for the last week before hematopoietic stem cell transplant and a 24-hour dietary recall on admission. Thirteen girls (31.7%) and 28 boys (68.3%) comprised the study group. Of the 41 children, 5 (12.2%) were classified as underweight; 12.2% at risk of being underweight; 53.6% healthy weight; 9.8% overweight; and 12.2% obese. Nutritional status of the children had no effect on the complication rate, duration of febrile neutropenia, and the day of neutrophil and platelet engraftment. Correlation analysis revealed that there was a negative correlation between the day of neutrophil engraftment and the amount of soluble fiber, iron, breast milk, bazlama (a traditional yeast bread), and bulgur consumption. A negative correlation was detected between the number of febrile neutropenia episodes and the amount of yogurt and onion intake. Increased intake of parsley and onion was associated with reduced duration of total parenteral nutrition. The amount of parsley consumption was found to be lower in patients who experienced transplant-related complications. The nutrient contents and nutritional habits of the patients may affect the course of transplant. It might be recommended that "let them eat yogurt, bazlama, bulgur, onion, and parsley."

Cadaveric aorta implantation for aortic graft infection.

PubMed

Ali, Asad; Bahia, Sandeep S S; Ali, Tahir

2016-01-01

This case report describes a 73-year-old gentleman who underwent explantation of an infected prosthetic aorto-iliac graft and replacement with a cryopreserved thoracic and aorto-iliac allograft. The patient has been followed up a for more than a year after surgery and remains well. After elective tube graft repair of his abdominal aortic aneurysm (AAA) in 2003, he presented to our unit in 2012 in cardiac arrest as a result of a rupture of the distal graft suture line due to infection. After resuscitation he underwent aorto-bifemoral grafting using a cuff of the original aortic graft proximally. Distally the new graft was anastomosed to his common femoral arteries, with gentamicin beads left in situ. Post discharge the patient was kept under close surveillance with serial investigations including nuclear scanning, however it became apparent that his new graft was infected and that he would require aortic graft replacement, an operation with a mortality of at least 50%. The patient underwent the operation and findings confirmed a synthetic graft infection. This tube graft was explanted and a cryopreserved aorta was used to the refashion the abdominal aorta and its bifurcation. The operation required a return to theatre day one post operatively for a bleeding side branch, which was repaired. The patient went on to make a full recovery stepping down from the intensive therapy unit day 6 post operatively and went on to be discharged 32 days after his cryopreserved aorta implantation. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Corneal graft reversal: Histopathologic report of two cases

PubMed Central

Qahtani, Abdullah A.; Alkatan, Hind M.

2014-01-01

Graft reversal is a rare cause for failed PKP. In this case report we are presenting 2 graft failure cases in which the corneal grafts were reversed unintentionally. The onset of signs of graft failure, however was variable. We have included their clinical course and the histopathologic findings of the removed corneal grafts. A total of 6 cases including ours have been reported so far. The aim of this report is to attract the attention of corneal surgeons to an additional rare cause for failed penetrating keratoplasty (PKP) which is donor graft reversal. PMID:25473355

Corneal graft reversal: Histopathologic report of two cases.

PubMed

Qahtani, Abdullah A; Alkatan, Hind M

2014-10-01

Graft reversal is a rare cause for failed PKP. In this case report we are presenting 2 graft failure cases in which the corneal grafts were reversed unintentionally. The onset of signs of graft failure, however was variable. We have included their clinical course and the histopathologic findings of the removed corneal grafts. A total of 6 cases including ours have been reported so far. The aim of this report is to attract the attention of corneal surgeons to an additional rare cause for failed penetrating keratoplasty (PKP) which is donor graft reversal.

The role of plant hormones during grafting.

PubMed

Nanda, Amrit K; Melnyk, Charles W

2018-01-01

For millennia, people have cut and joined different plant tissues together through a process known as grafting. By creating a chimeric organism, desirable properties from two plants combine to enhance disease resistance, abiotic stress tolerance, vigour or facilitate the asexual propagation of plants. In addition, grafting has been extremely informative in science for studying and identifying the long-distance movement of molecules. Despite its increasing use in horticulture and science, how plants undertake the process of grafting remains elusive. Here, we discuss specifically the role of eight major plant hormones during the wound healing and vascular formation process, two phenomena involved in grafting. We furthermore present the roles of these hormones during graft formation and highlight knowledge gaps and future areas of interest for the field of grafting biology.

Autogenous teeth used for bone grafting: a comparison with traditional grafting materials.

PubMed

Kim, Young-Kyun; Kim, Su-Gwan; Yun, Pil-Young; Yeo, In-Sung; Jin, Seung-Chan; Oh, Ji-Su; Kim, Heung-Joong; Yu, Sun-Kyoung; Lee, Sook-Young; Kim, Jae-Sung; Um, In-Woong; Jeong, Mi-Ae; Kim, Gyung-Wook

2014-01-01

This study evaluated the surface structures and physicochemical characteristics of a novel autogenous tooth bone graft material currently in clinical use. The material's surface structure was compared with a variety of other bone graft materials via scanning electron microscope (SEM). The crystalline structure of the autogenous tooth bone graft material from the crown (AutoBT crown) and root (AutoBT root), xenograft (BioOss), alloplastic material (MBCP), allograft (ICB), and autogenous mandibular cortical bone were compared using x-ray diffraction (XRD) analysis. The solubility of each material was measured with the Ca/P dissolution test. The results of the SEM analysis showed that the pattern associated with AutoBT was similar to that from autogenous cortical bones. In the XRD analysis, AutoBT root and allograft showed a low crystalline structure similar to that of autogenous cortical bones. In the CaP dissolution test, the amount of calcium and phosphorus dissolution in AutoBT was significant from the beginning, while displaying a pattern similar to that of autogenous cortical bones. In conclusion, autogenous tooth bone graft materials can be considered to have physicochemical characteristics similar to those of autogenous bones. Copyright © 2014 Elsevier Inc. All rights reserved.

Polyether-polyester graft copolymer

NASA Technical Reports Server (NTRS)

Bell, Vernon L. (Inventor)

1987-01-01

Described is a polyether graft polymer having improved solvent resistance and crystalline thermally reversible crosslinks. The copolymer is prepared by a novel process of anionic copolymerization. These polymers exhibit good solvent resistance and are well suited for aircraft parts. Previous aromatic polyethers, also known as polyphenylene oxides, have certain deficiencies which detract from their usefulness. These commercial polymers are often soluble in common solvents including the halocarbon and aromatic hydrocarbon types of paint thinners and removers. This limitation prevents the use of these polyethers in structural articles requiring frequent painting. In addition, the most popular commercially available polyether is a very high melting plastic. This makes it considerably more difficult to fabricate finished parts from this material. These problems are solved by providing an aromatic polyether graft copolymer with improved solvent resistance and crystalline thermally reversible crosslinks. The graft copolymer is formed by converting the carboxyl groups of a carboxylated polyphenylene oxide polymer to ionic carbonyl groups in a suitable solvent, reacting pivalolactone with the dissolved polymer, and adding acid to the solution to produce the graft copolymer.

