Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Donor selection”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources

Severe graft-versus-host disease in SCID mice is associated with a decrease of selective donor cell TCR Vbeta specificities and increased expression of IFN-gamma and IL-4.

Differences in T-cell selection and severity of graft-versus-host (GVH) disease were observed in immunodeficient C.B-17 SCID (SCID) mice after injection of allogeneic T lymphocytes from CBA/J or C57B1/6 (B6) mice. Infiltrating donor cells were analysed in bone marrow (BM), liver and spleen of newborn recipients and 5 days post-engraftment the number of B6 cells significantly exceeded that of CBA/J cells in these organs. At that time, cells in BM of B6 and CBA/J injected recipients were augmented in intracellular IL-4, IL-10, and TNF-alpha, whereas only cells in B6 treated BM were increased in IFN-gamma, and both treated groups of mice had up-regulated endogenous MHC class I and class II expression in the three organs. Already on day 5, and more pronounced day 10, B6 treated SCIDs had a relative decrease of four different TCR-Vbeta specificities among donor cells, whereas CBA/J injected mice had an abnormal expansion of Vbeta14+ donor T cells 10 days post injection. At the same time, the total cell contents of BM and spleen of B6 injected mice were substantially decreased, and this was paralleled by signs of severe GVHD; whereas SCIDs treated with CBA/J exhibited much milder symptoms. Moreover, adult SCID mice injected with Vbeta2, 4, 8 and 14 depleted B6 T cells showed an increased percentage of infiltrating donor cells and an enhanced decrease in BM cell content compared to SCIDs treated with total B6 T cell repertoire. In vitro, the Vbeta2, 4, 8 and 14 depleted population was more responsive to SCID spleen stimulators. Thus, a disturbed immunoregulation among donor T cells, caused by multiple changes in the TCR repertoire, may be responsible for inducing the severe GVHD.

Acute Disease↗

Small-for-size liver syndrome after auxiliary and split liver transplantation: donor selection.

Small-for-size liver grafts can be defined by a recognizable clinical syndrome that results from the transplantation of too small a functional mass of liver for a designated recipient. A graft to recipient body weight ratio less than 0.8, impaired venous inflow, and enhanced metabolic demands in patients with poor clinical conditions must be considered as main factors leading to the small-for-size syndrome (SFSS) when using living and cadaveric partial grafts such as split and auxiliary liver grafts. Increased risk of graft dysfunction is currently observed in fatty infiltration of more than 30%, abnormal liver test results (especially bilirubin and gamma glutaryl transferase), and other donor risk factors such as high inotrope administration and donor stay in the intensive care unit (>5 days). Older donors are especially vulnerable to prolonged cold ischemia and high inotrope levels, giving rise to early graft dysfunction and prolonged cholestasis. Increased metabolic need on a functionally small-for-size graft predisposes to surgical and septic complications and poorer survival. Splitting livers into right and left lobe grafts increases the potential risk of small-for-size grafts for both recipients. Several techniques of venous outflow reconstruction/implantation have been proposed to reduce the risk of obstruction postoperatively. Prevention and management of SFSS will improve in parallel with the increased experience, allowing us optimum usage of available organs and reducing overall morbidity and mortality.

Body Constitution↗

[Virologic considerations in donor selection for allogeneic keratoplasty].

Over a period of 14 months (from October 1985 to December 1986) 152 potential cornea donors were evaluated for human immunodeficiency virus (HIV) and hepatitis B surface (HBs) antigen. In three clinically normal donors (two deaths due to natural causes, one as a result of an automobile accident), HIV seroconversion was found by ELISA techniques in two cases and a positive Western Blot test in one. The two elderly patients had previously undergone multiple blood transfusions during major abdominal surgery in smaller community hospitals before blood donors were routinely tested for HIV; one 20-year-old patient was probably a homosexual, as in-depth interviews with his family doctor revealed. Hepatitis B serology was positive in four potential cornea donors. The authors conclude that interdisciplinary work-ups of potential cornea donors should include screening for infectious diseases.

Acquired Immunodeficiency Syndrome↗

Aerosolization of novel nitric oxide donors selectively reduce pulmonary hypertension.

