Novel Kidney Auto Transplantation Technique for Ischemia-Reperfusion Studies

Large animal studies of long-term ischemia reperfusion are hampered by the use of immunosuppressive drugs to inhibit the influence of the allogeneic response. In small animals, this can be controlled by using inbred strains of the animal. For obvious reasons, this is not possible in large animals such as pigs. Since studies in pigs usually are the last step before first-in-man studies, this remains a problem trying to resemble a clinical situation. In the following short paper, we describe a novel auto kidney transplantation model that can be used for long term ischemia reperfusion studies. We also suggest a control setting to balance out the possible influence of an increased surgical trauma.

Simultaneous right-sided nephrectomy with orthotopic liver and kidney transplantation—An alternative method for patients with autosomal dominant polycystic liver and kidney disease

Purpose In patients suffering from autosomal dominant polycystic liver and kidney disease (ADPLKD), combined organ transplantation often poses a technical challenge due to the large volume of both organs. To simplify the transplantation procedure by improving the exposure of anatomical structures, we introduce a novel surgical technique of orthotopic liver and kidney transplantation. Methods The modified simultaneous liver and kidney transplantation technique via a right-sided L-incision included three steps: (1) right-sided nephrectomy in the recipient followed by (2) orthotopic liver transplantation in cava replacement technique and (3) the orthotopic kidney transplantation with arterial reconstruction to the right common iliac artery. Results In total, seven patients with ADPLKD were transplanted by using the modified transplantation technique. The mean operation time was 342.43 min (±68.77). Postoperative patients were treated for 6.28 days (±2.50) in the intensive care unit and were discharged from the surgical ward approximately 28 days (±5.66) after the operation with normal graft function. Complications associated with the use of the modified technique, such as bleeding, anastomotic stenosis, biloma, or urinoma, did not occur. Conclusion Modified simultaneous liver and kidney transplantation is a safe alternative for patients with ADPLKD. By combining right-sided nephrectomy and orthotopic graft transplantation, the approach optimizes the exposure of anatomical structures and simplifies the transplantation procedure. Additionally, the modified transplantation technique does not require a particular organ explantation procedure and can be applied for all liver and kidney grafts.

PHENOMENON OF DEMIKHOV. In the Sklifosovsky Institute (1960–1986). C.N. Barnard and the first clinical heart transplantation (December 3, 1967). V.P. Demikhov and C.N. Barnard: touchpoints

Having studied the available printed, visual, and verbal sources from Russia, South Africa, the USA, and Germany, we have identified and reviewed in the article the facts of face-to-face and correspondence communication between V.P. Demikhov, the "father" of experimental heart transplantation (Moscow, USSR), and C.N. Barnard, a pioneer of clinical heart transplantation (Cape Town, South Africa). We have shown that C.N. Barnard mastered the heart surgery techniques, including those under conditions of artificial circulation, in the USA in 1956-1958, and later improved them in his homeland both in clinic (heart surgery for cardiac defects), and in the experiment (heart transplantation). The main events preceding the first world human heart transplant performed by C.N. Barnard on December 3, 1967, were his trip to the United States in August 1967 to study immunosuppression techniques, and the kidney transplantation he had performed in Cape Town in September, 1967. Prior to that time, C.N. Barnard had visited the USSR only once, in May 1960, as a delegate to the XXVII All-Union Congress of Surgeons. In the Soviet Union, he visited a number of clinics dealing with heart surgery and tissue and organ transplantation, including the N.V. Sklifosovsky Institute for Emergency Medicine, where he met V.P. Demikhov, but C.N. Barnard could neither talk to him personally, nor watch his operations. In December 1967, V.P. Demikhov spoke with C.N. Barnard on the phone, but the conversation was highly professional. This paper has shown different approaches of V.P. Demikhov and C.N. Barnard to the transplantation problem: the Soviet surgeon paid more attention to the transplantation technique, meanwhile, the South African surgeon considered the solution of immunological problems to be the basis of success. Nevertheless, C.N. Barnard knew about V.P. Demikhov's scientific achievements and used some of them in his surgical practice. The authors have substantiated the interaction between V.P. Demikhov and C.N. Barnard as between an ideological mentor and a student (in a broad sense) rather than as a teacher and a student (in a narrow sense). Therefore, in a broad, philosophical sense, the Soviet surgeon can be considered one of the inspirers of the world's first heart transplantation, which, in turn, proved that his ascetic work was not in vain.