Association between Pre-Transplant Serum Malondialdehyde Levels and Survival One Year after Liver Transplantation for Hepatocellular Carcinoma

PubMed Central

Lorente, Leonardo; Rodriguez, Sergio T.; Sanz, Pablo; Abreu-González, Pedro; Díaz, Dácil; Moreno, Antonia M.; Borja, Elisa; Martín, María M.; Jiménez, Alejandro; Barrera, Manuel A.

2016-01-01

Previous studies have found higher levels of serum malondialdehyde (MDA) in hepatocellular carcinoma (HCC) patients compared to healthy controls and higher MDA concentrations in tumoral tissue of HCC patients than in non-tumoral tissue. However, the association between pre-transplant serum levels of MDA and survival in HCC patients after liver transplantation (LT) has not been described, and the aim of the present study was to determine whether such an association exists. In this observational study we measured serum MDA levels in 127 patients before LT. We found higher pre-LT serum MDA levels in 15 non-surviving than in 112 surviving patients one year after LT (p = 0.02). Exact binary logistic regression analysis revealed that pre-LT serum levels of MDA over 3.37 nmol/mL were associated with mortality after one year of LT (Odds ratio = 5.38; 95% confidence interval (CI) = from 1.580 to infinite; p = 0.007) adjusting for age of the deceased donor. The main finding of our study was that there is an association between serum MDA levels before LT for HCC and 1-year survival after LT. PMID:27058525

Gingival Unit Graft Versus Free Gingival Graft for Treatment of Gingival Recession: A Randomized Controlled Clinical Trial

PubMed Central

Jenabian, Niloofar; Bahabadi, Mohadese Yazdanpanah; Bijani, Ali; Rad, Morteza Rahimi

2016-01-01

Objectives: Gingival recession can lead to root exposure and discomfort for patients. There are various techniques for root coverage. The aim of this study was to compare the use of gingival unit graft (palatal graft including the marginal gingiva and papillae) with free gingival graft for treatment of localized gingival recession. Materials and Methods: In this randomized controlled clinical trial, 18 bilateral localized recessions of Miller class I and II were treated in nine systemically healthy patients. Recessions were randomly treated with gingival unit graft in one side and conventional free gingival graft in the other side. Clinical parameters including clinical attachment level, keratinized tissue width, probing depth and vertical recession depth (VRD) were recorded at baseline and at one, three and six months after surgery. The healing index and patient satisfaction were also evaluated. One-way and two-way repeated measures ANOVA and paired t-test were used for statistical analyses. Results: Both techniques caused significant improvement in clinical parameters. Gingival unit graft produced higher satisfaction esthetically (P=0.050, 0.024 and 0.024, respectively at the three time points), higher healing index (P<0.001), higher root coverage percentage at one month after surgery (34.04%, P=0.011) and greater reduction of recession width three months after surgery (P=0.007) but the reduction in VRD at this side was not significantly greater. Conclusions: Gingival unit graft might be an acceptable modality in Miller Class I/II recession defects. This technique may have advantages over free gingival graft such as significantly superior clinical and esthetic results. PMID:28392815

Polyether/Polyester Graft Copolymers

NASA Technical Reports Server (NTRS)

Bell, Vernon L., Jr.; Wakelyn, N.; Stoakley, D. M.; Proctor, K. M.

1986-01-01

Higher solvent resistance achieved along with lower melting temperature. New technique provides method of preparing copolymers with polypivalolactone segments grafted onto poly (2,6-dimethyl-phenylene oxide) backbone. Process makes strong materials with improved solvent resistance and crystalline, thermally-reversible crosslinks. Resulting graft copolymers easier to fabricate into useful articles, including thin films, sheets, fibers, foams, laminates, and moldings.

Subclinical pulmonary function defects following autologous and allogeneic bone marrow transplantation: relationship to total body irradiation and graft-versus-host disease

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tait, R.C.; Burnett, A.K.; Robertson, A.G.

1991-06-01

Pulmonary function results pre- and post-transplant, to a maximum of 4 years, were analyzed in 98 patients with haematological disorders undergoing allogeneic (N = 53) or autologous bone marrow transplantation (N = 45) between 1982 and 1988. All received similar total body irradiation based regimens ranging from 9.5 Gy as a single fraction to 14.4 Gy fractionated. FEV1/FVC as a measure of airway obstruction showed little deterioration except in patients experiencing graft-versus-host disease in whom statistically significant obstructive ventilatory defects were evident by 6 months post-transplant (p less than 0.01). These defects appeared to be permanent. Restrictive ventilatory defects, asmore » measured by reduction in TLC, and defects in diffusing capacity (DLCO and KCO) were also maximal at 6 months post-transplant (p less than 0.01). Both were related, at least in part, to the presence of GVHD (p less than 0.01) or use of single fraction TBI with absorbed lung dose of 8.0 Gy (p less than 0.05). Fractionated TBI resulted in less marked restricted ventilation and impaired gas exchange, which reverted to normal by 2 years, even when the lung dose was increased from 11.0 Gy to between 12.0 and 13.5 Gy. After exclusion of patients with GVHD (30% allografts) there was no significant difference in pulmonary function abnormalities between autograft and allograft recipients.« less

Angiogenic response in the chick chorioallantoic membrane model to laser-irradiated cartilage

NASA Astrophysics Data System (ADS)

Karamzadeh, Amir M.; Wong, Brian J.; Milner, Thomas E.; Wilson, Marie; Liaw, Lih-Huei L.; Nelson, J. Stuart

