Prevention and treatment of iatrogenic premature ovarian insufficiency:r interpretation of the first Chinese guideline on ovarian tissue cryopreservation and transplantation

In recent years,with the rapid development of medical research,cancer diagnosis and treatment technology have significantly improved young cancer patient’s survival rate.Anticancer therapy such as chemotherapy,radiotherapy,or hematopoietic stem cell transplantation can lead to premature ovarian insufficiency.The endocrine and reproductive function of the ovary is critical to women’s physical and mental health.Ovarian tissue cryopreservation and transplantation can protect not only female fertility but also preserve ovarian endocrine function.This paper interprets the guidelines for ovarian tissue cryopreservation and transplantation issued by the Chinese Society of Gynecological Endocrinology affiliated to the International Society of Gynecological Endocrinology.The purpose of this guideline’s interpretation is to promote more medical workers to understand the technology of ovarian tissue cryopreservation and transplantation,which can provide patients with more choices of fertility protection methods and improve their quality of life.

Orthotopical transplantation of human renal carcinoma tissue into nude mice and the establishment of a high metastatic cell line MRCC

Objective To establish a SOI model of human renal carcinoma and a high metastatic cell subline. Methods A human renal cell line RCC-9863 has been established by inoculating a human renal tumor tissue into nude mice s. c.. When RCC-9863 passaged for 20 times, the tissue from the same xemotransplant tumor were used to construct SOI model. Cultured the metastatic tissue in vitro, the tumor cell suspension was then injected orthotopically, The metastatic tissue obtained underwent the same procedure again. At last, the metastatic tumor was cultured in vitro and cloned. Results 15 days later, a tumor mass sized 1. 7 cm × 0. 6 cm in the nude mouse’s renal parenchyma was grown which lobulated, rude, and with multiply blood vessels and 55 days later later the mouse became moribund and metastases in the lungs were formed. The transplanted renal tumor in the SOI model grew fast and invasively and metastasized to lungs, lymphatic node and liver. A subline, MRCC, with metastatic ability to the lung was selected.

In Vivo Function of Fresh and Cryopreserved Testicular Tissue

We evaluated the function of the fresh and cryopresereed newborn rat testicular tissue transplanted into outbred adult castrated male rats without immunosuppression for 30 days.Testis grafts were evaluated morphologically and histologically,and testosterone(T)levels of serum and homogenate of testis grafts were determined in recipients by 30 days after transplantation.The fresh tissues(GroupI)and cryopreserved tissues(Group Ⅱ),from the 2nd or 3rd day of postnatal,showed an overall increase in growth,with maintenance of architecture and minimal lymphocytic infiltration.Thirty days after implantation,mean(±s)serum T concentrations(0.986±0.028 nmol/L in group I;1.113±0.201 nmol/L in group Ⅱ)were significantly higher than that prior to transplantation(<0.347 nmol/L,respectively;P<0.01 and P<0.01).After transplantation,however,mean serum T levels between two groups were not significantly different(P<0.05),and their grafting homogenate T levels(0.944±0.164 nmol/g in group I;1.019±0.172 nmol/g in group Ⅱ) were also not significantly different between two groups(P>0.05).Our data suggest that the testicular tissue of newborn rats can not only survive,grow and differentiate,but also can produce enough T detectable in vivo after transplantation and no significant differences were found between fresh tissue and frozen tissue transplanted.

Liver transplantation using organs from deceased organ donors: a single organ transplant center experience

BACKGROUND： In 2011, a pilot program for deceased organ donation was initiated in China. We describe the first successful series of liver transplants in the pilot program.METHODS： From July 2011 to August 2012, our center performed 26 liver transplants from a pool of 29 deceased donors. All organ donation and allograft procurement were conducted according to the national protocol. The clinical data of donors and recipients were collected and summarized retrospectively.RESULTS： Among the 29 donors, 24 were China Category II donors（organ donation after cardiac death）, and five were China Category III donors（organ donation after brain death followed by cardiac death）. The recipients were mainly the patients with hepatocellular carcinoma. The one-year patient survival rate was 80.8% with a median follow-up of 422（2-696） days. Among the five mortalities during the follow-up,three died of tumor recurrence. In terms of post-transplant complications, 9 recipients（34.6%） experienced early allograft dysfunction, 1（3.8%） had non-anastomotic biliary stricture,and 1（3.8%） was complicated with hepatic arterial thrombosis.None of these complications resulted in patient death. Notably,primary non-function was not observed in any of the grafts.CONCLUSION： With careful donor selection, liver transplant from deceased donors can be performed safely and plays acritical role in overcoming the extreme organ shortage in China.

