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Female Donors (female + donor)
Selected AbstractsIdentification of naturally processed CD8 T,cell epitopes from prostein, a prostate tissue-specific vaccine candidateEUROPEAN JOURNAL OF IMMUNOLOGY, Issue 4 2004Rachel Abstract Prostein is a prostate tissue-specific protein that is uniquely and abundantly expressed in normal and cancerous prostate tissues. Due to this expression profile, we examined the immunogenicity of prostein as a potential vaccine candidate for prostate cancer. To determine the presence of CD8 T,cells specific for naturally processed prostein-derived epitopes in healthy individuals, we developed and applied an in vitro stimulation protocol. Using this protocol, we identified CD8 T,cells specific for prostein in the peripheral blood of a male and a female donor. Prostein-specific CD8 T,cell clones specifically recognized prostein-expressing targets, including prostate tumor cell lines expressing the relevant HLA alleles. CD8 T,cell clones isolated from the male donor were significantly less effective in recognizing target cells compared to cells isolated from the female donor and appeared to recognize subdominant epitopes. The identification of a prostein-specificCD8 T,cell repertoire supports the development of prostein in vaccination strategies against prostate cancer. Furthermore, the naturally processed peptide epitopes identified provide tools for the development of peptide-based vaccination strategies against prostate cancer and for monitoring of prostein-specific responses in vaccinated patients. [source] Recent Trends in Early Outcome of Adult Patients after Heart Transplantation: A Single-institution Review of 251 Transplants Using Standard Donor Organs,AMERICAN JOURNAL OF TRANSPLANTATION, Issue 6 2002Feng-Chun Tsai Older age, prior transplantation, pulmonary hypertension, and mechanical support are commonly seen in current potential cardiac transplant recipients. Transplants in 436 consecutive adult patients from 1994 to 1999 were reviewed. There were 251 using standard donors in 243 patients (age range 18,69 years). To emphasize recipient risk, 185 patients who received a nonstandard donor were excluded from analysis. The indications for transplant were ischemic heart disease (n = 123, 47%), dilated cardiomyopathy (n = 82, 32%), and others (n = 56, 21%). One hundred and forty-nine (57%) recipients were listed as status I; 5 and 6% were supported with an intra-aortic balloon and an assist device, respectively. The 30-d survival and survival to discharge were 94.7 and 92.7%, respectively; 1-year survival was 89.1%. Causes of early death were graft failure (n = 6), infection (n = 4), stroke (n = 4), multiorgan failure (n = 3) and rejection (n = 2). Predictors were balloon pump use alone (OR = 11.4, p =,0.002), pulmonary vascular resistance > 4 Wood units (OR = 5.7, p =,0.007), pretransplant creatinine > 2.0 mg/dL (OR = 6.9, p =,0.004) and female donor (OR = 8.3, p =,0.002). Recipient age and previous surgery did not affect short-term survival. Heart transplantation in the current era consistently offers excellent early and 1-year survival for well-selected recipients receiving standard donors. Early mortality tends to reflect graft failure while hospital mortality may be more indicative of recipient selection. [source] Allogenic hematopoietic stem-cell transplantation with reduced-intensity conditioning in patients with refractory and recurrent multiple myelomaCANCER, Issue 15 2010Long-term follow-up Abstract BACKGROUND: Allogeneic stem cell transplantation (SCT) with myeloablative conditioning is potentially curative therapy for myeloma, but is reportedly associated with a high risk of nonrecurrence mortality (NRM). Reduced-intensity conditioning (RIC) allows for the reduction of NRM, but the recurrence rate is increased. The role and timing of allogeneic SCT in the disease course remains controversial. To the authors' knowledge, there are limited data regarding the long-term outcome of RIC in the recurrent/refractory setting. METHODS: A retrospective analysis was conducted of SCT outcomes in 50 patients who received RIC for recurrent/refractory myeloma between the years 2001 and 2004. All patients were given fludarabine-melphalan based conditioning and stem cell grafts from a related (n = 27) or unrelated donor (n = 23). RESULTS: The median age was 53 years. Forty-seven patients failed a prior autologous