RESUMEN
On March 19 World Health Organization declare the pandemic situation by outbreak coronavirus disease 2019 in the world. The pressure on the health care system has been very high in several countries. Spanish National Transplant Organization (ONT) have made many efforts in maintaining transplantation activity. Although the impact of the pandemic on organ activity has been analysed, to date, less data exist regarding the impact on tissue activity. The aim of this study has been the evaluation of the possible impact on the procurement, processing and distribution of tissues during the peak period of the pandemic COVID-19 in Spain. For this study, a multicentre analysis has been made with a survey of the tissue banks in Spain, during the period March 1 to April 30, 2020. Our data suggest that the impact of coronavirus in Spain has affected dramatically tissue donation but with a moderate effect on stored tissues such as bone, valves, vessels or skin. Tissue banks should prepare if future next pandemic waves surges so that tissue provision is guaranteed both in urgent and elective surgeries.
Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Bancos de Tejidos/estadística & datos numéricos , Obtención de Tejidos y Órganos/estadística & datos numéricos , Trasplante/estadística & datos numéricos , Betacoronavirus , COVID-19 , Humanos , Pandemias , SARS-CoV-2 , España/epidemiología , Encuestas y CuestionariosRESUMEN
BACKGROUND: The need for high-cellular-content cord blood units (CBUs) for allogenic transplantation is evident to improve clinical outcomes. In our environment and with current donation programs, very few collected units meet suggested clinical thresholds, making collection programs highly inefficient. To increase the clinical conversion rate, we have assessed factors influencing the cellular content of the cord blood collection and established the estimated fetal weight percentile (EFWp) as a tool to predict which deliveries will obtain higher cellular counts. STUDY DESIGN AND METHODS: We conducted a retrospective analysis of 11,349 collected CBUs. An analysis of diagnostic efficiency (receiver operating characteristic [ROC] curve) was performed to establish the cutoffs of several obstetric and perinatal variables from which we would obtain more than 1500 × 106 total nucleated cells and 4 × 106 CD34 cells. We then calculated the optimal EFWp cutoff to increase efficiency. RESULTS: In the univariate analysis, factors positively and significantly associated were a greater neonatal and placental weight and longer weeks of gestation. In the multivariate analysis only neonatal and placental weight remain significant (p < 0.001). The ROC curve analysis showed that the optimal EFWp cutoff is 60, which has the maximum area under the curve. Applying this, donations meeting clinical cellular numbers will increase more than 30% with respect to not using any threshold. CONCLUSION: The EFWp predicts the quality of the collected CBUs and can be used to make a prenatal selection of the donors, therefore increasing the efficiency of umbilical cord blood collection programs.
Asunto(s)
Almacenamiento de Sangre/métodos , Recolección de Muestras de Sangre/métodos , Sangre Fetal/citología , Peso Fetal , Donantes de Sangre , Femenino , Humanos , Recién Nacido , Masculino , Embarazo , Estudios RetrospectivosRESUMEN
BACKGROUND: The introduction of molecular methods into routine blood typing is prompting the identification of new blood group alleles. Discrepancies between the results of genotyping and serology or chance events uncovered during genotyping prompted additional investigations, which revealed six new RHCE variant alleles. STUDY DESIGN AND METHODS: Samples from eight blood donors, two patients (one prenatal), and a patient's relative, all of diverse racial origin, were analyzed by standard serology methods, targeted genotyping arrays, DNA sequencing, and allele-specific polymerase chain reaction. RESULTS: Six new RHCE alleles were identified, namely, RHCE*cE84A, RHCE*ce202G, RHCE*ce307T, RHCE*Ce377G, RHCE*ce697G,712G,733G,744C, and RHCE*Ce733G. CONCLUSION: While implementation of new assays in commercial genotyping platforms to detect the polymorphisms reported here may not be justified given their apparent rarity, software interpretative algorithms may benefit from the identification of new alleles for a more accurate determination of genotypes and prediction of phenotypes.
Asunto(s)
Alelos , Población Negra/genética , Donantes de Sangre , Polimorfismo Genético , Sistema del Grupo Sanguíneo Rh-Hr/genética , Población Blanca/genética , Marcadores Genéticos , Genotipo , Técnicas de Genotipaje , Humanos , Fenotipo , Análisis de Secuencia de ADNRESUMEN
Fresh adipose-derived cells have been shown to be effective in the treatment of acute myocardial infarction (MI), but their role in the chronic setting is unknown. We sought to determine the long-term effect of the adipose derived-stromal vascular fraction (SVF) cell transplantation in a rat model of chronic MI. MI was induced in 82 rats by permanent coronary artery ligation and 5 weeks later rats were allocated to receive an intramyocardial injection of 10(7) GFP-expressing fresh SVF cells or culture media as control. Heart function and tissue metabolism were determined by echocardiography and (18)F-FDG-microPET, respectively, and histological studies were performed for up to 3 months after transplantation. SVF induced a statistically significant long-lasting (3 months) improvement in cardiac function and tissue metabolism that was associated with increased revascularization and positive heart remodeling, with a significantly smaller infarct size, thicker infarct wall, lower scar fibrosis, and lower cardiac hypertrophy. Importantly, injected cells engrafted and were detected in the treated hearts for at least 3 months, directly contributing to the vasculature and myofibroblasts and at negligible levels to cardiomyocytes. Furthermore, SVF release of angiogenic (VEGF and HGF) and proinflammatory (MCP-1) cytokines, as well as TIMP1 and TIMP4, was demonstrated in vitro and in vivo, strongly suggesting that they have a trophic effect. These results show the potential of SVF to contribute to the regeneration of ischemic tissue and to provide a long-term functional benefit in a rat model of chronic MI, by both direct and indirect mechanisms.