1999-06-01

Laser radiation can be used to reshape cartilage grafts via thermally mediated stress relaxation. While several studies have addressed the biophysical changes accompanying reshaping, cartilage viability following laser irradiation has not been extensively investigated. The objective of this study was to determine the extent of angioinvasion of irradiated cartilage explant placed onto the chick chorioallantoic membrane (CAM) model. Angioinvasion of the tissue matrix does not occur in viable cartilage tissue, whereas denatured tissue is readily vasculairzed and/or resorbed in vivo. Porcine septal cartilage specimens were removed from freshly sacrificed animals and divided into three protocols (n=10 each group) consisting of an untreated control, cartilage boiled in saline solution for one hour, and a laser irradiated group (Nd:YAG, λ=1.32 μm, 30.8 W/cm2, irradiation time = 10 sec). Following laser irradiation, tissue specimens were washed in antibiotic solution sand cut into small cubes (~1.5 mm3). The cartilage specimens were placed onto the surface of twenty CAMs, six of which, survived the entire 14 days incubation period. After incubation, the membranes and specimens were fixed in situ with formaldehyde, an then photographed using a dissection microscope. Cartilage specimens were prepared for histologic evaluation and stained with hematoxylin and eosin. Examination with a dissecting microscope showed no obvious vascular invasion of the cartilage or loss of gross tissue integrity in both the control and laser treated groups. In contrast, boiled specimens appeared to be partially or completely resorbed by the surrounding CAM vascular network. These gross findings were also confirmed by histological examination. In summary, our preliminary studies suggest that cartilage specimens treated using the present laser parameters remain resistant to angioinvasion or metabolism by the CAM, whereas boiled tissue undergoes resorption. Clinically, uncontrolled heating may

[An experimental study of the healing of velour grafts].

PubMed

Kobayashi, O

1986-02-01

An experimental study of implantation of velour grafts in the abdominal aorta or the external iliac artery of dogs was conducted with the object of evaluating the type of velour surface best fit for small-caliber artery implantation. Velour grafts measuring 4mm in diameter with differing velour surfaces were used as materials. Velour grafts now available on the market differ not only in velour surface but also in structure, notably in porosity and wall thickness. Hence each of the grafts used was reversed (i.e. inside out) and thus new grafts were prepared. These grafts were considered most suitable for making a comparative study of the effects of velour surface on healing. Macroscopic and histological findings revealed that each graft was good healing with the rate of patency as high as 84 percent. However, like Vasculour-D grafts, crimped grafts which preserve the crimp after implantation was significantly thicker at the internal valley than other grafts. Based on the findings of this experimental study non-crimped velour grafts were considered to be best fit for small-caliber artery implantation.

A multilayered polyurethane foam technique for skin graft immobilization.

PubMed

Nakamura, Motoki; Ito, Erika; Kato, Hiroshi; Watanabe, Shoichi; Morita, Akimichi

2012-02-01

Several techniques are applicable for skin graft immobilization. Although the sponge dressing is a popular technique, pressure failure near the center of the graft is a weakness of the technique that can result in engraftment failure. To evaluate the efficacy of a new skin graft immobilization technique using multilayered polyurethane foam in vivo and in vitro. Twenty-six patients underwent a full-thickness skin graft. Multiple layers of a hydrocellular polyurethane foam dressing were used for skin graft immobilization. In addition, we created an in vitro skin graft model that allowed us to estimate immobilization pressure at the center and edges of skin grafts of various sizes. Overall mean graft survival was 88.9%. In the head and neck region (19 patients), mean graft survival was 93.6%. Based on the in vitro outcomes, this technique supplies effective pressure (<30 mmHg) to the center region of the skin graft. This multilayered polyurethane foam dressing is simple, safe, and effective for skin graft immobilization. © 2011 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

Compliance effects on small diameter polyurethane graft patency.

PubMed

Uchida, N; Kambic, H; Emoto, H; Chen, J F; Hsu, S; Murabayshi, S; Harasaki, H; Nosé, Y

1993-10-01

Microporous compliance matched and noncompliant grafts were compared in a dog carotid artery interposition model. We fabricated 4 mm diameter sponge type polyurethane (Biomer) tubes 5 cm in length with a 0.5 mm wall thickness. The luminal surface was covered with a 50 microns coating of cross-linked gelatin. Compliance was measured in vitro and in vivo by volume and vessel diameter changes. Over a mean arterial pressure range of 55-155 mm Hg, the diameter changes of grafts and stump arteries were measured in situ using an ultrasonic Hokanson device. Compliance matched grafts were found to have the same in vitro compliance values as the natural canine carotid at a mean arterial pressure of 100 mm Hg. Compliance matched and noncompliant grafts had values of 10.3 +/- 1.3 and 0.9 +/- 0.1 x 10(-2) mm Hg, respectively. End to end arterial anastomoses were constructed between the graft and the host arteries. The use of synthetic grafts with matched compliance to the adjacent natural vessels has been advocated as the ideal solution to circumvent the problems of graft failure. These studies indicate that compliance values for compliance matched grafts decreased immediately after implantation (from 10.3 to 6.5 x 10(-2) %/mm Hg) and within 6 weeks decreased to 3.6 x 10(-2) %/mm Hg. The compliance values for noncompliant grafts remained constant throughout the test period. At autopsy all grafts showed a tightly adhered tissue capsule. The thickness of the anastomotic hyperplasia at the distal sites of compliance matched grafts was significantly different (P < .05) than that of the adjacent artery. The patency for compliant and noncompliant grafts was 64% and 50%, respectively. Evidence for polyurethane graft degradation was obtained by Fourier transform infrared spectroscopy and gel permeation chromatography analysis of patent explants. Compliance mismatch alone does not contribute to graft failure, however, material degradation, suture technique and/or capsule formation can

Graft union formation in tomato plants: peroxidase and catalase involvement.

PubMed

Fernandez-Garcia, Nieves; Carvajal, Micaela; Olmos, Enrique

2004-01-01

The use of grafted plants in vegetable crop production is now being expanded greatly. However, few data are available on the formation of graft unions in vegetables. In this work, the structural development of the graft union formation in tomato plants is studied, together with the possible relationship with activities of peroxidases and catalases. Tomato (Lycopersicon esculentum Mill.) seedlings of cultivar Fanny were grafted on the rootstock of cultivar AR-9704 using the 'tongue approach grafting' method, and were grown in a crop chamber. A study of the structural development of the graft union and the involvement of peroxidases and catalases in the process of graft formation was carried out during the first stages of the graft union (4, 8 and 15 d after grafting). Observation of the structure of the graft union showed formation of xylem and phloem vessels through the graft union 8 d after grafting. In addition, root hydraulic conductance, L0, indicate that the graft union is fully functional 8 d after grafting, which coincided with an increase of peroxidase and catalase activities. These results suggest that increased peroxidase and catalase activities might be implicated in graft development in tomato plants.

Double-layered collagen graft to the radial forearm free flap donor sites without skin graft.