OBJECTIVES: Inhaled nitric oxide (NO) reduces pulmonary hypertension in acute respiratory failure. Soluble nitric oxide donors (NO/nucleophile adducts-NONOates) are less cumbersome to deliver and may offer clinical advantage compared with inhaled NO. The objective of this study was to examine the pulmonary and systemic hemodynamic effects of tracheal aerosolization of a new class of NONOates in a porcine model of experimentally induced pulmonary hypertension. DESIGN: Prospective, randomized, controlled study. SETTING: Research laboratory. SUBJECTS: Yorkshire pigs (n = 18), weighing 11.4 to 16.4 kg. INTERVENTIONS: In anesthetized, mechanically ventilated, instrumented pigs, steady-state pulmonary hypertension (SSPH) was induced using a thromboxane agonist (U46619). Control animals received tracheal aerosolization of saline (n = 6); EP/NO animals received tracheal aerosolization of ethylputreanine NONOate (EP/ NO, n = 6); and DMAEP/NO animals received aerosolized 2-(dimethylamino) ethylputreanine NONOate (DMAEP/NO, n = 6). MEASUREMENTS AND MAIN RESULTS: Mean pulmonary (MPAP) and mean systemic arterial pressures (MAP), atrial pressures, cardiac output, and arterial blood gases were measured following drug instillation. DMAEP/NO animals had significant reductions in pulmonary vascular resistance index (PVRI) and MPAP at all time points compared with SSPH and control animals (p < .05), while systemic vascular resistance index did not change. EP/NO animals had a significant reduction in PVRI and MPAP at some time points compared with SSPH and control animals. For both NONOate-treated animal groups, MAP and cardiac index did not change significantly compared with SSPH and control animals (p < .05). CONCLUSIONS: In this porcine model of pulmonary hypertension, intratracheal aerosolization of soluble NO donors results in sustained reduction of pulmonary hypertension without reducing systemic arterial pressure. Intermittent aerosolization of NONOates may be an alternative to continuously inhaled NO in the treatment of acute pulmonary hypertension.

Acute Disease↗

Hepatitis-associated with markers in the American Red Cross volunteer blood donor population. III. Influence of donor selection practice upon HBsAg prevalence.

The American Red Cross collects blood from a number of defined subsets of the donor population and teh proportion of blood collected from each subset varies widely from center to center. A large part of the variation in prevalence of HBsAg may be related to variations in the proportion of blood collected from plants and factories, military units and schools or colleges. We have derived a regression equation, significant at the p less than 0.001 level, which links HBsAg prevalence with these collection parameters. Using this equation, we were able to predict the prevelance of HBsAg among first-time donors in 6 of the 9 geographic divisions of the United States with an accuracy exceeding 10%. The predictions for the remaining division were within 35% of the actual value. Correlation studies were supported by measurements of true donor prevalence in three blood centers.

Blood Donors↗

Maximizing optimal hematopoietic stem cell donor selection from registries of unrelated adult volunteers.

Today, more than 50 registries of HLA-typed potential adult hematopoietic stem cell donors have been established in 40 countries and include more than 7.5 million volunteers. HLA testing of new volunteers includes HLA-A, -B and often -DR typing at low to intermediate resolution. Searching patients are tested for these same loci, preferably at a higher level of resolution. Over 95,000 patient searches are received by registries annually resulting in approximately 4660 unrelated transplants. In 2001, nearly one-third of transplants involved a patient in one country receiving stem cells from a donor in another. The diversity of the HLA system complicates the search process, requiring sophisticated registry algorithms for matching, and expertise in allele and haplotype frequencies and associations to design search strategies. Within registries, HLA frequency data have been used to evaluate optimal registry size and composition.

Adult↗

Pancreas transplant protocols at the University of Minnesota: recipient and donor selection, operative and postoperative management, and outcome.

In summary, at the University of Minnesota we perform pancreas transplants from both living-related and cadaver donors. Living-related donors must meet strict criteria indicating that they are not at risk for diabetes. Segmental grafts are procured from living-related donors. We currently procure whole pancreas grafts from most cadaver donors, including those in whom a liver is procured. We will accept preservation times up to 24 hours using hyperosmolar silica-gel-filtered plasma as the preservation solution. In regard to recipient selection, we have several categories of patients, including nonuremic individuals with early secondary lesions of diabetes affecting the eyes, nerves, and kidneys. Pancreas transplants are also performed in patients with end-stage diabetic nephropathy, either simultaneous with or after a kidney transplant. The potential benefit from pancreas transplantation is greatest in patients who have early diabetic complications which in the absence of this intervention would progress to a severity more serious than the possible side effects of chronic immunosuppression. A careful pretransplant evaluation is necessary in order to select nonuremic, nonkidney recipients in whom pancreas transplantation is appropriate. The selection process is much easier in kidney transplant recipients; virtually any person who can withstand the additional surgery is a candidate, the risks associated with immunosuppression having already been accepted in lieu of the unsatisfactory alternative of chronic dialysis. The results we have obtained in the 3 categories of recipients since November 1984 in patients managed by our currently preferred surgical techniques and immunosuppressive protocols are shown in Figure 6. One-year pancreas survival rates in nonuremic, nonkidney transplant recipients are 63%, in recipients of a previous kidney 46%, and in recipients of simultaneous kidneys 75%. With respect to surgical technique, our current preference is the bladder drainage method because the ability to monitor exocrine function leads to earlier diagnosis and treatment of rejection episodes. With related donor transplant, we have continued to use enteric drainage. Because the rejection rate is much lower than with cadaver donors, the one-year functional survival rate has been relatively high for technically successful enteric-drained related donor grafts. Nevertheless, rejection does occur, and related donor segmental grafts are being performed with bladder drainage. Our current immunosuppressive protocol of quadruple drug therapy has been associated with the highest graft survival rates, particularly in the bladder-drained group where early diagnosis and treatment of rejection has been facilitated. In our experience, UAA monitoring results have had a high correlation with rejection episodes, and we have never seen loss of endocrine function with retention of high UAA levels.(ABSTRACT TRUNCATED AT 400 WORDS)

Clinical Protocols↗