2.Research progress of allogeneic abdominal wall transplantation.
Tong WANG ; Botao GAO ; Zhou YU ; Baoqiang SONG
Chinese Journal of Reparative and Reconstructive Surgery 2023;37(7):901-906
OBJECTIVE:
To summarize the research progress of surgical technique and immunosuppressive regimen of abdominal wall vascularized composite allograft transplantation in animals and clinical practice.
METHODS:
The literature on abdominal wall transplantation at home and abroad in recent years was extensively reviewed and analyzed.
RESULTS:
This review includes animal and clinical studies. In animal studies, partial or total full-thickness abdominal wall transplantation models have been successfully established by researchers. Also, the use of thoracolumbar nerves has been described as an important method for functional reconstruction and prevention of long-term muscle atrophy in allogeneic abdominal wall transplantation. In clinical studies, researchers have utilized four revascularization techniques to perform abdominal wall transplantation, which has a high survival rate and a low incidence of complications.
CONCLUSION
Abdominal wall allotransplantation is a critical reconstructive option for the difficulty closure of complex abdominal wall defects. Realizing the recanalization of the nerve in transplanted abdominal wall to the recipient is very important for the functional recovery of the allograft. The developments of similar research are beneficial for the progress of abdominal wall allotransplantation.
Animals
;
Abdominal Wall/surgery*
;
Vascularized Composite Allotransplantation/methods*
;
Transplantation, Homologous
;
Skin Transplantation/methods*
;
Hematopoietic Stem Cell Transplantation
3.Effects of body parameters on renal cortical stiffness measured by shear-wave elastography in patients with kidney transplantation.
Shuting YANG ; Yuwan LIU ; Huilan ZUO ; Linna FENG ; Chengshu XU ; Lan GU ; Feng GAO
Journal of Central South University(Medical Sciences) 2022;47(10):1385-1391
OBJECTIVES:
The results of elastic imaging in evaluating the function and histopathological changes of allogeneic renal transplantation are contradictory, one of the important reasons may be that there are differences in human parameters related to kidney transplantation among individuals. The purpose of this study is to explore the related human body parameters on shear-wave elastography (SWE) effects on quantitative stiffness of graft cortex.
METHODS:
From March 2021 to November 2021, a total of 63 patients with allogeneic kidney transplantation in the Department of Ultrasonography, Third Xiangya Hospital, Central South University, were selected to collect the parameters of two-dimensional, color Doppler and SWE. The subjects were divided into a <20% group and a 20%-30% group according to the variation of cortical hardness measurement. Mann Whitney U test was used to compare the differences in relevant human parameters, and Spearman rank correlation was used to analyze the correlation between relevant human parameters and cortical hardness of transplanted kidney.
RESULTS:
There was no significant difference between the 2 groups in age, sex, postoperative time, resistance index of interlobar artery, SCr, blood uric acid, ratio of fat layer to muscle layer, and BMI (all P>0.05). Compared with the <20% group, the patients in the 20%-30% group had smaller cortical hardness of the transplanted kidney, greater total distance between the transplanted kidney and the skin surface, and thicker fat layer or muscle layer in front of the transplanted kidney (all P<0.05). The age of patients, the total distance from the transplanted kidney to the skin surface, the thickness of fat layer and muscle layer, the ratio of fat layer to muscle layer, BMI, and the variation of cortical hardness were significantly negatively correlated with the cortical hardness of the transplanted kidney (all P<0.05).
CONCLUSIONS
Human parameters relevant to kidney transplantation affect the accuracy of SWE in measuring the cortical hardness of the transplanted kidney. It is very important to obtain the highly stabile elastic measurement value and interpret the elastic measurement results according to different levels of human body related parameters in combination with individual conditions.
Humans
;
Kidney Transplantation
;
Elasticity Imaging Techniques/methods*
;
Kidney
;
Ultrasonography/methods*
;
Transplantation, Homologous
4.Relationship between treatment and prognosis in patients with late-onset severe pneumonia after allogeneic hematopoietic stem cell transplantation.