PubMed

Park, Tae-Jun; Kim, Hong-Joon; Ahn, Kang-Min

2015-12-01

Radial forearm free flap is the most reliable flap for intraoral soft tissue reconstruction after cancer ablation surgery. However, unesthetic scar of the donor site and the need for a second donor site for skin graft are major disadvantages of the forearm flap. The purpose of this study was to report the clinical results of double-layered collagen graft to the donor site of the forearm free flap without skin graft. Twenty-two consecutive patients who underwent oral cancer ablation and forearm reconstruction between April 2010 and November 2013 were included in this study. Male to female ratio was 12:10, and average age was 61.0 years old (27-84). Double-layered collagen was grafted to the donor site of the forearm free flap and healed for secondary intention. Upper silicone had been trimmed at the periphery during secondary intention, and dry dressing was used. Postoperative scar healing and esthetic results and function were evaluated. An average follow-up period was 34.9 months. The scar area was decreased to 63.9 % in average. The complete healing was obtained between 1.5 and 3 months according to the defect size. There was no functional defect or impairment 3 months after operation. All patients were satisfied with the esthetic results. Three patients died of recurred cancer. Double-layered collagen graft was successfully performed in this study. Without the thigh skin graft, patients had experienced less painful postoperative healing periods and discomfort.

Management of Contaminated Autologous Grafts in Plastic Surgery

PubMed Central

Centeno, Robert F; Desai, Ankit R; Watson, Marla E

2008-01-01

Background: Contamination of autologous grafts unfortunately occurs in plastic surgery, but the literature provides no guidance for management of such incidents. Methods: American Society of Aesthetic Plastic Surgery members were asked to complete an online survey that asked about the number and causes of graft contaminations experienced, how surgeons dealt with the problem, the clinical outcomes, and patient disclosure. Results: Nineteen hundred surgeons were asked to participate in the survey, and 223 responded. Of these, 70% had experienced at least 1 graft contamination incident, with 26% experiencing 4 or more. The most frequently reported reason for graft contamination was a graft falling on the floor (reported by 75%). Nearly two thirds of the contaminated grafts related to craniofacial procedures. Ninety-four percent of grafts were managed with decontamination and completion of the operation. The most common method of decontamination was washing with povidone-iodine, but this practice is contrary to recommendations in the literature. Only 3 surgeons (1.9%) said a clinical infection developed following decontaminated graft use. Patients were not informed in 60% of graft contamination incidents. The survey results and review of the literature led to development of algorithms for the management of inadvertent graft contamination and patient disclosure. Conclusions: Although autologous grafts do become contaminated in plastic surgery, the overwhelming majority can be safely decontaminated and produce minimal or no clinical sequelae. The algorithms presented are intended to serve as guides for prevention of contamination events or for their management should they occur. PMID:18496583

Polyethylene oxide hydration in grafted layers

NASA Astrophysics Data System (ADS)

Dormidontova, Elena; Wang, Zilu

Hydration of water soluble polymers is one of the key-factors defining their conformation and properties, similar to biopolymers. Polyethylene oxide (PEO) is one of the most important biomedical-applications polymers and is known for its reverse temperature solubility due to hydrogen bonding with water. As in many practical applications PEO chains are grafted to surfaces, e.g. of nanoparticles or planar surfaces, it is important to understand PEO hydration in such grafted layers. Using atomistic molecular dynamic simulations we investigate the details of molecular conformation and hydration of PEO end-grafted to gold surfaces. We analyze polymer and water density distribution as a function of distance from the surface for different grafting densities. Based on a detailed analysis of hydrogen bonding between polymer and water in grafted PEO layers, we will discuss the extent of PEO hydration and its implication for polymer conformation, mobility and layer properties. This research is supported by NSF (DMR-1410928).

The effect of delayed graft function on graft and patient survival in kidney transplantation: an approach using competing events analysis.

PubMed

Fonseca, Isabel; Teixeira, Laetitia; Malheiro, Jorge; Martins, La Salete; Dias, Leonídio; Castro Henriques, António; Mendonça, Denisa

2015-06-01

In kidney transplantation, the impact of delayed graft function (DGF) on long-term graft and patient survival is controversial. We examined the impact of DGF on graft and recipient survival by accounting for the possibility that death with graft function may act as a competing risk for allograft failure. We used data from 1281 adult primary deceased-donor kidney recipients whose allografts functioned at least 1 year. The probability of graft loss occurrence is overestimated using the complement of Kaplan-Meier estimates (1-KM). Both the cause-specific Cox proportional hazard regression model (standard Cox) and the subdistribution hazard regression model proposed by Fine and Gray showed that DGF was associated with shorter time to graft failure (csHR = 2.0, P = 0.002; sHR = 1.57, P = 0.009), independent of acute rejection (AR) and after adjusting for traditional factors associated with graft failure. Regarding patient survival, DGF was a predictor of patient death using the cause-specific Cox model (csHR = 1.57, P = 0.029) but not using the subdistribution model. The probability of graft loss from competing end points should not be reported with the 1-KM. Application of a regression model for subdistribution hazard showed that, independent of AR, DGF has a detrimental effect on long-term graft survival, but not on patient survival. © 2015 Steunstichting ESOT.

Vascularized nerve graft: a clinical contribution.

PubMed

Luchetti, R; De Santis, G; Soragni, O; Deluca, S; Pederzini, L; Alfarano, M; Landi, A

1990-01-01

The authors present 4 cases of vascularized nerve graft. The results were better than those obtained with traditional grafting. The indication is a rare one, and the experimental results are contradictory. Indications are limited to Volkmann ischemic syndromes, post-actinic lesions of the brachial plexus, infections and finally, post-burning scarring. Nevertheless, traditional nerve grafts remain the treatment of choice for peripheral nerve lesions which cannot undergo direct suturing.

21 CFR 872.3930 - Bone grafting material.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Bone grafting material. 872.3930 Section 872.3930...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3930 Bone grafting material. (a) Identification. Bone grafting material is a material such as hydroxyapatite, tricalcium phosphate, polylactic and...

21 CFR 872.3930 - Bone grafting material.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Bone grafting material. 872.3930 Section 872.3930...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3930 Bone grafting material. (a) Identification. Bone grafting material is a material such as hydroxyapatite, tricalcium phosphate, polylactic and...

21 CFR 872.3930 - Bone grafting material.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Bone grafting material. 872.3930 Section 872.3930...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3930 Bone grafting material. (a) Identification. Bone grafting material is a material such as hydroxyapatite, tricalcium phosphate, polylactic and...

21 CFR 872.3930 - Bone grafting material.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Bone grafting material. 872.3930 Section 872.3930...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3930 Bone grafting material. (a) Identification. Bone grafting material is a material such as hydroxyapatite, tricalcium phosphate, polylactic and...

