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Muacevic A, Adler JR. Classic and Current Opinions in Human Organ and Tissue Transplantation. Cureus 2022; 14:e30982. [PMID: 36337306 PMCID: PMC9624478 DOI: 10.7759/cureus.30982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2022] [Indexed: 11/30/2022] Open
Abstract
Graft tolerance is a pathophysiological condition heavily reliant on the dynamic interaction of the innate and adaptive immune systems. Genetic polymorphism determines immune responses to tissue/organ transplantation, and intricate humoral and cell-mediated mechanisms control these responses. In transplantation, the clinician's goal is to achieve a delicate equilibrium between the allogeneic immune response, undesired effects of the immunosuppressive drugs, and the existing morbidities that are potentially life-threatening. Transplant immunopathology involves sensitization, effector, and apoptosis phases which recruit and engages immunological cells like natural killer cells, lymphocytes, neutrophils, and monocytes. Similarly, these cells are involved in the transfer of normal or genetically engineered T cells. Advances in tissue transplantation would involve a profound knowledge of the molecular mechanisms that underpin the respective immunopathology involved and the design of precision medicines that are safe and effective.
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Mallela DP, Bose S, Shallal CC, Goldsborough E, Xun H, Chen J, Stonko DP, Brandacher G, Sacks J, Kang SH, Hicks CW. A systematic review of sutureless vascular anastomosis technologies. Semin Vasc Surg 2021; 34:247-259. [PMID: 34911631 DOI: 10.1053/j.semvascsurg.2021.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 11/11/2022]
Abstract
Vascular anastomoses typically involve a handsewn technique requiring significant surgical training, expertise, and time. The aim of our systematic review was to identify and describe sutureless vascular anastomosis techniques. We performed a systematic review of all sutureless vascular anastomosis technologies published in MEDLINE, PubMed, Embase, CINAHL, Cochrane, Web of Science, and Scopus Library databases and a patent review using US Patent and Trade Office Application, US Patent and Trademark Office Patent, Google Patents, Lens, Patent Quality Through Artificial Intelligence, SureChEMBL, and E-Space Net. Data from inclusion studies and patents published between January 1, 1980 and July 15, 2021 were abstracted to describe their category, anastomosis type and configuration, study types, and advantages and disadvantages encountered with each technology. Two hundred eleven original studies and 475 patents describing sutureless vascular anastomosis technologies were identified. In the literature, stents/stent-grafts/grafts (n = 61), lasers (n = 53), and couplers (n = 27) were the predominant device categories. In the patent review, adhesive technologies (n = 103), stents/stent-grafts/grafts (n = 68), and mechanical connectors (n = 61) predominated. The majority of studies involved in vivo animal studies (n = 193); 32.2% (n = 68) of investigations involved human trials; and 17.9% (n = 85) of patent technologies were approved by the US Food and Drug Administration. The main advantages described for sutureless anastomosis technologies included faster procedure time and greater patency rates compared with handsewn anastomoses. The main disadvantages included reduced vessel compliance, stenosis, leakage, and device costs. The appeal of sutureless technology is substantiated by numerous animal trials, but their use in humans remains limited. This may be a reflection of strict regulatory criteria and/or vascular complications associated with currently available technologies.
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Affiliation(s)
- Deepthi P Mallela
- Division of Vascular Surgery and Endovascular Therapy, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Halsted 668, Baltimore, MD, 21287
| | - Sanuja Bose
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Christopher C Shallal
- Department of Biomedical Engineering, Johns Hopkins University Whiting School of Engineering, Baltimore, MD
| | | | - Helen Xun
- Department of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center Boston, MA
| | - Jonlin Chen
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - David P Stonko
- Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD
| | - Gerald Brandacher
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Justin Sacks
- Division of Plastic and Reconstructive Surgery, Washington University Medical Center, St Louis, MO
| | - Sung H Kang
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD
| | - Caitlin W Hicks
- Division of Vascular Surgery and Endovascular Therapy, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Halsted 668, Baltimore, MD, 21287.
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Lena T, Amabile A, Shang M, Torregrossa G, Geirsson A, Tesler UF. Alexis Carrel: The surgeon, the visionary, the Nobel Laureate. J Card Surg 2021; 37:277-279. [PMID: 34888954 DOI: 10.1111/jocs.16176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 11/30/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Tea Lena
- Cardiac Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences, University Hospital of Padua, Padua, Italy
| | - Andrea Amabile
- Section of Cardiac Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Michael Shang
- Section of Cardiac Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Gianluca Torregrossa
- Department of Cardiothoracic Surgery, Lankenau Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood, Pennsylvania, USA
| | - Arnar Geirsson
- Section of Cardiac Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Ugo F Tesler
- International School of Cardiac Surgery, Ettore Majorana Foundation and Center for Scientific Culture, Erice, Italy
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Rosa AL, Ferraz EP. Grand Challenges in Oral Surgery. FRONTIERS IN ORAL HEALTH 2020; 1:5. [PMID: 35047978 PMCID: PMC8757857 DOI: 10.3389/froh.2020.00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/04/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Adalberto L. Rosa
- Department of Oral & Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
- *Correspondence: Adalberto L. Rosa
| | - Emanuela P. Ferraz
- Department of Maxillofacial Surgery, Prosthodontics and Traumatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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González J, Gaynor JJ, Alameddine M, Ciancio G. Evolution of the Application of Techniques Derived from Abdominal Transplant Surgery in Urologic Oncology. Curr Urol Rep 2018; 19:6. [DOI: 10.1007/s11934-018-0753-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Sampogna G, Guraya SY, Forgione A. Regenerative medicine: Historical roots and potential strategies in modern medicine. J Microsc Ultrastruct 2015; 3:101-107. [PMID: 30023189 PMCID: PMC6014277 DOI: 10.1016/j.jmau.2015.05.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 05/04/2015] [Accepted: 05/08/2015] [Indexed: 12/20/2022] Open
Abstract
Regenerative medicine is a distinct major advancement in medical treatment which is based on the principles of stem cell technology and tissue engineering in order to replace or regenerate human tissues and organs and restore their functions. After many years of basic research, this approach is beginning to represent a valuable treatment option for acute injuries, chronic diseases and congenital malformations. Nevertheless, it is a little known field of research. The purpose of this review is to convey the state of the art in regenerative medicine in terms of historical steps, used strategies and pressing problems to solve in the future. This review represents a good starting point for more in-depth studies and personal research projects.
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Affiliation(s)
- Gianluca Sampogna
- Advanced International Mini-invasive Surgery - AIMS Academy, Milan, Italy
| | | | - Antonello Forgione
- Advanced International Mini-invasive Surgery - AIMS Academy, Milan, Italy
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