Le Qing CAO ; Jing Rui ZHOU ; Yu Hong CHEN ; Huan CHEN ; Wei HAN ; Yao CHEN ; Yuan Yuan ZHANG ; Chen Hua YAN ; Yi Fei CHENG ; Xiao Dong MO ; Hai Xia FU ; Ting Ting HAN ; Meng LV ; Jun KONG ; Yu Qian SUN ; Yu WANG ; Lan Ping XU ; Xiao Hui ZHANG ; Xiao Jun HUANG
Journal of Peking University(Health Sciences) 2022;54(5):1013-1020
OBJECTIVE:
To explore the relationship between drug treatment and outcomes in patients with late-onset severe pneumonia (LOSP) after allogeneic stem cell transplantation (allo-SCT).
METHODS:
We retrospectively analyzed the effects of the initiation time of treatment drugs, especially antiviral drugs and glucocorticoids on the clinical outcomes in 82 patients between January 2016 and August 2021 who developed LOSP after allo-SCT in Peking University People's Hospital. Univariate analysis was performed by Mann-Whitney U test and χ2 test, and multivariate analysis was performed by Logistic regression. When multiple groups (n>2) were involved in the χ2 test, Bonferroni correction was used for the level of significance test.
RESULTS:
Of all 82 patients in this study, the median onset time of LOSP was 220 d (93-813 d) after transplantation, and the 60-day survival rate was 58.5% (48/82). The median improvement time of the survival patients was 18 d (7-44 d), while the median death time of the died patients was 22 d (2-53 d). Multivariate analysis showed that the initiation time of antiviral drugs from the onset of LOSP (< 10 d vs. ≥10 d, P=0.012), and the initiation time of glucocorticoids from antiviral drugs (< 10 d vs. ≥10 d, P=0.027) were the factors affecting the final outcome of the patients with LOSP at the end of 60 d. According to the above results, LOSP patients were divided into four subgroups: group A (antiviral drugs < 10 d, glucocorticoids ≥10 d), group B (antiviral drugs < 10 d, glucocorticoids < 10 d), group C (antiviral drugs ≥10 d, glucocorticoids ≥10 d) and group D (antiviral drugs ≥10 d, glucocorticoids < 10 d), the 60-day survival rates were 91.7%, 56.8%, 50.0% and 21.4%, respectively.
CONCLUSION
Our study demonstrated that in patients who developed LOSP after allo-SCT, the initiation time of antiviral drugs and glucocorticoids were associated with the prognosis of LOSP, and the survival rate was highest in patients who received antiviral drugs early and glucocorticoids later. It suggested that for patients with LOSP of unknown etiology should be highly suspicious of the possibility of a secondary hyperimmune response to viral infection.
Antiviral Agents/therapeutic use*
;
Glucocorticoids/therapeutic use*
;
Hematopoietic Stem Cell Transplantation/methods*
;
Humans
;
Pneumonia/etiology*
;
Prognosis
;
Retrospective Studies
;
Transplantation, Homologous/adverse effects*
5.Histomorhological and clinical evaluation of maxillary alveolar ridge reconstruction after craniofacial trauma by applying combination of allogeneic and autogenous bone graft.
Francesco Saverio De PONTE ; Roberto FALZEA ; Michele RUNCI ; Enrico Nastro SINISCALCHI ; Floriana LAURITANO ; Ennio BRAMANTI ; Gabriele CERVINO ; Marco CICCIU
Chinese Journal of Traumatology 2017;20(1):14-17
A variety of techniques and materials for the rehabilitation and reconstruction of traumatized maxillary ridges prior to dental implants placement have been described in literature. Autogenous bone grafting is considered ideal by many researchers and it still remains the most predictable and documented method. The aim of this report is to underline the effectiveness of using allogeneic bone graft for managing maxillofacial trauma. A case of a 30-year-old male with severely atrophic maxillary ridge as a consequence of complex craniofacial injury is presented here. Augmentation procedure in two stages was performed using allogeneic and autogenous bone grafts in different areas of the osseous defect. Four months after grafting, during the implants placement surgery, samples of both sectors were withdrawn and submitted to histological evaluation. On the examination of the specimens, treated by hematoxylin and eosin staining, the morphology of integrated allogeneic bone grafts was revealed to be similar to the autologous bone. Our clinical experience shows how the allogeneic bone graft presented normal bone tissue architecture and is highly vascularized, and it can be used for reconstruction of severe trauma of the maxilla.