21 CFR 872.3930 - Bone grafting material.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Bone grafting material. 872.3930 Section 872.3930...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3930 Bone grafting material. (a) Identification. Bone grafting material is a material such as hydroxyapatite, tricalcium phosphate, polylactic and...

Effect of a blood transfusion protocol and low dose steroid regime on renal transplant survival.

PubMed

Notghi, A; Anderton, J L; Chisholm, G D; Hamer-Hodges, D; Wilkinson, S; Smith, G; Galloway, N T; Yap, P L; Winney, R J

1986-04-01

The effects of introduction of a low steroid regime and pre-transplant blood transfusion were evaluated. The kidney and patient survival rates for the period before such a policy was adopted were compared with the period after this policy. There has been a highly significant rise in patient survival rates to the present level of 95 per cent at three years. There was a similar rise in three year graft survival rates from less than 40 per cent to 66 per cent.

Analysis by early angiography of right internal thoracic artery grafting via the transverse sinus : predictors of graft failure.

PubMed

Ura, M; Sakata, R; Nakayama, Y; Arai, Y; Oshima, S; Noda, K

2000-02-15

There has been debate regarding whether technically demanding right internal thoracic artery (RITA) grafting via the transverse sinus can be extensively applied to patients in high-risk groups, such as patients with a small body size, elderly patients, and woman with relatively smaller coronary artery and internal thoracic artery (ITA) diameters. Of the 1456 patients who underwent isolated coronary artery bypass grafting between January 1989 and December 1998 at Kumamoto Central Hospital, 393 patients (mean age, 62.4+/-9.0 years) with the RITA anastomosed to the major branches of the circumflex artery were studied. Left ITA grafting was performed in 384 patients, and in 369, the in situ left ITA was anastomosed to the left anterior descending coronary artery using standard methods. Early postoperative angiography was performed in 381 patients. The RITA was occluded in 4 patients, and string-like artery and significant stenosis were present in 11 and 7 patients, respectively; RITA graft patency was thus 94.1%. Of the preoperative variables and angiographic data, simple and multiple logistic regression analyses identified decreased severity of native stenosis, diffuse sclerosis of native vessels, and residual side branches of the ITA as independent predictors of nonfunctional grafts. The method of ITA grafting did not influence the patency of the graft. The excellent patency rate demonstrated by this study, the largest angiographic study to date of RITA grafting via the transverse sinus, indicates that this technique can provide reliable revascularization of the left ventricle and that it has the potential to be applied to a wide variety of patients with diseased circumflex arteries.

Aortic Replacement with Sutureless Intraluminal Grafts

PubMed Central

Lemole, Gerald M.

1990-01-01

To avoid the anastomotic complications and long cross-clamp times associated with standard suture repair of aortic lesions, we have implanted sutureless intraluminal grafts in 122 patients since 1976. Forty-nine patients had disorders of the ascending aorta, aortic arch, or both: their operative mortality was 14% (7 patients), and the group's 5-year actuarial survival rate has been 64%. There have been no instances of graft dislodgment, graft infection, aortic bleeding, or pseudoaneurysm formation. Forty-two patients had disorders of the descending aorta and thoracoabdominal aorta: their early mortality was 10% (4 patients), and the group's 5-year actuarial survival rate has been 56%. There was 1 early instance of graft dislodgment, but no pseudoaneurysm formation, graft erosion, aortic bleeding, intravascular hemolysis, or permanent deficits in neurologic, renal, or vascular function. Thirty-one patients had the sutureless intraluminal graft implanted in the abdominal aortic position: their early mortality was 6% (2 patients), and the 5-year actuarial survival rate for this group has been 79%. There were no instances of renal failure, ischemic complication, postoperative paraplegia, pseudoaneurysm, or anastomotic true aneurysm. Our recent efforts have been directed toward developing an adjustable spool that can adapt to the widest aorta or the narrowest aortic arch vessel; but in the meanwhile, the present sutureless graft yields shorter cross-clamp times, fewer intraoperative complications, and both early and late results as satisfactory as those afforded by traditional methods of aortic repair. (Texas Heart Institute Journal 1990; 17:302-9) Images PMID:15227522

Comparison of sequential left internal thoracic artery grafting and separate left internal thoracic artery and venous grafting : A 5-year follow-up.

PubMed

Wendt, D; Schmidt, D; Wasserfuhr, D; Osswald, B; Thielmann, M; Tossios, P; Kühl, H; Jakob, H; Massoudy, P

2010-09-01

The superiority of left internal thoracic artery (LITA) grafting to the left anterior descending artery (LAD) is well established. Patency rates of 80%-90% have been reported at 10-year follow-up. However, the superiority of sequential LITA grafting has not been proven. Our aim was to compare patency rates after sequential LITA grafting to a diagonal branch and the LAD with patency rates of LITA grafting to the LAD and separate vein grafting to a diagonal branch. A total of 58 coronary artery bypass graft (CABG) patients, operated on between 01/2000 and 12/2002, underwent multi-slice computed tomography (MSCT) between 2006 and 2008. Of these patients, 29 had undergone sequential LITA grafting to a diagonal branch and to the LAD ("Sequential" Group), while in 29 the LAD and a diagonal branch were separately grafted with LITA and vein ("Separate" Group). Patencies of all anastomoses were investigated. Mean follow-up was 1958±208 days. The patency rate of the LAD anastomosis was 100% in the Sequential Group and 93% in the Separate Group (p=0.04). The patency rate of the diagonal branch anastomosis was 100% in the Sequential Group and 89% in the Separate Group (p=0.04). Mean intraoperative flow on LITA graft was not different between groups (69±8ml/min in the Sequential Group and 68±9ml/min in the Separate Group, p=n.s.). Patency rates of both the LAD and the diagonal branch anastomoses were higher after sequential arterial grafting compared with separate arterial and venous grafting at 5-year follow-up. This indicates that, with regard to the antero-lateral wall of the left ventricle, there is an advantage to sequential arterial grafting compared with separate arterial and venous grafting.

Does sterilization with fractionated electron beam irradiation prevent ACL tendon allograft from tissue damage?