Modification of simple limbal epithelial stem cell transplantation technique(clinical case)

Актуальность. Самым эффективным и малотравматичным методом хирургического лечения синдрома лимбальной недостаточности(СЛН) является «простая трансплантация лимбального эпителия» («simple limbal epithelialtransplantation»(SLET)), в ходе которой выделенный на 12 ч участок лимба здорового глаза протяженностью 2 мм, фрагментируется на 6-8 лоскутов, с равномерным размещением их в области стромы роговицы пораженного глаза на фибриновый клей, располагая два слоя амниона под и над фиксированными лоскутами. Цель. Оптимизировать методику SLET, исключив использование фибринового клея и одного слоя амниона. Материал и методы. Пациентке В., 59 лет, с диагнозом исход ожога роговицы, полный СЛН, состояние после сквозной кератопластики, частичное помутнение трансплантата, выполнена опeрация SLET, при которой 8 лоскутов, полученных путем фрагментации выделенного участка лимба здорового глаза, размещались в радиально сформированных туннелях на периферии роговицы. Операцию завершали наложением одного слоя амниона на поверхность роговицы пораженного глаза, наложением мягкой контактной линзы (МКЛ) и временной блефарорафией. Результаты. Спустя 3 недели МКЛ была снята, наблюдали полную эпителизацию роговицы. Спустя 12 месяцев отмечали уменьшение поверхностной неоваскуляризации, образование стойкого эпителиального покрова и увеличение прозрачности трансплантата. На здоровом глазу место выделения лимба визуализировалось слабо, было покрыто конъюнктивой. Выводы. Исключение применения фибринового клея и одного слоя амниона значительно уменьшает себестоимость операции, делая ее более доступной. Радиально сформированные туннели в строме на периферии роговицы максимально физиологичны и обеспечивают стабильное положение лоскутов без применения фибринового клея, выполняют роль своеобразных депо лимбальных стволовых клеток, тем самым способствуя их равномерной миграции по всей поверхности роговицы.

Resumption of donor-origin spermatogenesis in senescent goldfish Carassius auratus (Linnaeus, 1758) following spermatogonial cell therapy

Stem cell research has come into prominence because of its applications in assisted reproductive technology and the treatment of deadly diseases. In teleost fishes, spermatogonial stem cells have been effectively used to produce surrogate gametes and progeny through germ cell transplantation technique. The present study is the first report of an innovative application of stem cell therapy in fish species for revitalising the reproductive competence of senescent individuals. Senescent male goldfish, Carassius auratus, approximately 10 years of age were procured from a fish-breeding farm and were reared locally in the lab for an additional two years. The senescence of the individuals was then evaluated and confirmed using histological analysis, gonadal index assessment, and germ-cell specific vasa gene expression. Analyses revealed absence of spermatogonial cells and other germ cells in the testes of the senescent fish (n = 5). Spermatogonial cells from sexually immature C. auratus male donor were isolated using discontinuous percoll gradients, labelled with the fluorescent dye PKH-26, and transplanted into the gonads of senescent C. auratus males through urogenital papilla. Six months after the transplant, spermatozoa were collected through applying gentle manual pressure on the abdomen and were observed under a microscope. All C. auratus males with the transplant had produced spermatozoa from the transplanted cells. This was confirmed by the retention of PKH-26 in the spermatozoa and diagnostic SSR locus. Gravid C. auratus females were artificially inseminated with the spermatozoa of those senescent males and natural spawning was allowed. As a result viable progeny were produced. These observation suggests that the reproductive competence of senescent male fishes can be revitalised through spermatogonial stem cell therapy to produce functional gametes.

Transplantation of nest of amazonian turtle Podocnemis expansa (Schweigger, 1812)

The main objective of this study is to analyze the effectiveness of the Podocnemis expansa nest transplantation technique used to aid in the conservation of the species, aiming to increase the number of individuals in nature. The Amazonian turtle is famous for its large size and commercial attractiveness, being the target of rampant hunting, mainly by populations that depend on the species economically. In September 2018, natural nests of P. expansa that were in areas of flood risk were excavated and transplanted into new nests constructed by the team. At the same time, the breeding females had their dimensions verified, as well as their respective eggs. In the second stage of the experiment, which occurred in November of the same year, the nests previously transplanted were counted, including the amount of eggshell, indicating how many eggs hatched, and measuring the size of the newborns, besides the presence of deformities. The sand collected from the bottom and surface of the natural and transplanted nests were analyzed by sieving. Through Pearson's correlation, the data were tested and related. No significant relationships were found between the birth rate and the grain size of the nests, which shows that grain size did not influence the success of hatching in the present study. It was found a strong relation (r = 0.80) between the number of eggs and the percentage of deformities of each transplanted nest, showing that the presence of deformed individuals in turtle nests is natural.