Human corneal endothelial cells grafts to replace cadaveric donor corneas

Human corneal endothelial cells (HCEC) grafts to replace cadaveric donor corneas have made tremendous progress in recent years, and this article highlights the most recent discoveries and important achievements in this area. Cell injection therapy with cultured HCEC has just finished its first clinical research, which showed promising results. This follows on the heels of the success of autologous limbal stem cell transplantation in bioengineered ocular tissue transplantation. Transplantation techniques like bioengineered endothelium sheet transplantation and full-thickness corneal transplantation are likely to become more prevalent in the future decade. This goal will be achieved by a combination of current advancements in HCEC propagation, high-quality culture media, and 3D or 4D tissue culture, which will be the trend in the future.

Post-Traumatic Growth among Patients after Living and Cadaveric Donor Kidney Transplantation: The Role of Resilience and Alexithymia

The aim of this study was to determine the role of resilience and alexithymia in the post-traumatic growth as a response to extreme stress in patients after kidney transplantation and to determine whether there are differences in the level of posttraumatic growth in patients after living and cadaveric donor kidney transplantation. The relationships between these variables were also evaluated. The questionnaire survey of 91 kidney recipients took place in 2018 and 2019. The following tools were used: authorial post-transplant questionnaire for recipients and validated questionnaires, Post Traumatic Growth Inventory (PTGI-R), Resilience Coping Scale Questionnaire, and Toronto Alexithymia Scale Questionnaire (TAS20). The results obtained showed significant differences between the group of kidney recipients from living donors and recipients from cadaveric donors, in terms of overall post-traumatic growth, as well as changes in self-perception and a greater appreciation for life. Post-traumatic growth in both groups was related to the level of resilience and the level of alexithymia. Resilience is an accurate predictor of posttraumatic growth in general and for each of the groups of recipients separately.

Epithelial and stromal remodelling following femtosecond laser–assisted stromal lenticule addition keratoplasty (SLAK) for keratoconus

The purpose of this study was to evaluate corneal epithelium and stromal remodelling with anterior segment optical coherence tomography in patients who have undergone stromal lenticule addition keratoplasty (SLAK) for advanced keratoconus. This was a prospective non-comparative observational study. Fifteen eyes of 15 patients with advanced keratoconus underwent implantation with a cadaveric, donor negative meniscus-shaped intrastromal lenticule, produced with a femtosecond laser, into a stromal pocket dissected in the recipient cornea at a depth of 120 μm. Simulated keratometry, central corneal thickness (CTT), corneal thinnest point (CTP), central epithelial thickness (CET), central and peripheral lenticule thickness, anterior and posterior stromal thickness were measured. Regional central corneal epithelial thickness (CET) and variations in the inner annular area (IAT) and outer annular area (OAT) were also analysed. All parameters were measured preoperatively and 1, 3, and 6 months postoperatively. The average anterior Sim-k decreased from 59.63 ± 7.58 preoperatively to 57.19 ± 6.33 D 6 months postoperatively. CCT, CTP, CET, and OAT increased and IAT decreased significantly after 1 month. All parameters appeared unchanged at 6-months except that of OAT that further increased. Lenticule thickness was stable. In conclusion we observed that SLAK reshapes the cornea by central flattening with stromal thickening and epithelial thickness restoration.

Right renal vein lengthening with cava patch in cadaveric donor kidney transplantation: cohort study

Background: Right kidney transplant can become a surgical challenge, due to anatomical length disparity between the right and left veins. From 2011, lengthening of the right renal vein has been used in our program. The objective was to evaluate the outcome among kidney transplant recipients with or without the use of a cava patch, comparing safety, complications and patient / graft survival in both groups.Methods: Retrospective single center cohort study between 2011-2020 in a Kidney transplant program at Mexico.Results: 27 right cadaveric kidney transplant recipients were identified, 13 (48%) with and 14 (52%) without right renal vein lengthening (RRVL). Median overall operative time was 135 (120-157) minutes, with no significant difference between groups (p=0.181), even in overweight or obese recipients. Perioperative bleeding and postoperative drainage output was similar in both groups. There were two graft failures among recipients without RRVL one due to arterial bleeding and the other secondary to venous thrombosis. After one year of follow up, renal graft function and graft survival was similar in both groups.Conclusions: RRVL technique is safe and facilitates anastomoses in complex cases. Although no statistically significant difference in operative time was found between the groups, the RRVL technique in overweight / obese patients was thirty minutes faster. Routine use of this technique is suggested in cadaveric donor right kidney transplants.

The cornea of ​​a cadaveric donor is a key problem in keratoplasty

This monograph is a source of additional knowledge to the main program of the lecture material and the textbook "Eye Diseases" edited by prof. V.G. Kopaeva, addressed to teachers and students, residents and graduate students, practicing ophthalmic surgeons for in-depth independent development of the section of corneal transplantation.