Chondrocyte Viability at Time of Transplantation for Osteochondral Allografts Preserved by the Missouri Osteochondral Preservation System versus Standard Tissue Bank Protocol

2017 ◽  
Vol 31 (08) ◽  
pp. 772-780 ◽  
Author(s):  
Aaron Stoker ◽  
James Stannard ◽  
James Cook
Keyword(s):  
Femoral Condyle ◽  
Tissue Bank ◽  
Standard Of Care ◽  
Tissue Banks ◽  
Complication Rates ◽  
Current Standard ◽  
Cell Viability Assay ◽  
Chondrocyte Viability ◽  
Viability Assay ◽  
Osteochondral Allografts

AbstractThe Missouri Osteochondral Preservation System (MOPS) has been reported to effectively preserve osteochondral allografts (OCAs) twice as long as current tissue bank protocols in preclinical studies. However, viability of OCAs preserved using the MOPS protocol at the time of clinical implantation compared with the current standard of care (SOC) is not known. Viable chondrocyte density (VCD) at time of transplantation will be significantly higher in OCAs preserved using the MOPS protocol compared with OCAs preserved using the current tissue bank protocol and will significantly affect clinical complication rates. Femoral condyle OCAs were obtained from American Association of Tissue Banks accredited tissue banks for clinical use. The OCAs were stored using the current SOC protocol for each respective tissue bank (n = 26) or the MOPS protocol (n = 50). Nonimplanted femoral condyle OCA tissue normally discarded after surgery was collected and assessed for VCD within 1 hour after surgery. Control OCA samples (n = 34) were obtained from one tissue bank. VCD was determined using a validated cell viability assay. Patients (n = 76) had in-clinic follow-up at least 6 months after OCA transplantation. At the time of clinical implantation, mean storage time for OCAs in the SOC cohort was 20.4 days, and in the MOPS cohort was 44.2 days, after procurement. VCD in OCAs in the MOPS cohort was not significantly different from normal healthy cartilage VCD and 100% were above the desired minimum essential level 70% of control VCD at the time of transplantation. VCD in OCAs in the SOC cohort was significantly (p < 0.001) lower than controls and MOPS, and only 27% were above 70% of control VCD at the time of transplantation. MOPS preserves OCA chondrocyte viability at significantly higher levels than current tissue bank storage protocols for a longer period of time after procurement. All MOPS-preserved OCAs exceeded minimum essential VCD levels for up to 56 days after procurement.

scholarly journals Clinical and Echocardiographic Trends in Percutaneous Balloon Mitral Valvuloplasty

2020 ◽  
Author(s):  
Ofir Koren ◽  
Asaf Israeli ◽  
Ehud Rozner ◽  
Nassem Darawshy ◽  
Yoav Turgeman
Keyword(s):  
Standard Of Care ◽  
Complication Rates ◽  
Success Rates ◽  
Current Standard ◽  
Mitral Valvuloplasty ◽  
Patient Demographics ◽  
Percutaneous Balloon Mitral Valvuloplasty ◽  
Percutaneous Balloon ◽  
Male Patients ◽  
Over Time

Abstract Background Percutaneous balloon mitral valvuloplasty (PBMV) is the current standard of care for selected patients with rheumatic mitral stenosis. We examined trends in patient demographics, Wilkins score and additional echocardiographic characteristics, success rates, and complications over a 30-year period.Methods We conducted a retrospective observational descriptive study. The study population consists of patients hospitalized in intensive cardiac care (ICCU) due to significant symptomatic MS, from January 1990 to May 2019.Results 417 patients who underwent PBMV were eligible. Age did not change significantly over time. Male patients who were smoking and had multiple comorbidities such as hypertension, dyslipidemia, ischemic heart disease, and chronic kidney disease became more prevalence (p=0.02, p=0.02, p=0.001, p=0.01, p=0.02, and p=0.001 respectively). Wilkins score and all its components increased over time, which was higher in females (p=0.01), and was not correlated with age (p=0.95). Severe leaflets immobility (Grade 4) predicted complications (p=0.03, respectively). Wilkins over 9 successfully predicted the occurrence of complications, conversely, no efficient cutoff was found in the following decades. Wilkins score managed to predict a technically successful procedure (p=0.02), but not complications (p=0.12). Lastly, complication rates did not significantly change over the years.Conclusion Our research covers three decades of experience in PBMV and shows several trends: We see more male patients, who have multiple comorbidities. The Wilkins score increased over the years and was predictive of successful operations as opposed to complications who were predicted mainly by the leaflet mobility index.