PubMed

Schmidt, T; Grabau, D; Grotewohl, J H; Gohs, U; Pruß, A; Smith, M; Scheffler, S; Hoburg, A

2017-02-01

Allografts are frequently used for anterior cruciate ligament (ACL) reconstruction. However, due to the inherent risk of infection, a method that achieves complete sterilization of grafts is warranted without impairing their biomechanical properties. Fractionation of electron beam (FEbeam) irradiation has been shown to maintain similar biomechanical properties compared to fresh-frozen allografts (FFA) in vitro. Therefore, aim of this study was to evaluate the biomechanical properties and early remodelling of grafts that were sterilized with fractionated high-dose electron beam irradiation in an in vivo sheep model. ACL reconstruction was performed in 18 mature merino mix sheep. Sixteen were reconstructed with allografts sterilized with FEbeam irradiation (8 × 3.4 kGy) and two with FFA. Eight FFA from prior studies with identical surgical reconstruction and biomechanical and histological analyzes served as controls. Half of the animals were sacrificed at 6 and 12 weeks, and biomechanical testing was performed. Anterior-posterior laxity (APL) was assessed with an AP drawer test at 60° flexion, and load to failure testing was carried out. Histological evaluation of mid-substance samples was performed for descriptive analysis, cell count, crimp and vessel density. For statistical analysis a Kruskal-Wallis test was used for overall group comparison followed by a Mann-Whitney U test for pairwise comparison of the histological and biomechanical parameters. Biomechanical testing showed significantly decreased stiffness in FEbeam compared to FFA at both time points (p ≤ 0.004). APL was increased in FEbeam compared to FFA, which was significant at 6 weeks (p = 0.004). Median of failure loads was decreased in FEbeam grafts, with 12 reconstructions already failing during cyclic loading. Vessel density was decreased in FEbeam compared to FFA at both time points, with significant differences at 12 weeks (p = 0.015). Crimp length was significantly shorter in

Soluble CD30 and Hepatocyte growth factor as predictive markers of antibody-mediated rejection of the kidney allograft.

PubMed

Pavlova, Yelena; Viklicky, Ondrej; Slatinska, Janka; Bürgelova, Marcela; Süsal, Caner; Skibova, Jelena; Honsová, Eva; Striz, Ilja; Kolesar, Libor; Slavcev, Antonij

2011-07-01

Our retrospective study was aimed to assess the relevance of pre- and post-transplant measurements of serum concentrations of the soluble CD30 molecule (soluble CD30, sCD30) and the cytokine Hepatocyte growth factor (HGF) for prediction of the risk for development of antibody-mediated rejection (AMR) in kidney transplant patients. Evaluation of sCD30, HGF levels and the presence of HLA-specific antibodies in a cohort of 205 patients was performed before, 2weeks and 6months after transplantation. Patients were followed up for kidney graft function and survival for two years. We found a tendency of higher incidence of AMR in retransplanted patients with elevated pre-transplant sCD30 (≥100U/ml) (p=0.051), however no such correlation was observed in first-transplant patients. Kidney recipients with simultaneously high sCD30 and HLA-specific antibodies (sCD30+/Ab+) before transplantation had significantly lower AMR-free survival compared to the other patient groups (p<0.001). HGF concentrations were not associated with the incidence of AMR at any time point of measurement, nevertheless, the combined analysis HGF and sCD30 showed increased incidence of AMR in recipients with elevated pretransplant sCD30 and low HGF levels. the predictive value of pretransplant sCD30 for the development of antibody-mediated rejection after transplantation is significantly potentiated by the co-presence of HLA specific antibodies. The role of HGF as a rejection-protective factor in patients with high pretransplant HGF levels would need further investigation. Copyright © 2011 Elsevier B.V. All rights reserved.

The Effect of Graft Strength on Knee Laxity and Graft In-Situ Forces after Posterior Cruciate Ligament Reconstruction

PubMed Central

Lai, Yu-Shu; Chen, Wen-Chuan; Huang, Chang-Hung; Cheng, Cheng-Kung; Chan, Kam-Kong; Chang, Ting-Kuo

2015-01-01

Surgical reconstruction is generally recommended for posterior cruciate ligament (PCL) injuries; however, the use of grafts is still a controversial problem. In this study, a three-dimensional finite element model of the human tibiofemoral joint with articular cartilage layers, menisci, and four main ligaments was constructed to investigate the effects of graft strengths on knee kinematics and in-situ forces of PCL grafts. Nine different graft strengths with stiffness ranging from 0% (PCL rupture) to 200%, in increments of 25%, of an intact PCL’s strength were used to simulate the PCL reconstruction. A 100 N posterior tibial drawer load was applied to the knee joint at full extension. Results revealed that the maximum posterior translation of the PCL rupture model (0% stiffness) was 6.77 mm in the medial compartment, which resulted in tibial internal rotation of about 3.01°. After PCL reconstruction with any graft strength, the laxity of the medial tibial compartment was noticeably improved. Tibial translation and rotation were similar to the intact knee after PCL reconstruction with graft strengths ranging from 75% to 125% of an intact PCL. When the graft’s strength surpassed 150%, the medial tibia moved forward and external tibial rotation greatly increased. The in-situ forces generated in the PCL grafts ranged from 13.15 N to 75.82 N, depending on the stiffness. In conclusion, the strength of PCL grafts have has a noticeable effect on anterior-posterior translation of the medial tibial compartment and its in-situ force. Similar kinematic response may happen in the models when the PCL graft’s strength lies between 75% and 125% of an intact PCL. PMID:26001045

Cartilage grafting in nasal reconstruction.

PubMed

Immerman, Sara; White, W Matthew; Constantinides, Minas

2011-02-01

Nasal reconstruction after resection for cutaneous malignancies poses a unique challenge to facial plastic surgeons. The nose, a unique 3-D structure, not only must remain functional but also be aesthetically pleasing to patients. A complete understanding of all the layers of the nose and knowledge of available cartilage grafting material is necessary. Autogenous material, namely septal, auricular, and costal cartilage, is the most favored material in a free cartilage graft or a composite cartilage graft. All types of material have advantages and disadvantages that should guide the most appropriate selection to maximize the functional and cosmetic outcomes for patients. Copyright © 2011 Elsevier Inc. All rights reserved.

Low serum mannose-binding lectin as a risk factor for new onset diabetes mellitus after renal transplantation.

