Consequences of Cold-Ischemia Time on Primary Nonfunction and Patient and Graft Survival in Liver Transplantation: A Meta-Analysis

Introduction: The ability to preserve organs prior to transplant is essential to the organ allocation process. Objective: The purpose of this study is to describe the functional relationship between cold-ischemia time (CIT) and primary nonfunction (PNF), patient and graft survival in liver transplant. Methods: To identify relevant articles Medline, EMBASE and the Cochrane database, including the non-English literature identified in these databases, was searched from 1966 to April 2008. Two independent reviewers screened and extracted the data. CIT was analyzed both as a continuous variable and stratified by clinically relevant intervals. Nondichotomous variables were weighted by sample size. Percent variables were weighted by the inverse of the binomial variance. Results: Twenty-six studies met criteria. Functionally, PNF%=-6.678281+0.9134701*CIT Mean+0.1250879*(CIT Mean-9.89535) 2 - 0.0067663*(CIT Mean-9.89535) 3, r2=.625, p<.0001. Mean patient survival: 93 % (1 month), 88 % (3 months), 83 % (6 months) and 83 % (12 months). Mean graft survival: 85.9 % (1 month), 80.5 % (3 months), 78.1 % (6 months) and 76.8 % (12 months). Maximum patient and graft survival occurred with CITs between 7.5-12.5 hrs at each survival interval. PNF was also significantly correlated with ICU time, % first time grafts and % immunologic mismatches. Conclusion: The results of this work imply that CIT may be the most important pre-transplant information needed in the decision to accept an organ. © 2008 Stahl et al

Cell Surface Changes in Development: The I Blood Group Antigen in Humans

The I blood group system in humans was investigated in order to study cell surface changes in development. One advantage in studying the I-antigen in man is the availability of well defined, easily purifiable cold agglu­tinin molecules with anti-I specificity. Sera from patients with chronic cold agglutinin, post pneumonia cold agglutinin and post viral influenza cold agglutinin disease have been studied. The IgM agglutinins were isolated and their restric­ted heterogeneity established. These well characterized protein molecules were used in experiments to study the I antigen's development and in experiments designed to reveal information about the molecular basis of I antigen specifi­city. The development of I antigen and postnatal changes in hemoglobin were examined in human infants, to see whether the developmental changes in these two attributes are correlated individual cells in such a way as to suggest that they have common biochemical control mechanisms. The results demon­strated that the expression of I antigen on the erythrocyte surface is independent from the control mechanism of the biosynthesis of the beta chain of hemoglobin. These observa­tions are explained by suggesting two separate modulatory regulations, one for the enzymes involved in the expression of I-specific molecules on the cell surface and another for the regulation of hemoglobin subunit synthesis. The rates of A-antigen and I antigen site development were compared using I125 labeled anti-A IgG molecules in order to test for possible common control or close association. Erythrocytes from postnatal infants were fractionated with respect to their I-agglutinability. Experimental results indicate that cells with well expressed I-specificity have more A-antigen sites; less sites were found on erythrocytes with weak expression of I antigen. These results suggest that enzymes responsible for the expression of these two antigenic specificities are under a common control mechanism or that they are closely associated. Erythrocyte stromata from human adults and from umbilical cord blood samples were fractionated. Fingerprints of the two membrane preparations indicated that the major protein components are identical. Molecular fractionation of the stomata resulted in fractions with I antigen activity. All fractions with I-activity contained ABO blood activity, but some preparations with ABO activity failed to inhibit agglu­tinins with I-specificity. Hydrophilic fractions containing glycopeptides with blood group activity were isolated. The I-activity was pronase sensitive. Quantitation of molecular fractions with I blood group activity from cord and adult erythrocytes suggests that I-negative phenotype could be explained by either the two dimensional distribution of molecules on the cell surface or by the covering up of the I-specific molecules in the membrane. The significance of these findings are discussed with respect to embryonic cell surface specificity and with respect to the recognition of molecular patterns by IgM molecules with multiple binding sites.</p

Prevention from transfusion transmissive diseases in the regional center for transfusion medicine in Stip, Republic of Macedonia for the period 2009-2010