scholarly journals Early operative morbidity in 184 cases of anterior vertebral body tethering

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
James Meyers ◽  
Lily Eaker ◽  
Theodor Di Pauli von Treuheim ◽  
Sergei Dolgovpolov ◽  
Baron Lonner
Keyword(s):  
Vertebral Body ◽  
Standard Of Care ◽  
Allogenic Blood Transfusion ◽  
Complication Rates ◽  
Current Standard ◽  
Allogenic Blood ◽  
Nerve Root Injury ◽  
Major Complications ◽  
Root Injury ◽  
Superficial Wound

AbstractFusion is the current standard of care for AIS. Anterior vertebral body tethering (AVBT) is a motion-sparing alternative gaining interest. As a novel procedure, there is a paucity of literature on safety. Here, we report 90-day complication rates in 184 patients who underwent AVBT by a single surgeon. Patients were retrospectively reviewed. Approaches included 71 thoracic, 45 thoracolumbar, 68 double. Major complications were those requiring readmittance or reoperation, prolonged use of invasive materials such as chest tubes, or resulted in spinal cord or nerve root injury. Minor complications resolved without invasive intervention. Mean operative time and blood loss were 186.5 ± 60.3 min and 167.2 ± 105.0 ml, respectively. No patient required allogenic blood transfusion. 6 patients experienced major (3.3%), and 6 had minor complications (3.3%). Major complications included 3 chylothoracies, 2 hemothoracies, and 1 lumbar radiculopathy secondary to screw placement requiring re-operation. Minor complications included 1 patient with respiratory distress requiring supplementary oxygen, 1 superficial wound infection, 2 cases of prolonged nausea, and 1 Raynaud phenomenon. In 184 patients who underwent AVBT for AIS, major and minor complication rates were both 3.3%.

scholarly journals Vitrification of Intact Porcine Femoral Condyle Allografts Using an Optimized Approach

Cartilage ◽  
2020 ◽  
pp. 194760352096707
Author(s):  
Kezhou Wu ◽  
Leila Laouar ◽  
Janet A. W. Elliott ◽  
Nadr M. Jomha
Keyword(s):  
Articular Cartilage ◽  
Femoral Condyle ◽  
Membrane Integrity ◽  
Cartilage Defects ◽  
Chondrocyte Viability ◽  
Cell Membrane Integrity ◽  
A Cell ◽  
Vitrification Solution ◽  
Femoral Condyles ◽  
Osteochondral Allografts

Objective Successful preservation of articular cartilage will increase the availability of osteochondral allografts to treat articular cartilage defects. We compared the effects of 2 methods for storing cartilage tissues using 10-mm diameter osteochondral dowels or femoral condyles at −196°C: (a) storage with a surrounding vitrification solution versus (b) storage without a surrounding vitrification solution. We investigated the effects of 2 additives (chondroitin sulfate and ascorbic acid) for vitrification of articular cartilage. Design Healthy porcine stifle joints ( n = 11) from sexually mature pigs were collected from a slaughterhouse within 6 hours after slaughtering. Dimethyl sulfoxide, ethylene glycol, and propylene glycol were permeated into porcine articular cartilage using an optimized 7-hour 3-step cryoprotectant permeation protocol. Chondrocyte viability was assessed by a cell membrane integrity stain and chondrocyte metabolic function was assessed by alamarBlue assay. Femoral condyles after vitrification were assessed by gross morphology for cartilage fractures. Results There were no differences in the chondrocyte viability (~70%) of 10-mm osteochondral dowels after vitrification with or without the surrounding vitrification solution. Chondrocyte viability in porcine femoral condyles was significantly higher after vitrification without the surrounding vitrification solution (~70%) compared to those with the surrounding vitrification solution (8% to 36%). Moreover, articular cartilage fractures were not seen in femoral condyles vitrified without surrounding vitrification solution compared to fractures seen in condyles with surrounding vitrification solution. Conclusions Vitrification of femoral condyle allografts can be achieved by our optimized approach. Removing the surrounding vitrification solution is advantageous for vitrification outcomes of large size osteochondral allografts.

