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Emmanuel Morelon, Palmina Petruzzo, Jean Kanitakis
PURPOSE OF REVIEW: Vascularized composite allografts (VCA), which restore severely damaged body parts that cannot be repaired with conventional surgical techniques, often undergo acute skin rejection episodes in the early postgraft period. Although the risk of human VCA to be affected by chronic rejection was initially unknown, such cases were recently observed. RECENT FINDINGS: Chronic rejection targets preferentially the skin (dermal sclerosis, adnexal atrophy, necrosis) and vessels (graft vasculopathy) and may cause graft dysfunction, often resulting in ischemic graft loss...
August 9, 2018: Current Opinion in Organ Transplantation
Charles Anton Fries, Carole Yasay Villamaria, Jerry Richard Spencer, Shari Lawson, Lin Wang, Thomas Raj, E George Wolf, Bijaya Kumar Parida, Vijay Saradhi Gorantla, Rory Frederick Rickard, Michael Robert Davis
BACKGROUND:  Ischemia-reperfusion injury (IRI) precipitates acute rejection of vascularized composite allografts (VCA). Hyperbaric preservation of tissues ex vivo, between harvest and revascularization, may reduce IRI and mitigate acute rejection of VCA. METHODS:  A porcine heterotopic musculocutaneous gracilis flap model was used. In phase 1, control autografts ( n  = 5) were infused with University of Wisconsin Solution (UWS) and stored at 4°C for 3 hours...
August 12, 2018: Journal of Reconstructive Microsurgery
Wida S Cherikh, Linda C Cendales, Christopher L Wholley, Jennifer Wainright, Vijay S Gorantla, David K Klassen, Sue McDiarmid, L Scott Levin
On July 3, 2014, the Organ Procurement and Transplantation Network/United Network for Organ Sharing was charged with the oversight of Vascularized Composite Allograft (VCA) procurement and transplantation in the U.S. As of December 31, 2017, 61 VCA programs at 27 centers were approved in the U.S. Fifty candidates have been added to the waiting list at 15 centers. Twenty-eight VCA transplants have been performed at 14 programs (10 upper limb, 10 uterus, 5 craniofacial, 1 scalp, 1 abdominal wall, and 1 penile)...
August 9, 2018: American Journal of Transplantation
Laura C Burlage, Shannon N Tessier, Joanna W Etra, Korkut Uygun, Gerald Brandacher
PURPOSE OF REVIEW: In this review, we discuss novel strategies that allow for extended preservation of vascularized composite allografts and their potential future clinical implications for the field of vascularized composite allotransplantation (VCA). RECENT FINDINGS: The current gold standard in tissue preservation - static cold preservation on ice - is insufficient to preserve VCA grafts for more than a few hours. Advancements in the field of VCA regarding matching and allocation, desensitization, and potential tolerance induction are all within reasonable reach to achieve; these are, however, constrained by limited preservation time of VCA grafts...
August 4, 2018: Current Opinion in Organ Transplantation
Adriano Taddeo, Catherine Tsai, Esther Vögelin, Robert Rieben
PURPOSE OF REVIEW: The long-term adverse effects of immunosuppressive treatment, the high rate of acute rejection and the development of chronic rejection are the main factors preventing a wider clinical application of vascularized composite allotransplantation (VCA). Targeted immunosuppression using innovative drug delivery systems (DDS) may help to overcome these hurdles, increasing therapeutic efficacy while reducing systemic toxicity. This review provides a summary of the recently developed strategies for targeted delivery of immunosuppressive drugs in VCA...
August 1, 2018: Current Opinion in Organ Transplantation
Gianluca Trevisi, Simon B Eickhoff, Fahmida Chowdhury, Ashwani Jha, Roman Rodionov, Mark Nowell, Anna Miserocchi, Andrew W McEvoy, Parashkev Nachev, Beate Diehl
The medial frontal cortex remains functionally ill-understood; this is reflected by the heterogeneity of behavioural outcomes following damage to the region. We aim to use the rich information provided by extraoperative direct electrical cortical stimulation to enhance our understanding of its functional anatomy. Examining a cohort of 38 epilepsy patients undergoing direct electrical cortical stimulation in the context of presurgical evaluation, we reviewed stimulation findings and classified them in a behavioural framework (positive motor, negative motor, somatosensory, speech disturbances, and "other")...
July 6, 2018: Cortex; a Journal Devoted to the Study of the Nervous System and Behavior
Irina Tcherniaeva, Gerco den Hartog, Guy Berbers, Fiona van der Klis
Latent infection with Cytomegalovirus (CMV) or Epstein-Bar virus (EBV) is associated with compromised immune responses. The commercially available ELISA-kits provide a semi-quantitative or qualitative detection of IgG antibodies against either CMV or EBV. To reduce the amount of sample needed and improve throughput and range of quantitation compared to ELISAs, a multiplex immunoassay (MIA) for the simultaneous quantitative detection of antibodies against CMV and two antigens of EBV (EBV capsid antigen (EBV-VCA) and EBV nuclear antigen 1 (EBNA-1)) was developed and standardized...