Introduction: Blood transfusion is a transplantation of fluid tissue or an introduction of human biological material that needs to survive in the donor organism and to play important biological functions. During the blood and blood products transfusion, it is possible to transmit many transfusion transmissive diseases, which increases the need of securing safe blood transfusion. Objective: To present the procedures and measures taken in order to prevent the transmission of transfusion transmissive diseases in the blood and blood products donors at the Clinical Hospital in Stip. Materials and methods: Each blood unit was mandatory tested for HBSAG, anti- HCV, anti-HIV and Treponema pallidum antibodies at the Regional center for transfusion medicine. The testing was done with the ELISA technique by using the Dade Berhing BEP 200 instrument and the tests from Siemens and Ortho for anti-HCV. The confirmation tests were done at the Institute of Transfusion Medicine in the capital Skopje. Results: In total, 6067 blood samples were tested. The presence of HBAGS was detected in 81 sample (1.33%), anti-HCV in 19 (0.313%), anti-HIV in one (0,016%) and Treponema pallidum antibodies in 5 samples (0.082%). Discussion and conclusion: In order to achieve high level of security of the transfusion blood and blood products it is essential to use highly specific and sensitive tests, modern equipment, well trained health personnel and sufficient financial resources allocated specifically for that aim

Correlation of heavy metals and theirs impact to epidemiological survey in the miners blood donors and other human population

Introduction: Miners who are blood donors, and work in mines for lead-zinc ores are constantly exposed to heavy metals (lead, zinc and cadmium) and this aspect is expected to increase or decrease many hematological parameters. Aim of the Study: The concentration of lead, zinc and cadmium was studied in exposed blood donors and non-exposed blood donors (control group). Knowing the structure of various heavy metals, all of the analysis was carried out to examine the impact of these heavy metals on the occurrence and severity of certain epidemiological diseases and hematological parameters on the miners who are blood donors. Material and Methods: In this research 120 miners were included who were blood donors (mining for lead and zinc) from the Republic of Macedonia and a control group of 30 participants that included blood donors not directly exposed to heavy metals, while living in the immediate vicinity of the lead and zinc mine. In this research biochemical analysis (inductively coupled plasma spectrometry (ICP) one of the most sensitive analytical techniques for the determination of elements in biological materials was applied and the basic haematological parameters were determined. Results: The observation of increased blood lead level on blood donors in the exposed group (mean = 0.089 mg/l) and 20% on blood donors in the control group (mean = 0066), increased blood zinc level in the exposed (mean = 1391) and in the control group (mean = 1074), increased blood cadmium level in 62% of exposed (mean = 0007) and in 50% of the control group (mean = 0006); If the normal BLL (blood lead level) is 0.04–0.07 mg/l, we concluded that all male blood donors in the exposed group had above normal BLL. In the control group 20% of male blood donors had above normal BLL; if the normal BZL (blood zinc level) is 0.1 mg/l, we concluded that all male blood donors exposed in the control group had above normal BZL. If the normal BCL is 0.005 mg/l, we concluded that 62% of the male blood donors in the exposed group had above normal BCL. In the control group 50% of male blood donors had above normal BCL; The blood lead, zinc and cadmium level will rise during exposure at work. forty eight percent of miners (exposed group) had an exposure period of 20 years, 29% between 10 and 20 years and the remaining 23% an exposure period under 10 years. Results showed negative correlation between the number of red blood cells and hemoglobin and blood levels of heavy metals; positive correlation between the number of leukocytes and blood heavy metals levels. Epidemiological survey showed that nearly all workers complained of headache. While 25 of 70 miners who were blood donors (with long exposure) were found to be suffering from various diseases such as asthma, respiratory tract, irritation and watering of eyes. Conclusion: The research confirms that the increased content of heavy metals in blood donors affects the concept of professional risk that involves probability that as a result of exposure of workers to certain harmful agents in the work environment negative effects are manifested on their health. The change of some haematological parameters in the blood donors, results in the emergence of certain diseases with complex etiologies and risks to their health

New Advances in Stem Cell Transplantation

This book documents the increased number of stem cell-related research, clinical applications, and views for the future. The book covers a wide range of issues in cell-based therapy and regenerative medicine, and includes clinical and preclinical chapters from the respected authors involved with stem cell studies and research from around the world. It complements and extends the basics of stem cell physiology, hematopoietic stem cells, issues related to clinical problems, tissue typing, cryopreservation, dendritic cells, mesenchymal cells, neuroscience, endovascular cells and other tissues. In addition, tissue engineering that employs novel methods with stem cells is explored. Clearly, the continued use of biomedical engineering will depend heavily on stem cells, and this book is well positioned to provide comprehensive coverage of these developments