The Effect of Arthroscopic Partial Medial Meniscectomy on Tibiofemoral Stability

2012 ◽  
Author(s):  
C. P. Bell ◽  
S. Arno ◽  
S. Hadley ◽  
K. Campbell ◽  
M. Hall ◽  
...  
Keyword(s):  
Medial Meniscus ◽  
Femoral Condyle ◽  
Standard Of Care ◽  
Partial Meniscectomy ◽  
Posterior Horn ◽  
Meniscal Injury ◽  
Arthroscopic Partial Meniscectomy ◽  
Current Standard ◽  
Medial Meniscectomy ◽  
Anterior Posterior

Irreparable tears of the posterior horn of the medial meniscus are the most common meniscal injury and arthroscopic partial meniscectomy is the current standard of care (1–3). However, despite the excellent results of partial meniscectomy, there is still little known regarding the effects of the size of a resection on tibiofemoral stability, as measured by laxity and anterior-posterior (AP) position. Therefore in this study, we sought to determine this by conducting three successive partial meniscectomies of the posterior horn of the medial meniscus (PMM) and measuring the laxity and AP position of the medial femoral condyle over a series of loading conditions following each resection. It was hypothesized that more than a 50% resection would result in significant changes in laxity and AP position equivalent to a 100% removal of the PMM.

Analysis of Stored Osteochondral Allografts at the Time of Surgical Implantation

2005 ◽  
Vol 33 (10) ◽  
pp. 1479-1484 ◽  
Author(s):  
R. Todd Allen ◽  
Catherine M. Robertson ◽  
Andrew T. Pennock ◽  
William D. Bugbee ◽  
Frederick L. Harwood ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Cell Viability ◽  
Cell Density ◽  
Tissue Bank ◽  
Viable Cell ◽  
Viable Cell Density ◽  
Proteoglycan Synthesis ◽  
Superficial Zone ◽  
Chondrocyte Viability ◽  
Osteochondral Allografts

Background To date, the morphological, biochemical, and biomechanical characteristics of articular cartilage in osteochondral allografts that have been stored have not been fully described. Hypothesis Osteochondral allografts procured and stored commercially for a standard period as determined by tissue banking protocol will have compromised chondrocyte viability but preserved extracellular matrix quality. Study Design Controlled laboratory study. Methods Unused cartilage from 16 consecutive osteochondral allografts was sampled during surgery after tissue bank processing and storage. Ten grafts were examined for cell viability and viable cell density using confocal microscopy, proteoglycan synthesis via 35SO4 uptake, and glycosaminoglycan content and compared with fresh cadaveric articular cartilage. Biomechanical assessment was performed on the 6 remaining grafts by measuring the indentation stiffness of the cartilage. Results The mean storage time for the transplanted specimens was 20.3 ± 2.9 days. Chondrocyte viability, viable cell density, and 35SO4 uptake were significantly lower in allografts at implantation when compared to fresh, unstored controls, whereas matrix characteristics, specifically glycosaminoglycan content and biomechanical measures, were unchanged. In addition, chondrocyte viability in the stored allografts was preferentially decreased in the superficial zone of cartilage. Conclusion Human osteochondral allografts stored for a standard period (approximately 3 weeks) before implantation undergo decreases in cell viability, especially in the critically important superficial zone, as well as in cell density and metabolic activity, whereas matrix and biomechanical characteristics appear conserved. The exact clinical significance of these findings, however, is unknown, as there are no prospective studies examining clinical outcomes using grafts stored for extended periods. Clinical Relevance Surgeons who perform this procedure should understand the cartilage characteristics of the graft after 21 days of commercial storage in serum-free media.