July 26, 2018: Journal of Immunological Methods
Nicco Krezdorn, Sotirios Tasigiorgos, Luccie Wo, Rachel Lopdrup, Marvee Turk, Harriet Kiwanuka, Salman Ahmed, Palmina Petruzzo, Ericka Bueno, Bohdan Pomahac, Leonardo V Riella
Background: Kidney dysfunction is a major complication after nonrenal solid organ transplants. Transplantation of vascularized composite allografts (VCA) has yielded successful midterm outcomes despite high rates of acute rejection and greater requirements of immunosuppression. Whether this translates in higher risks of kidney complications is unknown. Methods: Ninety-nine recipients of facial or extremity transplants from the Brigham and Women's Hospital (BWH) and the International Registry on Hand and Composite Tissue Transplantation (IR) were reviewed...
July 2018: Transplantation Direct
Hanan M Fouad, Ehab M Reyad, Amany Gmal El-Din
Acute hepatic illness is an important health issue in children. Our work aimed to determine the prevalence of viral hepatitis in symptomatic children. It is a prospective cohort study of 268 children presented with acute hepatitis. Complete blood count, liver panel, and anti-hepatitis A virus (HAV) IgM were done initially. Cases negative for HAV were tested for anti-hepatitis E (HEV) IgM, anti-Epstein-Barr virus viral capsid antigen (EBV VCA) IgM, anti-cytomegalovirus virus IgM, hepatitis B surface antigen, anti-hepatitis B core IgM antibody, and anti-HCV antibody...
July 20, 2018: European Journal of Clinical Microbiology & Infectious Diseases
Nilgun Kasifoglu, Semra Oz, Ener Cagri Dinleyici, Tercan Us, Ozcan Bor, Gul Durmaz, Yurdanur Akgun
The accurate diagnosis of Epstein-Barr virus (EBV) infections is important, as many other infectious agents or diseases can cause similar symptoms. In this study, sera of pediatric patients who were suspected to have an EBV infection, were sent to Eskisehir Osmangazi University Faculty of Medicine, Department of Clinical Microbiology, and investigated by IFA, ELISA, immunoblotting and Real-time PCR. The performances of these tests were compared with IFA. The rates of agreement between ELISA and IFA were found as 100% for seronegative, 100% for acute primary infection, 22...
March 9, 2018: Polish Journal of Microbiology
Batirtze Prats-Mateu, Martin Felhofer, Anna de Juan, Notburga Gierlinger
Background: Plant cell walls are nanocomposites based on cellulose microfibrils embedded in a matrix of polysaccharides and aromatic polymers. They are optimized for different functions (e.g. mechanical stability) by changing cell form, cell wall thickness and composition. To reveal the composition of plant tissues in a non-destructive way on the microscale, Raman imaging has become an important tool. Thousands of Raman spectra are acquired, each one being a spatially resolved molecular fingerprint of the plant cell wall...
2018: Plant Methods
Katrina A Bramstedt
Introduction: Most solid organ transplantation is viewed as lifesaving, whereas vascularized composite allotransplantation (VCA) has been viewed as life enhancing. This article challenges the latter and argues that "social death" evident in severe face, hand, and larynx disfigurement can be potentially treated via VCA. Social death (from a social science perspective) consists of a combination of 7 components: social isolation, loneliness, ostracism, loss of personhood, change of role and identity, harm, and disfigurement...
June 2018: Journal of patient experience
Yuan Qu, Di Wang, Lin Yang, Hui-Ying Liu, Wei Cui, Yi-Qun Che
Nasopharyngeal carcinoma (NPC) has the highest incidence of all types of head and neck cancer in China. The present study aimed to investigate the association between the expression of programmed death ligand 1 (PD-L1) in NPC tissues and clinicopathological features, as well the outcomes for NPC patients. In addition, the association between tissue expression of PD-L1 and immune components in peripheral blood was assessed. The expression of PD-L1 was determined by immunohistochemistry, while immune indexes were determined by ELISA and flow cytometry...
July 2018: Molecular and Clinical Oncology
Hande Arslan, Tuba Çandar, Özge Vural
INTRODUCTION: The immune reaction developing against Ebstein-Barr virus (EBV) infection may be one of the major determinants of severe adenoid hypertrophy (AH) and chronic otitis media with effusion (COME) needing surgery. In this study, we aimed to investigate the relationship between these antibodies and the need for surgery due to complications such as severe AH and COME. METHODS: Sixty consecutive patients <15 years old who were admitted to our outpatient clinics between January 2014 and December 2015 with severe AH ± COME and underwent adenoidectomy ± ventilation tube insertion and 129 control patients who had a history of EBV infection at least three months before the inclusion to the study without current symptoms of upper airway obstruction and middle ear disease were included in this study...
