MyMedR

Requirements for the development of a hand transplantation program

Gordon CR, Siemionow M

Ann Plast Surg, 2009 Sep;63(3):262-73.

PMID: 19692900 DOI: 10.1097/SAP.0b013e31818d45e9

Since 1998, 42 hand transplants in 30 patients have been performed in countries such as France, United States, China, Austria, Malaysia, Italy, Belgium, Poland, Spain, and Germany. Now, with recent improvements in immunosuppression, the clinical applicability may expand and the ethical obstacles may soon be overcome, allowing multiple US institutions to perform hand allotransplantation. The main purpose of this article is to facilitate access to pertinent details in regards to hand transplantation, such as donor/recipient selection criteria, immunosuppressive therapies, and associated complications. It is a comprehensive literature review compiled from published reports from multiple hand transplant programs throughout the world. Due to its inherent complexity, hand transplantation should only be attempted at institutions within the US capable of orchestrating a specialized multidisciplinary team, and each institution's protocol should be extremely detailed and individualized.

Matched MeSH terms: Tissue Donors

Allogeneic and autologous mode of stem cell transplantation in regenerative medicine: which way to go?

Mamidi MK, Dutta S, Bhonde R, Das AK, Pal R

Med Hypotheses, 2014 Dec;83(6):787-91.

PMID: 25456787 DOI: 10.1016/j.mehy.2014.10.010

Stem cell transplantation is a generic term covering different techniques. However there is argument over the pros and cons of autologous and allogeneic transplants of mesenchymal stem cells (MSCs) for regenerative therapy. Given that the MSCs have already been proven to be safe in patients, we hypothesize that allogeneic transplantation could be more effective and cost-effective as compared to autologous transplantation specifically in older subjects who are the likely victims of degenerative diseases. This analysis is based on the scientific logic that allogeneic stem cells extracted in large numbers from young and healthy donors could be physiologically, metabolically and genetically more stable. Therefore stem cells from young donors may be expected to exhibit higher vigor in secreting trophic factors leading to activation of host tissue-specific stem cells and also be more efficient in remodeling the micro-environmental niche of damaged tissue.

Matched MeSH terms: Tissue Donors

Fulltext Lyophilised Platelet-Rich Fibrin: Physical and Biological Characterisation

Ngah NA, Dias GJ, Tong DC, Mohd Noor SNF, Ratnayake J, Cooper PR, et al.

Molecules, 2021 Nov 25;26(23).

PMID: 34885714 DOI: 10.3390/molecules26237131

BACKGROUND: Platelet-rich fibrin (PRF) has gained popularity in craniofacial surgery, as it provides an excellent reservoir of autologous growth factors (GFs) that are essential for bone regeneration. However, the low elastic modulus, short-term clinical application, poor storage potential and limitations in emergency therapy use restrict its more widespread clinical application. This study fabricates lyophilised PRF (Ly-PRF), evaluates its physical and biological properties, and explores its application for craniofacial tissue engineering purposes.

MATERIAL AND METHODS: A lyophilisation method was applied, and the outcome was evaluated and compared with traditionally prepared PRF. We investigated how lyophilisation affected PRF's physical characteristics and biological properties by determining: (1) the physical and morphological architecture of Ly-PRF using SEM, and (2) the kinetic release of PDGF-AB using ELISA.

RESULTS: Ly-PRF exhibited a dense and homogeneous interconnected 3D fibrin network. Moreover, clusters of morphologically consistent cells of platelets and leukocytes were apparent within Ly-PRF, along with evidence of PDGF-AB release in accordance with previously reports.

CONCLUSIONS: The protocol established in this study for Ly-PRF preparation demonstrated versatility, and provides a biomaterial with growth factor release for potential use as a craniofacial bioscaffold.

Matched MeSH terms: Tissue Donors

Predictors of the yield of mobilized peripheral blood CD34+ cells in HLA-matched sibling donor

Fadilah SA, Mohd-Razif MI, Seery ZA, Nor-Rafeah T, Wan-Fariza WJ, Habsah A, et al.

Transfus Apher Sci, 2013 Dec;49(3):583-9.

PMID: 24012241 DOI: 10.1016/j.transci.2013.07.032

We examined the donor factors that may affect the yield of peripheral blood stem cell (PBSC) mobilized from healthy donors. Pre-apheresis PB-CD34(+) cell count was the only factor that correlated with PBSC yield. Leukocyte count (LC) and monocyte count (MC) correlated with PB-CD34(+) cell. Male gender and PB-CD34(+) cell count of at least 87.1/μL and 69.8/μL on day-4 and -5 of G-CSF were associated with the ability to harvest at least 5×10(6)/kg CD34(+) cells after one apheresis. We concluded that gender and PB-CD34(+) cell count are important predictors of PBSC yield. LC and MC may serve as surrogate markers for estimating the PB-CD34(+) cell count.