SCT. Thirty patients were in disease remission at the time of SCT and 20 had stable or progressive disease. With a median follow-up of 6.4 years (range, 5-7.9 years), the overall and progression-free survival (PFS) rates were 34% and 26%, respectively. The NRM rate was 26%. Adverse prognostic factors for survival included SCT not in remission, long duration of disease (>5 years from diagnosis), and transplantation from a female donor to a male recipient. The 7-year PFS in 19 patients with none of these adverse prognostic factors was 47%. Chronic graft versus host disease and the achievement of complete remission after SCT were associated with improved outcome. CONCLUSIONS: Allogeneic SCT can result in long-term PFS in a subset of myeloma patients who fail prior therapy and should be considered early after failure and after achieving remission. Cancer 2010. © 2010 American Cancer Society. [source] Successful transplantation of organs from a donor who died from acute cocaine intoxicationCLINICAL TRANSPLANTATION, Issue 2 2003Francisco Caballero One to two percent of the general population of western countries are regular consumers of cocaine, 10% being sporadic consumers. This proportion increases considerably in the population age groups which are most frequently organ donors. Cocaine may directly cause brain death, or be present in those with brain death who died from other causes, especially head trauma. We present a 30-yr-old female donor, a regular consumer of inhaled cocaine, who died of brain anoxia after cocaine inhalation. Twenty-five hours after cocaine inhalation, the liver and kidneys were removed for transplantation. The liver was transplanted to a patient with acute hepatocellular failure caused by isoniazids, and the kidneys to two recipients with renal polycystosis. Toxicity attributable to the cocaine was not observed in any of the three recipients. All three grafts presented immediate function, and the clinical evolution of all three recipients and the function of all three grafts were excellent during the 5 yr of follow-up. The serum creatinines of the two kidney recipients 5 yr from transplantation were 76 and 72 ,mol/L, respectively. [source] Evidence against a sexual dimorphism in glucose and fatty acid metabolism in skeletal muscle cultures from age-matched men and post-menopausal womenACTA PHYSIOLOGICA, Issue 3 2009A. Rune Abstract Aim:,In vivo whole body differences in glucose/lipid metabolism exist between men and women. Thus, we tested the hypothesis that intrinsic sex differences exist in skeletal muscle gene expression and glucose/lipid metabolism using cultured myotubes. Methods:, Myotube cultures were prepared for gene expression and metabolic studies from vastus lateralis skeletal muscle biopsies obtained from age-matched men (n = 11; 59 ± 2 years) and post-menopausal women (n = 10; 60 ± 1 years). Results:, mRNA expression of several genes involved in glucose and lipid metabolism was higher in skeletal muscle biopsies from female vs. male donors, but unaltered between the sexes in cultured myotubes. Basal and insulin-stimulated glucose uptake, as well as glucose incorporation into glycogen, was similar in myotube cultures derived from male vs. female donors. In males vs. females, insulin increased glucose uptake (1.3 ± 0.1 vs. 1.5 ± 0.1-fold respectively) and incorporation into glycogen (2.3 ± 0.3 vs. 2.0 ± 0.3-fold respectively) to the same extent. Basal fatty acid oxidation and rate of uptake/accumulation was similar between sexes. In response to the 5,AMP-activated protein kinase activator AICAR, lipid oxidation was increased to the same extent in myotubes established from male vs. female donors (1.6 ± 0.6 vs. 2.0 ± 0.3-fold respectively). Moreover, the AICAR-induced rate of uptake/accumulation was similar between sexes. Conclusion:, Differences in metabolic parameters and gene expression profiles between age-matched men and post-menopausal women noted in vivo are not observed in cultured human skeletal muscle cells. Thus, the sexual dimorphism in glucose and lipid metabolism is likely a consequence of systemic whole body factors, rather than intrinsic differences in the skeletal muscle proper. [source] Myeloablative hematopoietic stem cell transplantation for myelodysplastic syndrome in patients younger than 55 years: impact of comorbidity and disease burden on the long-term outcomeINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 2 2010H. KANAMORI Summary