August 2018: International Journal of Pediatric Otorhinolaryngology
Matthew G Varga, Hui Cai, Tim Waterboer, Gwen Murphy, Taichi Shimazu, Phil R Taylor, You-Lin Qiao, Sue K Park, Keun-Young Yoo, Sun Ha Jee, Eo Rin Cho, Jeongseon Kim, Christian C Abnet, Shoichiro Tsugane, Qiuyin Cai, Wei Zheng, Michael Pawlita, Xiao-Ou Shu, Meira Epplein
BACKGROUND: Epstein-Barr virus (EBV)-positive gastric cancers represent a distinct subtype of gastric cancers and account for nearly 10% of the gastric cancer burden, yet risk detection strategies for this cancer subtype are lacking. METHODS: We conducted a nested case-control study where we assayed 4 EBV antigens [viral capsid antigen (VCA), early antigen (EA), Epstein-Barr nuclear antigen (EBNA), and BZLF1-encoded replication activator protein (ZEBRA)] in either sera or plasma from 1447 gastric cancer cases and 1797 controls obtained from seven prospective cohorts representing individuals from the high gastric cancer-risk countries of China, Japan, and Korea...
June 8, 2018: Digestive Diseases and Sciences
Krishna S Vyas, Anita T Mohan, Shane D Morrison, Duy C Tran, Samir Mardini
BACKGROUND:  Dendritic cells (DCs) are bone marrow-derived, professional antigen-presenting cells with tolerogenic function. The ability of DCs to regulate alloantigen-specific T cell responses and to promote tolerance has aligned them ideally for a role in vascularized composite allotransplantation (VCA). In this study, we summarize the current evidence for DC therapies for tolerance induction to alleviate the requirement for chronic immunosuppression. METHOD:  A comprehensive and structured review of manuscripts published on VCA was performed using the MEDLINE and PubMed databases...
June 26, 2018: Journal of Reconstructive Microsurgery
Xia Yu, Mingfang Ji, Weimin Cheng, Biaohua Wu, Yun Du, Sumei Cao
Background: Nasopharyngeal carcinoma (NPC) remains as a major public health burden in Southern China. Over the last decade, Epstein-Barr virus (EBV) serological detection has been the most promising tool used for NPC screening. The present study aims to evaluate the long-term diagnostic performance of a new NPC screening scheme (probability of NPC units [logit P], PROB≥0.65), and compare this with other EBV seromarkers used within 2009-2015. Methods: Enzyme-linked immunosorbent assay (ELISA) for EBV capsid antigen (VCA/IgA) and nuclear antigen-1 (EBNA1/IgA) was performed in 16,712 subjects, who were within 30-59 years old...
2018: Journal of Cancer
Holger J Klein, Fabienne Lehner, Riccardo Schweizer, Barbara Rüsi-Elsener, Jakob Nilsson, Jan A Plock
BACKGROUND: Since the inception of clinical VCA almost two decades ago, burn victims have been identified as immunologically complex patients owing to preformed HLA antibodies. However, it remains unclear whether the detected HLA antibodies are the result of former alloantigenic events or if their de novo formation occurs during primary burn care. METHODS: Patients with burns >20% of total body surface area (TBSA) admitted to Zurich Burn Centre between May 2015 and September 2016 were screened for HLA antibodies at admission and 6 months post trauma...
August 2018: Burns: Journal of the International Society for Burn Injuries
Bohdan Pomahac, Muayyad Alhefzi, Ericka M Bueno, Sue V McDiarmid, L Scott Levin
Living donation has become a medically and ethically accepted practice in solid organ transplantation. Published proceedings from the international kidney transplant community and from the Ethics Committee of The Transplantation Society (TTS) articulated the general principles as well as specific recommendations for living donation, which remain the backbone of the Centers for Medicare and Medicaid Services (CMS) and Organ Procurement and Transplantation Network (OPTN) requirements and policies.Meanwhile, there have been major advancements in another revolutionary field of transplant medicine: vascularized composite allotransplantation, or VCA...
June 14, 2018: Plastic and Reconstructive Surgery
Wen-Qiong Xue, Yong-Qiao He, Xiao-Yu Liao, Fang-Fang Li, Ya-Fei Xu, Feng-Hua Xu, Xi-Zhao Li, Qi-Sheng Feng, Li-Zhen Chen, Su-Mei Cao, Qing Liu, Yi-Xin Zeng, Wei-Hua Jia
The link of nasopharyngeal carcinoma (NPC) with Epstein-Barr virus (EBV) has been established for decades. Although an abnormal high level of EBV sero-antibody spectrum and cell-free circulating EBV DNA loads were exhibited in NPC patients, oral EBV DNA loads, which are primarily responsible for the EBV transmission, has not been previously studied in NPC patients. We conducted an epidemiological study to measure the oral EBV loads, viral components, and the relationship with the serum antibody titers in a large case-control population (968 cases and 1656 controls) and a family-based population (91 cases and 165 unaffected family members)...
June 14, 2018: Cancer Medicine
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