Matched MeSH terms: Tissue Donors

Neoral (cyclosporine) C2 monitoring in renal transplant recipients: a single-center experience in Asia

Wong HS, Morad Z

Transplant Proc, 2003 Feb;35(1):230-1.

PMID: 12591376

Matched MeSH terms: Tissue Donors

Outcome of overseas kidney transplantation in Malaysia

Morad Z, Lim TO

Transplant Proc, 2000 Nov;32(7):1485-6.

PMID: 11119799

Matched MeSH terms: Tissue Donors

Cadaveric renal transplantation at University Hospital Kuala Lumpur: a preliminary report

Tan SY, Chen TP, Lee SH, Tan PS, Chua CT, Teo SM, et al.

Transplant Proc, 2000 Nov;32(7):1811-2.

PMID: 11119947

Matched MeSH terms: Tissue Donors

Fulltext Acute protein loading in the assessment of renal reserve

Loo CS, Zaki M, Sulaiman AB, Sukanya AB, Voon YC, Kua SL

Med J Malaysia, 1994 Mar;49(1):36-43.

PMID: 8057988

Functional renal reserve is a measure of the capacity of the kidney to increase the glomerular filtration in response to the stimulus of a protein meal or amino acid infusion. The aim of this study was to evaluate the usefulness of protein meal test to measure functional renal reserve in normal subjects and various groups of renal patients. One hundred and twenty five subjects from the Nephrology Clinic, Kuala Lumpur General Hospital were subjected to a protein loading test to measure their renal reserve. Each subject had to eat a 100 gram cooked chicken meat and timed 2 hours urine collections before and after the test meal were done to measure the creatinine clearances. The 62 healthy subjects showed a mean renal reserve (creatinine clearance after protein loading-baseline creatinine clearance) of 31.0 ml/min. The 31 subjects with various kidney diseases showed a mean renal reserve of 13.5 ml/min. The 19 renal transplant recipients showed renal reserve of 13.2 ml/min. The 12 nephrectomised donors showed renal reserve of 5.4ml/min. Renal reserve may be used to assess suitability of living related transplant donor for nephrectomy.

Study site: Nephrology Clinic, Kuala Lumpur General Hospital

Matched MeSH terms: Tissue Donors

Hepatitis in renal transplant recipients with and without donor-specific blood transfusion

Morad Z, Suleiman AB, Kong CT

Transplant Proc, 1989 Feb;21(1 Pt 2):1825-6.

PMID: 2652593

Matched MeSH terms: Tissue Donors

Viva-Asia Blood and Marrow Transplantation Groups - A Survey of Consortium Activity over a 12-year Period (2000 to 2011)

Tan AM, Ha C, Li CF, Chan GC, Lee V, Tan PL, et al.

Ann Acad Med Singap, 2016 Mar;45(3):106-9.

PMID: 27146463

Matched MeSH terms: Tissue Donors/statistics & numerical data

Comparison of patient survival between various subgroups among renal transplant patients: a single center experience

Go KW, Teo SM

Transplant Proc, 2004 Sep;36(7):2046-7.

PMID: 15518740

To compare patient graft survival between various subgroups among renal transplant patients.

Matched MeSH terms: Tissue Donors

Cure of beta-thalassaemia major by umbilical cord blood transplantation--a case report of Malaysia's first cord blood transplantation

Chan LL, Lin HP

J Trop Pediatr, 1999 Aug;45(4):243-5.

PMID: 10467839

A 25-month-old boy with beta-thalassaemia major was presented with an opportunity for umbilical cord blood transplantation when his unborn sibling was diagnosed in utero to be a beta-thalassaemia carrier and also human leucocyte antigen compatible. A barely adequate amount of cord blood was collected at the birth of his sibling and infused into the patient after appropriate chemo-conditioning. Engraftment occurred without major complications. The subject is now alive and well 9 months post-transplant, thus marking our first success in umbilical cord blood transplantation.

Matched MeSH terms: Tissue Donors

Fulltext Human immunodeficiency virus infection in recipients of living unrelated donor renal transplants--a report of 4 cases

Hooi LS

Med J Malaysia, 1993 Jun;48(2):232-5.

PMID: 8350803

Four cases of Human Immunodeficiency Virus (HIV-1) infection, probably following living unrelated donor renal transplantation done in India, are reported. One of them subsequently developed Acquired Immunodeficiency Syndrome (AIDS).