We retrospectively investigated 31 myelodysplastic syndrome (MDS) patients receiving myeloablative hematopoietic stem cell transplantation (HCT) and focused on prognostic factors affecting the long-term outcome. Patients were classified according to the French-American-British classification and the HCT-comorbidity index was determined. Cytosine arabinoside or thiotepa combined with cyclophosphamide and total body irradiation was used as myeloablative conditioning in eight and 23 patients respectively. After a follow-up period of 0.8,14.2 years from transplantation (median: 6.4 years), 23 patients were alive in complete remission, and the 5-year overall survival (OS) and disease-free survival (DFS) rates were 79% and 72% respectively. The cumulative nonrelapse mortality (NRM) rate was 22% at 5 years. According to multivariate analysis, ,20% blasts in the bone marrow and an HCT-comorbidity score , 3 were significantly associated with poor OS and DFS. Patients with a high HCT-comorbidity score and male patients receiving transplantation from female donors were significantly more likely to have a higher NRM according to the univariate, but not the multivariate analysis. These data suggest that comorbidity and the tumor burden at the time of transplantation may be useful variables for predicting the outcome in MDS patients receiving myeloablative HCT. [source] Long-Term Results of Cardiac TransplantationJOURNAL OF CARDIAC SURGERY, Issue 3 2003Alberto Juffe M.D. From April 1991 to December 2000, 345 patients underwent heart transplantation at the Juan Canalejo Hospital. The mean age of recipients was54.5 ± 11.4 years; 286 (83%) were male patients. Idiopathic (52.2%) and ischemic (34.9%) end-stage cardiomyopathy were the main causes leading to transplantation. Ninety-four patients had undergone a previous heart operation. The mean left ventricular ejection fraction was22.8 ± 11.4. Forty patients (11.5%) were transplanted in urgent (status I) condition. The mean time spent on the waiting list was 35.9 days. In-hospital mortality was 10.6% and 24% for transplantations performed on an elective and urgent basis, respectively. Operative (30-day), one-year and six-year survival was 87.2%, 81.3% and 64%, respectively. In terms of actuarial survival, there were no significant differences with regard to the recipient's age, sex, previous cardiac surgery, and the etiology of the end-stage cardiomyopathy. The six-year actuarial survival for recipients receiving hearts from female donors was 59% compared with 72% for male donors(p = 0.05). There has been a low incidence of rejection, as well as cardiac graft vasculopathy. Actuarial survival at six years was 66% for patients transplantated on an elective basis compared with 57% for patients transplanted on an urgent basis(p = 0.04). The aim of the study was to evaluate long-term results for patients who underwent orthotopic heart transplantation. In our experience, status I is associated with a higher mortality.(J Card Surg 2003;18:183-189) [source] Donor quality of life before and after adult-to-adult right liver live donor liver transplantationLIVER TRANSPLANTATION, Issue 10 2006See Ching Chan Donor right hepatectomy for adult-to-adult live donor liver transplantation (ALDLT) is a major surgical operation for the benefit of the recipient. Justification of procedure mandates knowledge of the possible physical and psychological negative effects on the donor. We prospectively and longitudinally quantified donor quality of life using generic and condition-specific questionnaires up to 1 year. The generic questionnaires were the Karnofsky Performance Status scale and the Chinese (Hong Kong) version of the Medical Outcomes Study 36-Item Short-Form Survey, which measures 8 health concepts: 4 physical components and 4 mental components. Within 1 year, 30 consecutive donors were included. These 11 male and 19 female donors (36.7% and 63.3%, respectively) had a median age of 35 years (range, 21-56 years). There was no donor mortality or major complications. Donor quality-of-life worsening was most significant in the first 3 postoperative months, particularly among the physical components. The physical and mental components returned to the previous levels in 6 to 12 months' time, though the Karnofsky performance scores were slightly lower at 1 year (P = 0.011). Twenty-six (86.7%) donors declared that they would donate again if there were such a need and it were