Adult
;
Bone Transplantation
;
methods
;
Facial Injuries
;
pathology
;
surgery
;
Humans
;
Male
;
Maxilla
;
injuries
;
pathology
;
surgery
;
Reconstructive Surgical Procedures
;
methods
;
Transplantation, Autologous
;
Transplantation, Homologous
6.Tyrosine Kinase Inhibitor for Treatment of Adult Allogeneic Hematopoietic Stem Cell Transplantation Candidate with Philadelphia-Positive Acute Lymphoblastic Leukemia.
Chinese Medical Journal 2017;130(2):127-129
Hematopoietic Stem Cell Transplantation
;
methods
;
Humans
;
Precursor Cell Lymphoblastic Leukemia-Lymphoma
;
drug therapy
;
mortality
;
therapy
;
Protein Kinase Inhibitors
;
therapeutic use
;
Protein-Tyrosine Kinases
;
antagonists & inhibitors
;
Survivors
;
Transplantation, Homologous
;
Treatment Outcome
7.Preventing Varus Deformity in Senile Patients with Proximal Humerus Fractures and Poor Medial Support.
Young Kyu KIM ; Suk Woong KANG ; Jin Woo KIM
Clinics in Shoulder and Elbow 2016;19(4):216-222
BACKGROUND: We investigated the effectiveness of fibular strut allograft augmentation of proximal humerus fractures to prevent varus deformity in patients over the age of 65 years with insufficient medial support. METHODS: We analyzed the clinical and radiological outcomes of locking plate fixation with adjunct fibular strut allograft augmentation in 21 patients with proximal humeral fractures. The inclusion criteria were age (65-year-old or older); presence of severe medial comminution; inadequate medial support; and those who could participate in at least a one year follow-up. The average age was 76.4 years. We analyzed each patient's Constant score, our indicator of clinical outcome. As radiological parameters, we analyzed time-to-bone union; restoration of the medial hinge; difference between the immediately postoperative and the last follow-up humeral neck-shaft angles;; and anatomical reduction status, which was assessed using the Paavolainen method. RESULTS: A successful bone union was achieved in all patients at an average of 11.4 weeks. We found that the average Constant score was 74.2, showing a satisfactory outcome. The average difference in the humeral neck-shaft angles between the immediately postoperative time-point and at the final follow-up was 3.09°. According to the Paavolainen method, the anatomical reduction was rated excellent. The medial hinge was restored in 14 of 21 patients. Although we did not find evidence for osteonecrosis, we found that a single patient had a postoperative complication of screw cut-out. CONCLUSIONS: Fibular strut allografting as an adjunct treatment of proximal humeral fractures may reduce varus deformity in patients with severe medial comminution.
Allografts
;
Congenital Abnormalities*
;
Follow-Up Studies
;
Humans
;
Humerus*
;
Methods
;
Osteonecrosis
;
Postoperative Complications
;
Shoulder Fractures
;
Transplantation, Homologous
8.Transplantation of a Scaffold-Free Cartilage Tissue Analogue for the Treatment of Physeal Cartilage Injury of the Proximal Tibia in Rabbits.
Sang Uk LEE ; Jae Young LEE ; Sun Young JOO ; Yong Suk LEE ; Changhoon JEONG
Yonsei Medical Journal 2016;57(2):441-448
PURPOSE: The purpose of this study was to investigate the effects of transplantation of an in vitro-generated, scaffold-free, tissue-engineered cartilage tissue analogue (CTA) using a suspension chondrocyte culture in a rabbit growth-arrest model. MATERIALS AND METHODS: We harvested cartilage cells from the articular cartilage of the joints of white rabbits and made a CTA using a suspension culture of 2x107 cells/mL. An animal growth plate defect model was made on the medial side of the proximal tibial growth plate of both tibias of 6-week-old New Zealand white rabbits (n=10). The allogenic CTA was then transplanted onto the right proximal tibial defect. As a control, no implantation was performed on the left-side defect. Plain radiographs and the medial proximal tibial angle were obtained at 1-week intervals for evaluation of bone bridge formation and the degree of angular deformity until postoperative week 6. We performed a histological evaluation using hematoxylin-eosin and Alcian blue staining at postoperative weeks 4 and 6. RESULTS: Radiologic study revealed a median medial proximal tibial angle of 59.0degrees in the control group and 80.0degrees in the CTA group at 6 weeks. In the control group, statistically significant angular deformities were seen 3 weeks after transplantation (p<0.05). On histological examination, the transplanted CTA was maintained in the CTA group at 4 and 6 weeks postoperative. Bone bridge formation was observed in the control group. CONCLUSION: In this study, CTA transplantation minimized deformity in the rabbit growth plate injury model, probably via the attenuation of bone bridge formation.