Matched MeSH terms: Tissue Donors

Surgical complications of living unrelated kidney transplantations in a Third-World country

Lei C, Abdullah K, Morad Z, Suleiman AB

Transplant Proc, 1992 Oct;24(5):1815.

PMID: 1412860

Matched MeSH terms: Tissue Donors

A Review of Skin Banking Guidelines and Standards Worldwide: Towards the Harmonization of Guidelines for Skin Banking in Therapeutic Applications for the Regions under the Asia Pacific Burn Association (APBA)

Heng WL, Wang QW, Sornarajah R, Tremblay J, Putri NM, Hamid SSA, et al.

Burns Trauma, 2020;8:tkaa019.

PMID: 33123605 DOI: 10.1093/burnst/tkaa019

Currently, there are no harmonized guidelines which govern skin banking in the Asia Pacific region. Therefore, skin banks are either unregulated or rely on their nation's legislation or international accreditation to uphold their quality standards. A new set of skin banking guidelines was developed through a comprehensive review and collation of best international practices for the Asia Pacific Burn Association (APBA) members, from donor screening and testing, to skin recovery, processing, storage and distribution, and quality assurance. National regulatory requirements reviewed include the European directives, Australia's Therapeutic Goods Administration and Singapore's tissue banking standards. Further technical and quality management recommendations are referenced from the American Association of Tissue Banks (AATB), the United States Food and Drug Administration standards and guidance documents, various relevant European guides, Japanese Society of Tissue Transplantation guidelines and the Asia Pacific Association of Surgical Tissue Banking. Adapted mainly from the AATB standards, the new Asia Pacific Burn Association Guidelines for Skin Banking in Therapeutic Applications offer a comprehensive manual, addressing: governance and contracts; staff responsibilities; quality management; facilities, equipment and supplies management; donor consent and testing; and recommendations of good practices pertaining to skin recovery, processing, storage and distribution. Besides complementing current generic regulations, they provide technical specifications of major aspects unaddressed in most legislations. This inaugural set of new regional skin banking guidelines would be a start for regional members of the APBA to adopt, and will hopefully culminate in a set of standards so that, in the long run, skin allografts from this region can be of similar quality, which can simplify import process and facilitate the exchange of allografts between members.

Matched MeSH terms: Tissue Donors

Fulltext Evaluation of two short tandem repeat multiplex systems for post-haematopoietic stem cell transplantation chimerism analysis

Ariffin H, Daud SS, Mohamed Z, Ibrahim K, Lee TF, Chong LA

Singapore Med J, 2007 Apr;48(4):333-7.

PMID: 17384881

The follow-up of chimerism status after allogeneic haematopoietic stem cell transplantation (HSCT) is essential to predict successful engraftment to assess the development of graft-versus-host disease, graft rejection and disease relapse. Analysis of short tandem repeats (STR) via polymerase chain reaction is frequently used for chimerism determination. However, most commercially-available kits have been designed for forensic purposes and may not be optimal for chimerism analysis. The present study aims to identify suitable STR markers for patient-donor pairs of predominantly Malay and Chinese ethnicity using two commercially-available forensic kits.

Matched MeSH terms: Tissue Donors

Do Family Members of Dialysis Patients Have a Positive Attitude Toward Organ Donation?

Tumin M, Tafran K, Zakaria RH, Satar NM, Ng KP, Lim SK

Ann. Transplant., 2015 Dec 22;20:752-6.

PMID: 26690676 DOI: 10.12659/aot.894427

BACKGROUND: Malaysia, which currently uses the informed consent system (ICS), is suffering from a severe shortage of organs for transplantation. Family members of dialysis patients (FMDPs) are expected to have a positive attitude toward deceased organ donation (DOD) because they have a close relative in need of a kidney donation. This study explores FMDPs' attitude toward DOD under the ICS and the presumed consent system (PCS).

MATERIAL/METHODS: The attitude of 350 FMDPs toward DOD under the ICS and PCS were sought between June and October 2013 in 3 dialysis institutions in Kuala Lumpur, Malaysia.

RESULTS: Under the ICS, 6.6% of respondents were registered donors, 6.6% were ready to register at the time of the survey, 38.6% were willing to donate but not ready to register at the time of the survey, and 48.2% were unwilling to donate organs upon death. If the PCS were implemented, 57.7% of respondents (28.7% of the willing donors and 88.7% of the unwilling respondents) stated that they would officially object to organ donation.

CONCLUSIONS: FMDPs' attitude toward DOD is not more positive or significantly better than that of the general public (based on earlier studies). The PCS may increase the number of donors, but it may also worsen the attitude of FMDPs toward DOD. Strategies aiming to promote DOD in Malaysia should be revised, and should perhaps be focused on enhancing trust of the medical system.