Evaluation of a cell viability assay based on cultures of CTICs to identify treatment options in third-line pancreatic cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 338-338
Author(s):  
Mark Ricigliano ◽  
William H. Isacoff ◽  
Allyson J. Ocean ◽  
Brandon Cooper ◽  
Mary Welkie ◽  
...  
Keyword(s):  
Cell Viability ◽  
Treatment Options ◽  
Standard Of Care ◽  
Response To Treatment ◽  
Patient Treatment ◽  
P Value ◽  
Line Treatment ◽  
Cell Viability Assay ◽  
Viability Assay ◽  
A Cell

338 Background: Standard of care treatment for pancreatic adenocarcinoma (PDAC) includes FOLFIRINOX or gemcitabine with nab-paclitaxel used in either the front-line or 2nd line treatment setting. There is no consensus for 3rd line treatment for this cohort of poor prognosis patients with clinical trials being the only viable option. We evaluated a cell viability assay using cultures of circulating tumor and invasive cells (CTICs) to identify effective 3rdline PDAC treatment options. Methods: CTICs were isolated from peripheral blood samples of 17 PDAC patients who previously had received one of the two standard of care regimens using an immunomagnetic separation for EPCAM epitope Ber-EP4 and cultured in enriched DMEM-F12 medium. After 14 days, seven chemotherapeutics (gemcitabine (G), oxaliplatin (O), fluorouracil (F), irinotecan (I), mitomycin C (M), cisplatin (C) and paclitaxel (P)) were added to the cultures and response to treatment was measured 48 hr. after treatment by immunofluorescence using a live-cell resazurin assay. Response to treatment was determined by a reduction of fluorescence in the treated cultures compared to control and the mean florescence (Fm) was calculated for each chemotherapeutic. A one-sample t-test was used to measure the variance between Fm control and treated samples. (p-value <0.005). Sensitivity to treatment was determined using linear regression based on Fm values and the sensitivity of each chemotherapeutic was interpolated from a standard curve (range 1.0-5.0, sensitive <2, intermediate 2-3, resistant >3). Results: m (Fm=1.6) demonstrated the most effective treatment option with marked resistance to treatment for G, I, P and O. (Fm=3.4, 3.7, 3.4 and 3.7). Intermediate response was observed for F and C (Fm=2.8 and 2.8). Patient treatment response to m will be described. Conclusions: CTICs can be routinely isolated and cultured for cell viability assays. m based regimens with C and F should be considered for 3rd line PDAC patients.

Variability in the Processing of Fresh Osteochondral Allografts

2021 ◽  
Author(s):  
Kyle D. Paul ◽  
Romil K. Patel ◽  
Alexandra M. Arguello ◽  
Adam Kwapisz ◽  
Eugene W. Brabston ◽  
...  
Keyword(s):  
Storage Temperature ◽  
The United States ◽  
Osteochondral Allograft ◽  
Tissue Banks ◽  
Aseptic Processing ◽  
Chondrocyte Viability ◽  
Insulin Growth Factor ◽  
Tissue Handling ◽  
Microbiological Testing ◽  
Osteochondral Allografts

AbstractThe indications for fresh osteochondral allograft continue to increase. As a result, variations in graft processing and preservation methods have emerged. An understanding of these techniques is important when evaluating the optimal protocol for processing fresh osteochondral allografts prior to surgical implantation. The aim of this study is to review the literature and understand various tissue processing protocols of four leading tissue banks in the United States. Donor procurement, serological and microbiological testing, and storage procedures were compared among companies of interest. Similarities between the major tissue banks include donor screening, aseptic processing, and testing for microorganisms. Variability exists between these companies with relation to choice of storage media, antibiotic usage, storage temperature, and graft expiration dates. Potential exists for increased chondrocyte viability and lengthened time-to-expiration of the graft through a protocol of delicate tissue handling, proper choice of storage medium, adding hormones and growth factors like insulin growth factor-1 (IGF-1) to serum-free nutrient media, and storing these grafts closer to physiologic temperatures.