technically possible. It was noticed that older donors were more likely to express unwillingness to donate again. In conclusion, the temporary worsening of donor quality of life substantiates ALDLT as an acceptable treatment modality. Liver Transpl 12:1529,1536, 2006. © 2006 AASLD. [source] Venous hemodynamics in living donor right lobe liver transplantationLIVER TRANSPLANTATION, Issue 9 2002Gabriel E. Gondolesi MD We evaluated the influence of portal and hepatic venous hemodynamics on the immediate and 3-month postoperative function of living donor right lobe grafts. Portal velocity was measured prospectively by ultrasound in 14 consecutive donor/recipient pairs. Velocity was converted to flow with the Moriyasu formula. Measurements were taken in donors in the operating room and in recipients at 1 hour after reperfusion and 3 months after transplant. Recipient liver function tests were measured postoperatively. Prereperfusion and postreperfusion liver biopsies were evaluated and correlated with the hemodynamic and biochemical results. There were 11 male (78.6%) and 3 female donors (mean age, 38.9 ± 9.8 years) for 10 male (71.4%) and 4 female recipients (mean age, 49.3 ± 14 years). The mean graft/recipient weight ratio was 1.22 ± 0.3. The mean right portal vein pressure was 8 ± 1.8 mm Hg in donors versus 13 ± 4.7 mm Hg in recipients (P < .05). The mean peak flow velocity (Vmax) in the portal vein in donors was 47.6 ± 12.8 cm/sec (normal, 44 cm/sec). One hour after graft reperfusion in the recipient, the mean portal Vmax was significantly higher at 94.7 ± 28.4 cm/sec (P = .004), but by 3 months follow-up, mean portal Vmax had fallen to 58.8 ± 37.8 (P = .01). Recipient portal vein Vmax highly correlated with portal flow (r = 0.7, P = .01). Increased recipient total bilirubin on postoperative day 2 correlated highly with higher recipient portal flow one hour after transplant (r = 0.6; P = .03). Portal vein velocity/flow dramatically increases after reperfusion, returning to baseline about 3 months after transplant. Evaluation of hepatic and portal venous flow is a relatively easy skill to acquire. Intraoperative ultrasound may enable the surgeon to predict graft dysfunction and possibly, may be used to implement pre-emptive therapies. [source] Successful Organ Transplantation from Donors Poisoned with a Carbamate InsecticideAMERICAN JOURNAL OF TRANSPLANTATION, Issue 6 2010J. H. Garcia Currently, liver transplantation is the only option for patients with end-stage liver disease. In Brazil, the mortality rate on the waiting list is about 25%. Multiple strategies to expand the donor pool are being pursed, however, grafts from poisoned donors are rarely used. This report documents successful liver, kidney and heart transplantations from four female donors who suffered brain death by hypoxia despite cardiopulmonary resuscitation following Aldicarb exposure ([2-methyl-2-(methylthio)propionaldehyde O-(methylcarbamoyl)-oxime]). The success rate of 12 grafts from four donors poisoned by Aldicarb was 91% 6 months after transplantation. Poisoned patients are another pool of organ donors who at present are probably underused by transplantation services. More studies are necessary to confirm the safety for the recipients. [source] Chimerism in Kidneys, Livers and Hearts of Normal Women: Implications for Transplantation StudiesAMERICAN JOURNAL OF TRANSPLANTATION, Issue 6 2005Marije Koopmans Tissue chimerism was recently described in transplanted organs from female donors into male recipients, by demonstration of the Y-chromosome in tissue-derived cells. It was claimed that these Y-chromosome positive cells were recipient derived. To find out whether the chimeric cells, derived from pregnancies of sons or blood transfusions, could have been present in the solid organs before transplantation, we performed the following study. In situ hybridization for the Y-chromosome was performed on the normal organs (51 kidneys, 51 livers, 69 hearts) from 75 women of the normal population, whose child and blood transfusion status were known. Chimeric cells were found in 13 kidneys, 10 livers and 4 hearts, of 23 women. There was no relation between the child status or the blood transfusion history with the presence of Y-chromosome positive cells. We have for the first time demonstrated that male cells are present in normal kidneys, livers and hearts. Theoretically, these organs could have been used for the transplantation. Therefore, our