Neural plasticity after spinal cord injury

Plasticity changes of uninjured nerves can result in a novel neural circuit after spinal cord injury, which can restore sensory and motor functions to different degrees. Although processes of neural plasticity have been studied, the mechanism and treatment to effectively improve neural plasticity changes remain controversial. The present study reviewed studies regarding plasticity of the central nervous system and methods for promoting plasticity to improve repair of injured central nerves. The results showed that synaptic reorganization, axonal sprouting, and neurogenesis are critical factors for neural circuit reconstruction. Directed functional exercise, neurotrophic factor and transplantation of nerve-derived and non-nerve-derived tissues and cells can effectively ameliorate functional disturbances caused by spinal cord injury and improve quality of life for patients.

Functional and immunological peculiarities of peripheral nerve allografts

This review addresses the accumulating evidence that live(not decellularized)allogeneic peripheral nerves are functionally and immunologically peculiar in comparison with many other transplanted allogeneic tissues.This is relevant because live peripheral nerve allografts are very effective at promoting recovery after segmental peripheral nerve injury via axonal regeneration and axon fusion.Understanding the immunological peculiarities of peripheral nerve allografts may also be of interest to the field of transplantation in general.Three topics are addressed:The first discusses peripheral nerve injury and the potential utility of peripheral nerve allografts for bridging segmental peripheral nerve defects via axon fusion and axon regeneration.The second reviews evidence that peripheral nerve allografts elicit a more gradual and less severe host immune response allowing for prolonged survival and function of allogeneic peripheral nerve cells and structures.Lastly,potential mechanisms that may account for the immunological differences of peripheral nerve allografts are discussed.

Current status of vascularized composite tissue allotransplantation

Vascularized composite tissue allotransplantation(VCA)offers treatment options of complex functional deficiencies that cannot be repaired with conventional reconstructive methods.VCAs consist of blocks of functional units comprising different tissue types such as skin,bone,muscle,nerves,blood vessels,tendons,ligaments and others,and are thus substantially different from the composition of organ transplants.The field of VCA has made fascinating progresses in the recent past.Among other VCAs,numerous successful hand,face and limb transplants have been performed in the world.At the same time,specific questions in regard to innate and adaptive immunity,consequences of ischemia/reperfusion injury,immunosuppression,preservation,and regenerative capacity remain.In spite of this,the field is poised to make significant advances in the near future.

Emerging issues in peripheral nerve repair

It is today widely acknowledged that nerve repair is now more than a matter of perfect microsurgical reconstruction only and that, to further improve clinical outcome, the involvement of different scientific disciplines is required. This evolving reconstructive/regenerative approach is based on the interdisciplinary and integrated pillars of tissue engineering such as reconstructive microsurgery, transplantation and biomaterials. In this paper, some of the most promising innovations for the tissue engineering of nerves, emerging from basic science investigation, are critically overviewed with special focus on those approaches that appear today to be more suitable for clinical translation.

Histological Analysis and Morphometric Changes after Autologous Fat Grafting in Large Volumes on Pigs

Nowadays, fat transfer is an accepted technique that has been popularized in clinical practice, during which large volumes of fat are strategically relocated to increase and improve the contour of the body. In the present study, we investigated the histological and morphometric changes after large volumes of fat were grafted within the subcutaneous cellular tissue. An experimental study was designed using four 3-month-old male pigs. One hundred cc of decanted fat tissue was transferred into the right leg. Volume augmentation achieved by auto lipo-injecting within the subcutaneous cellular tissue persisted up to two months. Although there is a reduction in cell number and size, an increased amount of extracellular matrix and the presence of oily cysts and microcalcifications were observed. Conclusion: The volume augmentation, which is achieved by autologous fat transfer in large quantities in subcutaneous cellular tissue, can remain for months.

Current role in facial allograft transplantation:what have we learned?

Face transplant(FT)has evolved enormously in the last 10 years since the successful completion of the first facial transplant.This procedure has become a new reconstructive option for complex facial deformities to restore the anatomy of patients with severely disfigured faces.The authors review the literature and discuss the main surgical,immunological,and ethical aspects as well as the results described in patients undergoing FT.To date there have been more than thirty FT worldwide.The main indication was post-traumatic deformity.In all cases a standard immunosuppression was performed with three drugs,although acute rejection episodes were observed,that could be controlled with conventional immunosuppressive regimen.Overall,functional and aesthetic results have been excellent at short-term and high satisfaction rate exceeded initial expectations,although long-term data are still scarce.Major complications were opportunistic infections.Five deaths that occurred have reopened the ethical debate about the potential complications and concerns of providing informed consent to recipients.Continuous progresses in microsurgical techniques and preoperative planning have promoted the evolution from partial to full FT.All these are on the basis of accurate and careful selection of well-motivated candidates.The next challenge will be getting new immunosuppressive treatment strategies.Although clinical experience has demonstrated the FT viability,it is still considered an experimental procedure in which we have much to learn to define its true role in the current reconstructive surgery and resolve major technical,medical and ethical problems involved.