PubMed

Ibernon, Meritxell; Moreso, Francesc; Moreno, José M; Bestard, Oriol; Cruzado, Josep M; Grinyó, Josep M; Ricart, Wifredo; Fernández-Real, José M; Serón, Daniel

2009-07-27

Infections and new onset diabetes mellitus after transplantation (NODAT) are frequent complications after renal transplantation and may be related to innate immunity alterations. We evaluate the relationship among serum mannose-binding lectin (MBL), chronic inflammation, NODAT, and infection. Between March 2005 and October 2006, consecutive nondiabetic renal transplant recipients were recruited. MBL, soluble tumor necrosis factor receptor 2, and neutrophil gelatinase-associated lipocalin were determined before transplant and at 1 and 3 months. An oral glucose tolerance test was performed at 3 months. A total of 125 patients were recruited, and 111 patients had a functioning graft at 3 months. MBL levels remained unchanged after transplantation. Subjects with low MBL (lower tertile) had higher pretransplant soluble tumor necrosis factor receptor 2 (40+/-13 ng/mL vs. 35+/-11 ng/mL; P=0.05) and neutrophil gelatinase-associated lipocalin (638+/-114 ng/mL vs. 553+/-185 ng/mL; P=0.03), an increased incidence of bacterial/fungal infection (P=0.021), and an increased prevalence of NODAT at 3 months (44.4% vs. 22.6%; P=0.01). Multivariate analysis confirmed that MBL was a risk factor for NODAT (relative risk: 3.04, 95% confidence interval: 1.18-7.81; P=0.021) adjusting for age, pretransplant impaired fasting glucose, and body mass index. Low pretransplant MBL is associated with chronic inflammation, NODAT, and infection.

Foam-rubber stents for skin grafts.

PubMed

Larson, P O

1990-09-01

A variety of stents are used to immobilize skin grafts and to hold them firmly to the recipient site. Tie-down stents, the most common type, are constructed from bulky, sterile dressing and are overtied with suture material. These stents are often cumbersome to apply. As an alternative, stents made from foam-rubber pads (Reston, 3M Company, St. Paul, MN) were stapled over skin grafts. These stents could be applied quickly, and they maintain continuous, uniform pressure on the immobilized grafts.

Evaluation of interleukin 12 and CD56+ lymphocyte cells in pediatric hematopoietic stem cell transplantation for early diagnosis of acute graft versus host disease.

PubMed

Tootoonchian, Raziyeh; Pak, Fatemeh; Ardekani, Ali M; Sehati, Nasrin; Abedi-Valugerdi, Manuchehr; Kokhaei, Parviz

2016-11-01

The present study tried to explain CD56+ lymphocyte cells activities and possible prognostic role of these cells in Graft-Versus-Host-Disease (GVHD). The role of IL-12 activation and function is of interest in this study. Peripheral blood samples of 51 Hematopoietic Stem Cell Transplantation (HSCT) recipients collected at before (day -8) and after (days 7 and 14). PBMC were collected by Ficoll separation and analyzed by Flow Cytometry using triple antibody (CD45-PerCP, CD56-FITC, and CD69-PE staining and control antibody. Levels of the cytokine IL-12 in the patient's serum were evaluated by ELISA. Percentage of CD56+ lymphocytes (CD56+ bright ) cells was significantly increased at day 14 in patients with acute GVHD and percentage of lymphocytes expressing CD69 was significantly increased at days 7 and 14 posts HSCT in patients with acute GVHD in comparison to those in non-GVHD patients. Baseline serum IL-12 levels (pre-HSCT, day -8) were significantly higher in those HSCT recipients who did not develop GVHD. This study showed that post-transplant CD56+ lymphocytes and pre-transplant serum levels of IL-12 play significant roles in the induction of and protection against GVHD, respectively. The increase in the percentage of CD69+ cells indicates the activation of lymphocyte in acute GVHD group. Copyright © 2016 Elsevier B.V. All rights reserved.

Acellular vascular matrix grafts from human placenta chorion: Impact of ECM preservation on graft characteristics, protein composition and in vivo performance.

PubMed

Schneider, Karl H; Enayati, Marjan; Grasl, Christian; Walter, Ingrid; Budinsky, Lubos; Zebic, Gabriel; Kaun, Christoph; Wagner, Anja; Kratochwill, Klaus; Redl, Heinz; Teuschl, Andreas H; Podesser, Bruno K; Bergmeister, Helga

2018-05-29

Small diameter vascular grafts from human placenta, decellularized with either Triton X-100 (Triton) or SDS and crosslinked with heparin were constructed and characterized. Graft biochemical properties, residual DNA, and protein composition were evaluated to compare the effect of the two detergents on graft matrix composition and structural alterations. Biocompatibility was tested in vitro by culturing the grafts with primary human macrophages and in vivo by subcutaneous implantation of graft conduits (n = 7 per group) into the flanks of nude rats. Subsequently, graft performance was evaluated using an aortic implantation model in Sprague Dawley rats (one month, n = 14). In situ graft imaging was performed using MRI angiography. Retrieved specimens were analyzed by electromyography, scanning electron microscopy, histology and immunohistochemistry to evaluate cell migration and the degree of functional tissue remodeling. Both decellularization methods resulted in grafts of excellent biocompatibility in vitro and in vivo, with low immunogenic potential. Proteomic data revealed removal of cytoplasmic proteins with relative enrichment of ECM proteins in decelluarized specimens of both groups. Noteworthy, LC-Mass Spectrometry analysis revealed that 16 proteins were exclusively preserved in Triton decellularized specimens in comparison to SDS-treated specimens. Aortic grafts showed high patency rates, no signs of thrombus formation, aneurysms or rupture. Conduits of both groups revealed tissue-specific cell migration indicative of functional remodeling. This study strongly suggests that decellularized allogenic grafts from the human placenta have the potential to be used as vascular replacement materials. Both detergents produced grafts with low residual immunogenicity and appropriate mechanical properties. Observed differences in graft characteristics due to preservation method had no impact on successful in vivo performance in the rodent model. Copyright �

Viability of porcine nasal septal cartilage grafts following Nd:YAG (n=1.32μm) laser radiation

NASA Astrophysics Data System (ADS)

Chao, Kenneth K. H.; Wong, Brian J.; Kim, Hong K.; Milner, Thomas E.; Sung, Chung-Ho; Sobol, Emil N.; Nelson, J. Stuart