findings demonstrate that the chimeric cells thus far described in transplantation studies, are not necessarily donor derived, and could have been present in the organs before the transplantation. [source] Effect of donor characteristics, technique of harvesting and in vitro processing on culturing of human marrow stroma cells for tissue engineered growth of boneCLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2005Helge Bertram Abstract: The aim of this study was to assess the effect of donor characteristics and the technique of harvesting and in vitro processing on the efficacy of culturing of human mesenchymal stem cells (hMSCs) for tissue engineered growth of bone. Cultures of hMSCs were derived from iliac crest bone marrow aspirates (21 donors, age 11,76) and from cancellous bone grafting material (32 donors, age 13,84). Age had no significant effect on the ability to isolate and culture hMSCs, although the failure rate was 55.6% in donors beyond the age of 60, while it varied between 14.3% and 22.2% in donors under 60 years of age. Male and female donors had comparable failure rates (27.3% and 28.6%, respectively). Culturing of hMSCs was successful in 90.4% of marrow aspirates from 21 donors and in 62.5% of cancellous bone specimens from 35 donors. This difference was statistically significant (P=0.023). Regression analysis confirmed that at simultaneous testing of the three variables, only the source of cells significantly affected the result (P=0.043). Morphological evaluation of the unfractionated primary population showed a change in cell shape of the adherent cells from a triangular into thin spindle-shaped elongated form, which remains until confluence. When the cultures were exposed to osteoinductive medium, various morphotypes expressing different levels of alkaline phosphatase and secreting different amounts of mineral were evident. Morphology of marrow stroma cells (MSCs) from marrow aspirates was not different from MSCs derived from cancellous bone specimens. Expression of osteogenic markers in MSCs as shown by PCR as well, did not differ between the two sources. It is concluded that marrow aspirates and cancellous bone specimens produce comparable populations of MSCs. However, bone marrow aspirates from donors under the age of 60 years rather than cancellous bone chips are favourable for isolation and expansion of hMSCs for tissue engineered growth of bone. Résumé Le but de cette étude a été d'analyser l'effet des caractéristiques du donneur et la technique de prélèvement et du processus in vitro sur l'efficacité des cultures des cellules souches mésenchymateuses humaines (hMSC) pour la croissance tissulaire en laboratoire de l'os. Les cultures de hMSC provenaient de la moelle osseuse de la crête iliaque (21 donneurs de 11 à 76 ans) et de matériel de greffe osseuse d'os spongieux (32 donneurs de 13 à 84 ans). L'âge n'avait aucun effet significatif sur l'habilitéà isoler et à mettre en culture les hMSC bien que le taux d'échec était de 56% chez les donneurs au-dessus de 60 ans et variait de 14 à 22% chez les donneurs en-dessous de 60 ans. Les hommes et les femmes avaient des taux d'échec comparables de respectivement 27 et 28%. La mise en culture des hMSC a réussi dans 90% des prélèvements de moelle et dans 63% dans les échantillons osseux spongieux. Cette différence était statistiquement significative (P=0,023). L'analyse de régression a confirmé qu'avec un test simultané des trois variables, seul la source de cellules avait un réel effet sur le résultat (P=0,043). L'évaluation morphologique de la population primaire non-fractionnée a montré un changement dans l'apparence des cellules adhérentes depuis un aspect triangulaire à une forme allongée en forme de fuseau qui restait jusqu'à confluence. Lorsque les cultures étaient exposées à un milieu ostéoinductif différents morphotypes exprimant différents niveaux de phosphatase alcaline et secrétant différentes quantitées de minéraux étaient mis en évidence. La morphologie des MSC des prélèvements de la moelle n'était pas différente des MSC provenant des spécimens osseux spongieux. L'expression des marqueurs ostéogéniques dans les MSC ne montrait par PCR aucune différence entre ces deux sources. Les prélèvements de moelle et les spécimens osseux spongieux produisent donc des populations comparables de MSC. Cependant, les aspirations de moelle de donneurs en-dessous de 60 ans plutôt que les chips osseux