Matched MeSH terms: Tissue Donors/psychology*

Fulltext Quantitative and qualitative evaluation of sural nerve graft donor site

Ng SS, Kwan MK, Ahmad TS

Med J Malaysia, 2006 Dec;61 Suppl B:13-7.

PMID: 17600987

This study is designed to evaluate twenty patients after sural nerve harvest using the single longitudinal incision method. The area of sensory loss to pin prick was assessed by the authors at different intervals. Donor site factors, scar cosmesis, functional status and complications were assessed using a questionnaire. The mean area of anaesthesia at one month was 65 cm2 and it had reduced by 77% to 15 cm2 at one and a half years. The mean area of reduced sensation was 49 cm2 at one month and it increased by 18% to 58 cm2 over the same period. Therefore, the total area of sensory deficit was reduced by 36% from 114 cm2 at one month to 73 cm2 at one and a half years. Subjective patient evaluation indicated moderate level of pain during immediate post surgical period, which reduced significantly at one month. A low level of neuroma symptoms was recorded throughout the study period. At a mean follow-up period of two years, there was no area of anaesthesia in 50% of the patients. Mean area of anaesthesia for all patients was 12 cm2 and mean area of reduced sensation was 55 cm2. Subjective patient evaluation indicated a low level of pain, neuroma symptoms and numbness over the sural nerve sensory distribution. Twenty five percent of the patients were not satisfied with the scar appearance. Function and daily activities were not affected significantly. No surgical complications were observed.

Matched MeSH terms: Tissue Donors*

Development of de novo HLA donor specific antibodies (HLA-DSA), HLA antibodies (HLA-Ab) and allograft rejection post blood transfusion in kidney transplant recipients

Jalalonmuhali M, Carroll RP, Tsiopelas E, Clayton P, Coates PT

Hum Immunol, 2020 Jul;81(7):323-329.

PMID: 32327243 DOI: 10.1016/j.humimm.2020.04.002

BACKGROUND: Blood transfusion during the post-operative period of kidney transplantation is common as part of a life-saving procedure, especially in the event of acute blood loss. However, there have been conflicting opinions since the pre-cyclosporine era. The risk of sensitization post-transfusion remains the main limiting factor following transfusion in kidney transplant recipients. Thus, the objective of this study is to assess the development of de novo HLA-DSA, HLA-Ab and allograft rejection post blood transfusion.

METHODOLOGY: This is a retrospective cohort study recruiting all kidney transplant recipients in South Australia from January 2010 till December 2018. Following that, the incidence of blood transfusion within one week post-operatively were traced (transfusion group). The outcomes were compared with all other transplant recipients (non-transfusion group). Recipient's demographic, donor characteristics and immunological risk profiles were obtained from the transplant unit database, while the biopsy report, history of blood transfusion, latest serum creatinine and follow-up status was gathered from the electronic medical system (OASIS). The HLA-DSA and HLA-Ab results were collected from the NOMS database. Finally, the survival data were merged with the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry for South Australia recipients graft survival.

RESULTS: A total of 699 patients were eligible for analysis. The mean age was 50.64 ± 13.23 years old. There were more elderly (>65 years old) and females who needed transfusion. The majority had glomerulonephritis as the primary disease. There was no statistical difference in donor characteristics, cold ischemic time and immunological risk between the transfusion and non-transfusion group. There was no difference in the development of de novo HLA-DSA, HLA-Ab and rejection episodes between the group and the results were consistent in a model adjusted for all potential confounders. Median graft survival in days between the transfusion vs non-transfusion group was 1845 IQR (961,2430) and 1250 IQR (672,2013).

CONCLUSION: Blood transfusion under strong immunosuppressive cover within a one-week post-operative period is safe with no significant association with the development of de novo HLA-DSA, HLA-Ab or clinical rejection.

Matched MeSH terms: Tissue Donors*

Knowledge, attitudes, practices and behaviors regarding deceased organ donation and transplantation in Malaysia's multi-ethnic society: a baseline study

Wong LP

Clin Transplant, 2011 Jan-Feb;25(1):E22-31.

PMID: 20718827 DOI: 10.1111/j.1399-0012.2010.01312.x

Malaysia's organ and tissue donation rates are among the lowest in the world. The study aims to explore the knowledge, attitudes, practices and behaviors regarding deceased organ donation and transplantation in the diverse ethnic communities in the state of Selangor, Malaysia.

Matched MeSH terms: Tissue Donors/psychology*

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