2000-06-01

Mechanically deformed morphologic cartilage grafts undergo a temperature dependent phase transformation during sustained laser irradiation that results in reshaping of the specimen. While thermal, optical, and mechanical properties of cartilage undergoing laser heating have been previously investigated, the viability of these irradiated grafts has yet to be examined closely until now. In this study, chondrocyte viability following laser irradiation was determined by measuring the incorporation of radiolabelled sulfate (Na 35SO4-2) into proteoglycan (PTG) macromolecules. Proteoglycans are highly sulfated and are the principal molecular constituents of cartilage matrix. Their synthesis directly reflects chondrocyte viability. By measuring the scintillation counts of 35SO4-2 uptake and normalizing the value by the total protein content of each specimen we can determine the level of PTG synthesis rates following laser reshaping. Regional baseline PTG synthesis rates as a function of location was determined by dividing each specimen into six regions. All regions except the most cephalic are demonstrated similar PTG synthesis rates. The most cephalic region exhibited a significantly greater PTG synthesis rates. In order to establish a positive control for this study, specimens were immersed in boiling saline water for approximately 40 minutes. The boiled specimens demonstrated a fivefold increase in normalized radioisotope uptake and suggest that the non-specific uptake of radioactive Na35SO4-2 is caused by structural alterations in the collagen matrix caused by extensive thermal exposure. To avoid this thermal artifact, another positive control was established using nitric oxide was to induce apoptosis of the chondrocytes, resulting in significantly lower PTG synthesis compared to untreated tissue. Cartilage specimens (25 X 10 X 2 mm) were irradiated with light emitted from an Nd:YAG laser (25 W/cm2, (lambda) equals 1.32 micrometer) while radiometric surface temperature

Soft tissue graft interference fit fixation: observations on graft insertion site healing and tunnel remodeling 2 years after ACL reconstruction in sheep.

PubMed

Hunt, Patrick; Rehm, Oliver; Weiler, Andreas

2006-12-01

Using soft tissue grafts for anterior cruciate ligament (ACL) reconstruction, insertion site healing plays a crucial role in the long-term fate of the graft. It has been shown in an experimental animal study that using a soft tissue graft and anatomic graft fixation, a direct ligamentous insertion alike the native ACL developed 24 weeks postoperatively. Yet there are no reports on the long-term insertion site healing of anatomically fixed soft tissue grafts. The objective of this study was to evaluate graft insertion site healing, the intra-tunnel fate of the graft and its osseous replacement 2 years after ACL reconstruction in sheep. The left ACLs of six sheep were replaced by an autologous flexor tendon split graft and anatomically fixed with biodegradable poly-(D, L-lactide) interference screws. Animals received polychromic sequential labeling at different points in time to determine bone apposition per period. For evaluation of the insertion site healing and intra-tunnel changes, MRI scans were taken in vivo. Following sacrifice, radiographic imaging, conventional histology and fluorescence microscopy was undertaken. Most of the specimens showed a wide direct ligamentous insertion. It showed patterns alike the direct ligament insertion seen in intact ACLs. The intra-tunnel part of the graft had completely lost its tendon-like structure and in two cases, it was separated from the graft insertion by a thick bony layer. The biodegradable interference screw was fully degraded in all specimens. Ossification of the former drill tunnels was intense, showing only partial-length tunnel remnants in one femoral and three tibial specimens. As the graft heals to the joint surface and the aperture site is closed with soft tissue, mechanical stress of the intra-tunnel part of the graft is eliminated and the bone tunnel is protected from synovial fluid, resulting in osseous bridging of the tunnel aperture site, accelerated intra-tunnel graft resorption and its osseous

Carbon-centered radicals in γ-irradiated bone substituting biomaterials based on hydroxyapatite.

PubMed

Sadlo, Jaroslaw; Strzelczak, Grazyna; Lewandowska-Szumiel, Malgorzata; Sterniczuk, Marcin; Pajchel, Lukasz; Michalik, Jacek

2012-09-01

Gamma irradiated synthetic hydroxyapatite, bone substituting materials NanoBone(®) and HA Biocer were examined using EPR spectroscopy and compared with powdered human compact bone. In every case, radiation-induced carbon centered radicals were recorded, but their molecular structures and concentrations differed. In compact bone and synthetic hydroxyapatite the main signal assigned to the CO(2) (-) anion radical was stable, whereas the signal due to the CO(3) (3-) radical dominated in NanoBone(®) and HA Biocer just after irradiation. However, after a few days of storage of these samples, also a CO(2) (-) signal was recorded. The EPR study of irradiated compact bone and the synthetic graft materials suggest that their microscopic structures are different. In FT-IR spectra of NanoBone(®), HA Biocer and synthetic hydroxyapatite the HPO(4) (2-) and CO(3) (2-) in B-site groups are detected, whereas in compact bone signals due to collagen dominate.

[Features of skin graft in pediatric plastic surgery].

PubMed

Depoortère, C; François, C; Belkhou, A; Duquennoy-Martinot, V; Guerreschi, P

2016-10-01

Skin graft is a skin tissue fragment transferred from a donor site to a receiving site with a spontaneous revascularization. Basic process of plastic surgery, skin graft known in children, specific, warnings and refinements. It finds its indication in many pediatric cases: integumental diseases (neavus, hamartoma), acute burns and scars, traumatic loss of substance or surgically induced, congenital malformations of the hands and feet, etc. Specific skin graft techniques in children are developed: donor sites, sampling technique and procedure, early postoperative care. Especially in children, the scalp is a perfect site for split skin graft and technique is actively developed. Refinements and special cases are discussed: use of dermal matrices, allografts, xenografts, negative pressure therapy, prior skin expansion of the donor site. Results of skin graft in children are exposed: taking of graft, growth and shrinkage, pigmentation. Skin graft sometimes allows to stay the complex movement and get the best final benefit, permanent or at least temporary, in a growing being. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Bone graft

MedlinePlus

... dry. Follow instructions about showering. DO NOT smoke. Smoking slows or prevents bone healing. If you smoke, the graft is more likely to fail. Be aware that nicotine patches slow healing just like smoking does.

Successful Antibiotic Treatment of Severe Staphylococcal Infection of a Long Stent Graft in the Superficial Femoral Artery with Graft Preservation in the Long Term

DOE Office of Scientific and Technical Information (OSTI.GOV)

Treitl, Marcus, E-mail: Marcus.Treitl@med.uni-muenchen.de; Rademacher, Antje; Becker-Lienau, Johanna

2011-06-15

Introduction: Bacterial infection of endovascular stent grafts is a serious condition, regularly leading to graft replacement by open bypass surgery.Case ReportWe describe the case of a staphylococcal infection of a 150-mm covered stent graft (Gore Viabahn), placed in the superficial femoral artery. Stent graft infection was successfully treated by oral administration of penicillinase-resistant flucloxacillin and the lipopeptide daptomycin with complete graft preservation, not requiring surgical treatment. During 1-year follow-up, the graft infection did not reappear. However, the patient developed restenosis at the proximal margin of the stent with recurrence of mild claudication, so far treated conservatively. Conclusion: With the increasedmore » use of covered stent grafts in the peripheral vasculature, the frequency of graft infection will increase. We demonstrate that with newly developed antibiotics, it is possible to treat this severe complication conservatively, with complete graft preservation and without the need for bypass surgery in selected cases.« less