spongieux sont favorables pour l'isolation et l'expansion des hMSC pour la croissance osseuse en laboratoire. Zusammenfassung Es war das Ziel dieser Studie, den Einfluss von Spender-Merkmalen, Entnahmetechnik und in vitro -Behandlung bei der erfolgreichen Kultivierung von menschlichen mesenchymalen Stammzellen (hMSCs) für das gewebsgesteuerte Knochenwachstum zu untersuchen. Die Kulturen der hMSCs gewann man aus vom Beckenkamm aspiriertem Knochenmark (21 Spender, Alter 11,76) und von Spongiosa aus Spendermaterial (32 Spender, Alter 13,84). Das Alter hatte keinen signifikanten Einfluss auf die erfolgreiche Isolierung und Kultivierung von hMSCs, obgleich die Misserfolgsrate bei Spendern über 60 Jahren 55.6% betrug, währenddem sie bei Spendern unter 60 Jahren zwischen 14.3% und 22.2% variierte. Männer und Frauen hatten vergleichbare Misserfolgsraten (27.3%, beziehungsweise 28.6%). Die Kultivierung von hMSCs war bei 90.4% des aspirierten Marks von 21 Spendern und 62.5% der Spongiosa von 35 Spendern erfolgreich. Diese Differenz war statistisch signifikant (P=0.023). Die Regressionsanalyse bestätigte, dass von den drei gleichzeitig getesteten Variablen nur die Entnahmequelle der Zellen das Resultat signifikant beeinflusste (P=0.043). Die morphologische Untersuchung der unfraktionierten Primärpopulation zeigte bei den adhärenten Zellen eine Veränderung der Zellform von einer dreieckigen zu einer spindelförmigen länglichen Form. Diese blieb bis zu ihrem Zusammenwachsen erhalten. Wurden die Kulturen einem osteoinduktiven Einfluss ausgesetzt, entwickelten sich verschiedene Morphotypen, die auch verschiedene Mengen alkalischer Phosphatase und Mineralien ausschieden. Die Morphologie der MSCs aus dem aspirierten Knochenmark war nicht anders als diejenige von MSCs aus spongiösen Knochenproben. Die Ausscheidung von osteogenen Markern durch die MSCs, auch messbar durch den PCR, verhielt sich bei den Zellen aus beiden Quellen gleich. Man schloss daher, dass aspiriertes Knochenmark und Spongiosa vergleichbare Populationen von MSCs produzieren. Für die Isolation und Expansion von hMSCs zur gesteuerten Knochengewebsregeneration ist aspiriertes Knochenmark vorteilhafter als spongiöse Knochenchips und der Spendern ist von Vorteil jünger als 60 Jahre. Resumen La intención de este estudio fue valorar el efecto de las características del donante y de la técnica de recogida y del procesamiento in vivo sobre la eficacia del cultivo de células madre mesenquimales humanas (hMSCs) para crecimiento óseo por ingeniería tisular. Los cultivos de hMSCs se derivaron de aspirados de la médula ósea de la cresta iliaca (21 donantes, edad 11,76) y de material de injerto de hueso esponjoso (32 donantes, edad 13,84). La edad no tuvo un efecto significativo en la habilidad para aislar y cultivar hMSCs, aunque el índice de fracaso fue del 55.6% en donantes por encima de los 60 años, mientras que varió entre el 14.3% y el 22.2% en donantes por debajo de los 60 años. Los donantes varones y hembras tuvieron índices de fracaso comparables (27.3 y 28.6%, respectivamente). El cultivo de hMSCs tuvo éxito en el 90.4% de los aspirados medulares de 21 donantes y en 62.5% de los especímenes de hueso esponjoso de 35 donantes. Esta diferencia fue estadísticamente significativa (P=0.023). El análisis de regresión confirmó que en la prueba simultanea de las tres variables, solo el origen de las células afectó significativamente el resultado (P=0.043). La evaluación morfológica de la población primaria no fraccionada mostró un cambio en la forma celular de las células adherentes de triangular a una forma de huso fino elongado, que se mantiene hasta su confluencia. Cuando los cultivos se expusieron a un medio osteoconductivo se evidenciaron varios morfotipos manifestando diferentes niveles de fosfatasa alcalina y segregando diferentes cantidades de mineral. La morfología de las MSCs de los aspirados medulares no fue diferente de las MSCs derivadas de los especímenes de hueso esponjoso. La manifestación de marcadores osteogénicos en MSCs mostrado por PCR tampoco difirió entre las dos fuentes. Se concluye que los aspirados medulares y los especímenes de hueso esponjoso producen poblaciones comparables de MSCs. De todos modos, los aspirados de médula ósea de donantes menores de 60 años por encima de las virutas de hueso esponjoso son más favorables para el aislamiento y la expansión de hMSCs para crecimiento óseo por ingeniería tisular. [source] | ||||||||||