Proliferative Effect of Tilapia Fish (Oreochromis niloticus) Lectin on BALB/c Mice Splenocytes

2019 ◽  
Vol 26 (12) ◽  
pp. 887-892
Author(s):  
Cynarha Daysy Cardoso da Silva ◽  
Cristiane Moutinho Lagos de Melo ◽  
Elba Verônica Matoso Maciel Carvalho ◽  
Mércia Andréa Lino da Silva ◽  
Rosiely Félix Bezerra ◽  
...  
Keyword(s):  
Cell Proliferation ◽  
Oreochromis Niloticus ◽  
Cytokine Production ◽  
Thymidine Incorporation ◽  
Con A ◽  
Cell Viability Assay ◽  
Proliferative Effect ◽  
Viability Assay ◽  
Apoptosis And Necrosis

Background: Lectins have been studied in recent years due to their immunomodulatory activities. Objective: We purified a lectin named OniL from tilapia fish (Oreochromis niloticus) and here we analyzed the cell proliferation and cytokine production in Balb/c mice splenocytes. Methods: Cells were stimulated in vitro in 24, 48, 72 hours and 6 days with different concentrations of OniL and Con A. Evaluation of cell proliferation was performed through [3H]-thymidine incorporation, cytokines were investigated using ELISA assay and cell viability assay was performed by investigation of damage through signals of apoptosis and necrosis. Results: OniL did not promote significant cell death, induced high mitogenic activity in relation to control and Con A and stimulated the cells to release high IL-2 and IL-6 cytokines. Conclusion: These findings suggest that, like Con A, OniL lectin can be used as a mitogenic agent in immunostimulatory assays.

Acute Rejection Following Kidney Transplantation: State-of-the-Art and Future Perspectives

2020 ◽  
Vol 26 (28) ◽  
pp. 3468-3496
Author(s):  
Emilio Rodrigo ◽  
Marcio F. Chedid ◽  
David San Segundo ◽  
Juan C.R. San Millán ◽  
Marcos López-Hoyos
Keyword(s):  
Kidney Transplantation ◽  
Acute Rejection ◽  
Rescue Therapy ◽  
Standard Of Care ◽  
Rejection Rate ◽  
New Drugs ◽  
High Dose ◽  
Current Standard ◽  
Antibody Mediated Rejection ◽  
Cellular Rejection

: Although acute renal graft rejection rate has declined in the last years, and because an adequate therapy can improve graft outcome, its therapy remains as one of the most significant challenges for pharmacists and physicians taking care of transplant patients. Due to the lack of evidence highlighted by the available metaanalyses, we performed a narrative review focused on the basic mechanisms and current and future therapies of acute rejection in kidney transplantation. : According to Kidney Disease/Improving Global Outcomes (KDIGO) guidelines, both clinical and subclinical acute rejection episodes should be treated. Usually, high dose steroids and basal immunosuppression optimization are the first line of therapy in treating acute cellular rejection. Rabbit antithymocytic polyclonal globulins are used as rescue therapy for recurrent or steroid-resistant cellular rejection episodes. Current standard-of-care (SOC) therapy for acute antibody-mediated rejection (AbMR) is the combination of plasma exchange with intravenous immunoglobulin (IVIG). Since a significant rate of AbMR does not respond to SOC, different studies have analyzed the role of new drugs such as Rituximab, Bortezomib, Eculizumab and C1 inhibitors. Lack of randomized controlled trials and heterogenicity among performed studies limit obtaining definite conclusions. Data about new direct and indirect B cell and plasma cell depleting agents, proximal and terminal complement blockers, IL-6/IL-6R pathway inhibitors and antibody removal agents, among other promising drugs, are reviewed.

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