Animals
;
*Bone Transplantation
;
Cartilage/anatomy & histology
;
Cell Culture Techniques
;
Cells, Cultured
;
Chondrocytes/*cytology/transplantation
;
Growth Plate/anatomy & histology/*surgery
;
*Mesenchymal Stem Cell Transplantation
;
Rabbits
;
Tibia/*surgery
;
Tissue Engineering
;
Transplantation, Autologous/methods
;
Transplantation, Homologous
9.Application of combination of xenoskin with delayed microskin graft in extensively burned patients.
Bin LIU ; Weifeng LIU ; Renwu JIANG ; Jianfeng YANG ; Gang LI ; Pingzhi ZOU
Journal of Central South University(Medical Sciences) 2016;41(11):1202-1207
To observe clinical effects of combination of acellular porcine skin with delayed microskin graft on extensively burned patients.
Methods: Forty extensively burned patients were assigned into a treatment group and a control group. In the treatment group, 20 patients were covered with acellular porcine skin after escharectomy, and the delayed microskin grafting was performed 5 days later. In the control group, 20 patients were covered with allograft skin combined with microskin graft after escharectomy. The cure rate, the graft survival rate, wound healing time and cost per 1% wound were observed.
Results: The cure rate for the 2 groups was the same (90%), and wound healing time was similar between the two groups (P>0.05). The graft survival rate in the treatment group was higher than that in the control group (P<0.05), and cost per 1% wound in the treatment group was less than that in the control group (P<0.05).
Conclusion: The combination of acellular porcine skin with delayed microskin graft is an effective method to treat extensively burned patients, and it provides an ideal substitute for allograft skin combined with microskin graft.
Acellular Dermis
;
economics
;
statistics & numerical data
;
Animals
;
Biological Dressings
;
economics
;
statistics & numerical data
;
Burns
;
therapy
;
Cost-Benefit Analysis
;
Graft Survival
;
Humans
;
Skin Transplantation
;
economics
;
methods
;
Swine
;
Transplantation, Homologous
;
adverse effects
;
economics
;
methods
;
Wound Healing
10.Preventing Varus Deformity in Senile Patients with Proximal Humerus Fractures and Poor Medial Support
Young Kyu KIM ; Suk Woong KANG ; Jin Woo KIM
Journal of the Korean Shoulder and Elbow Society 2016;19(4):216-222
BACKGROUND: We investigated the effectiveness of fibular strut allograft augmentation of proximal humerus fractures to prevent varus deformity in patients over the age of 65 years with insufficient medial support. METHODS: We analyzed the clinical and radiological outcomes of locking plate fixation with adjunct fibular strut allograft augmentation in 21 patients with proximal humeral fractures. The inclusion criteria were age (65-year-old or older); presence of severe medial comminution; inadequate medial support; and those who could participate in at least a one year follow-up. The average age was 76.4 years. We analyzed each patient's Constant score, our indicator of clinical outcome. As radiological parameters, we analyzed time-to-bone union; restoration of the medial hinge; difference between the immediately postoperative and the last follow-up humeral neck-shaft angles;; and anatomical reduction status, which was assessed using the Paavolainen method. RESULTS: A successful bone union was achieved in all patients at an average of 11.4 weeks. We found that the average Constant score was 74.2, showing a satisfactory outcome. The average difference in the humeral neck-shaft angles between the immediately postoperative time-point and at the final follow-up was 3.09°. According to the Paavolainen method, the anatomical reduction was rated excellent. The medial hinge was restored in 14 of 21 patients. Although we did not find evidence for osteonecrosis, we found that a single patient had a postoperative complication of screw cut-out. CONCLUSIONS: Fibular strut allografting as an adjunct treatment of proximal humeral fractures may reduce varus deformity in patients with severe medial comminution.
Allografts
;
Congenital Abnormalities
;
Follow-Up Studies
;
Humans
;
Humerus
;
Methods
;
Osteonecrosis
;
Postoperative Complications
;
Shoulder Fractures
;
Transplantation, Homologous

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