Asunto(s)
Adipocitos/citología , Infarto del Miocardio/terapia , Comunicación Paracrina , Células del Estroma/trasplante , Remodelación Ventricular , Proteínas Angiogénicas/metabolismo , Animales , Diferenciación Celular , Enfermedad Crónica , Citocinas/metabolismo , Modelos Animales de Enfermedad , Ecocardiografía , Femenino , Ventrículos Cardíacos/fisiopatología , Infarto del Miocardio/patología , Revascularización Miocárdica , Fenotipo , Tomografía de Emisión de Positrones , Ratas , Ratas Sprague-Dawley , Células del Estroma/citología , Inhibidor Tisular de Metaloproteinasa-1/metabolismo , Inhibidores Tisulares de Metaloproteinasas/metabolismo , Inhibidor Tisular de Metaloproteinasa-4RESUMEN
AIMS: To determine the effect of transplantation of undifferentiated and cardiac pre-differentiated adipose stem cells compared with bone marrow mononuclear cells (BM-MNC) in a chronic model of myocardial infarction. METHODS: Ninety-five Sprague-Dawley rats underwent left coronary artery ligation and after 1 month received by direct intramyocardial injection either adipose derived stem cells (ADSC), cardiomyogenic cells (AD-CMG) or BM-MNC from enhanced-Green Fluorescent Protein (eGFP) mice. The control group was treated with culture medium. Heart function was assessed by echocardiography and 18F-FDG microPET. Cell engraftment, differentiation, angiogenesis and fibrosis in the scar tissue were also evaluated by (immuno)histochemistry and immunofluorescence. RESULTS: One month after cell transplantation, ADSC induced a significant improvement in heart function (LVEF 46.3+/-9.6% versus 27.7+/-8% pre-transplant) and tissue viability (64.78+/-7.2% versus 55.89+/-6.3% pre-transplant). An increase in the degree of angiogenesis and a decrease in fibrosis were also detected. Although transplantation of AD-CMG or BM-MNC also had a positive, albeit smaller, effect on angiogenesis and fibrosis in the infarcted hearts, this benefit did not translate into a significant improvement in heart function or tissue viability. CONCLUSION: These results indicate that transplantation of adipose derived cells in chronic infarct provides a superior benefit to cardiac pre-differentiated ADSC and BM-MNC.
Asunto(s)
Infarto del Miocardio/terapia , Células del Estroma/trasplante , Tejido Adiposo/citología , Animales , Trasplante de Médula Ósea , Enfermedad Crónica , Femenino , Leucocitos Mononucleares/trasplante , Masculino , Trasplante de Células Madre Mesenquimatosas , Ratones , Ratones Endogámicos C57BL , Ratas , Ratas Sprague-Dawley , Recuperación de la Función , RegeneraciónRESUMEN
OBJECTIVE: This study was performed to examine both brain and systemic interleukin-6 (IL-6) release in patients with an acute brain injury (ABI), to study whether a correlation exists between the transcranial IL-6 gradient during the first days after injury and prognosis, and finally, to investigate the relationship between a nucleotide polymorphism at position -174 in the promoter of the gene encoding IL-6, IL-6 responsiveness, and clinical evolution. DESIGN: Prospective clinical investigation. SETTING: A 19-bed intensive care unit in a university hospital. PATIENTS AND METHODS: A total of 62 patients were followed up for 3 days after acute brain injury, and both their arterial and jugular IL-6 levels were measured serially and at the moment of brain death diagnosis. Genetic polymorphism of IL-6 was also determined in all patients. Data were correlated with those from score procedures for clinical severity. Neurologic outcome was graded according to the Glasgow Outcome Scale 6 months after injury. IL-6 levels and IL-6 genotyping was performed in control healthy individuals. MAIN RESULTS: There is a significant transcranial IL-6 gradient at admission and at the moment of brain death. The gradient is higher in those patients who evolved toward a fatal outcome during the first 6 months after injury (p <.001). There is significant correlation between the transcranial IL-6 gradient and the acute brain injury severity. CONCLUSIONS: IL-6 is elevated in patients with acute brain injury, and a significant relationship exits between the severity of acute brain injury and the transcranial IL-6 gradient at admission. It can be considered to be a prognosis marker at admission. When data at the moment of brain death are considered, venous IL-6 (p <.01) and the transcranial IL-6 gradient (p <.005) are significantly higher than at the time of admission. Although the IL-6 C allele is associated with significantly lower concentrations of IL-6, there was no correlation between low or high IL-6 responders and patient outcome.