1
|
Lau FH, Hoffman RD, Danos D, Torabi R, Patterson CW, McKendrick AD, Stalder M, Dupin C, Hilaire HS. Regenerative vs flap-based limb salvage: a multi-centered, prospective, randomized controlled trial. Regen Med 2023; 18:207-218. [PMID: 36794542 DOI: 10.2217/rme-2022-0147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Aim: The goal of this study was to compare success rates of a regenerative limb salvage approach (rLS) using dehydrated human chorion amnion membrane (dHACM) to traditional flap-based limb salvage (fLS). Materials & methods: This prospective RTC enrolled patients presenting with complex extremity wounds over a 3-year period. Primary outcomes included success of primary reconstruction, persistence of exposed structures, time to definitive closure, and time to weight bearing. Results: Patients meeting inclusion criteria were randomized to fLS (n = 14) or rLS (n = 25). The primary reconstructive method was successful for 85.7% of fLS subjects and 80% of rLS subjects (p = 1.00). Conclusion: This trial provides strong evidence that rLS is an effective option in the setting of complex extremity wounds, with success rates comparable to traditional flaps. Clinical Trial Registration: NCT03521258 (ClinicalTrials.gov).
Collapse
Affiliation(s)
- Frank H Lau
- Department of Surgery, Louisiana State University Health Sciences Center New Orleans, Section of Plastic & Reconstructive Surgery, LA, USA
| | - Ryan D Hoffman
- Louisiana State University Health Sciences Center New Orleans, School of Medicine, LA, USA
| | - Denise Danos
- Department of Behavioral & Community Health Sciences Louisiana State University Health Sciences Center New Orleans, LA, USA
| | | | - Charles W Patterson
- University of Vermont Larner College of Medicine, Division of Plastic, Reconstructive, & Cosmetic Surgery, VT, USA
| | - Ann D McKendrick
- Department of Surgery, Louisiana State University Health Sciences Center New Orleans, Section of Plastic & Reconstructive Surgery, LA, USA
| | - Mark Stalder
- Department of Surgery, Louisiana State University Health Sciences Center New Orleans, Section of Plastic & Reconstructive Surgery, LA, USA
| | - Charles Dupin
- Department of Surgery, Louisiana State University Health Sciences Center New Orleans, Section of Plastic & Reconstructive Surgery, LA, USA
| | - Hugo St Hilaire
- Department of Surgery, Louisiana State University Health Sciences Center New Orleans, Section of Plastic & Reconstructive Surgery, LA, USA
| |
Collapse
|
2
|
Matar AJ, Crepeau RL, Mundinger GS, Cetrulo CL, Torabi R. Large Animal Models of Vascularized Composite Allotransplantation: A Review of Immune Strategies to Improve Allograft Outcomes. Front Immunol 2021; 12:664577. [PMID: 34276656 PMCID: PMC8278218 DOI: 10.3389/fimmu.2021.664577] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 06/07/2021] [Indexed: 11/23/2022] Open
Abstract
Over the past twenty years, significant technical strides have been made in the area of vascularized composite tissue allotransplantation (VCA). As in solid organ transplantation, the allogeneic immune response remains a significant barrier to long-term VCA survival and function. Strategies to overcome acute and chronic rejection, minimize immunosuppression and prolong VCA survival have important clinical implications. Historically, large animals have provided a valuable model for testing the clinical translatability of immune modulating approaches in transplantation, including tolerance induction, co-stimulation blockade, cellular therapies, and ex vivo perfusion. Recently, significant advancements have been made in these arenas utilizing large animal VCA models. In this comprehensive review, we highlight recent immune strategies undertaken to improve VCA outcomes with a focus on relevant preclinical large animal models.
Collapse
Affiliation(s)
- Abraham J Matar
- Department of Surgery, Emory University School of Medicine, Atlanta, GA, United States
| | - Rebecca L Crepeau
- Department of Surgery, Emory University School of Medicine, Atlanta, GA, United States
| | - Gerhard S Mundinger
- Department of Surgery, Division of Plastic and Reconstructive Surgery, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | - Curtis L Cetrulo
- Department of Surgery, Division of Plastic Surgery, Massachusetts General Hospital, Boston, MA, United States.,Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, United States.,Shriner's Hospital for Children, Department of Plastic and Reconstructive Surgery, Boston, MA, United States
| | - Radbeh Torabi
- Department of Surgery, Division of Plastic and Reconstructive Surgery, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, United States
| |
Collapse
|
3
|
Torabi R, Ward Coker CT, Hood CS, Riker AI. Facilitating Outpatient (Same Day) Mastectomy Using Multimodal Pain Control. J Am Coll Surg 2018. [DOI: 10.1016/j.jamcollsurg.2018.07.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
4
|
Torabi R, Hui A, Barton JS, Lau F. Tumescent-Based Radical Excision of Hidradenitis Suppurativa: Safe, Fast, and Efficacious. J Am Coll Surg 2018. [DOI: 10.1016/j.jamcollsurg.2018.08.393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
5
|
Tessler O, Bourn L, Lin SJ, Dupin C, Mundinger GS, Patterson C, St. Hilaire H, Bartow M, Torabi R, Hanemann M. Cosmetic Surgeon Representation. Ann Plast Surg 2018; 80:S431-S436. [DOI: 10.1097/sap.0000000000001430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
6
|
Rahimnia R, Rezayat S, Torabi R, Soltanghoraee H, Mehravi B, Amani A, Kharrazi S, Amanlou M. Research Article Gold nanoparticle sucrose complexes as potent anti-inflammatory agents. Genet Mol Res 2018. [DOI: 10.4238/gmr18037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
7
|
Torabi R, Bartow M, Stalder MW, Dupin C, St Hilaire H. Predictors of Complications after Autologous Breast Reconstruction: Patient Age and Outcome. J Am Coll Surg 2017. [DOI: 10.1016/j.jamcollsurg.2017.07.923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
8
|
Leonard DA, Mallard C, Albritton A, Torabi R, Mastroianni M, Sachs DH, Kurtz JM, Cetrulo CL. Skin grafts from genetically modified α-1,3-galactosyltransferase knockout miniature swine: A functional equivalent to allografts. Burns 2017; 43:1717-1724. [PMID: 28602591 DOI: 10.1016/j.burns.2017.04.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 04/19/2017] [Accepted: 04/27/2017] [Indexed: 12/22/2022]
Abstract
Burn is associated with a considerable burden of morbidity worldwide. Early excision of burned tissue and skin grafting of the resultant wound has been established as a mainstay of modern burn therapy. However, in large burns, donor sites for autologous skin may be limited. Numerous alternatives, from cadaver skin to synthetic substitutes have been described, each with varying benefits and limitations. We previously proposed the use of genetically modified (alpha-1,3-galactosyl transferase knockout, GalT-KO) porcine skin as a viable skin alternative. In contrast to wild type porcine skin, which has been used as a biologic dressing following glutaraldehyde fixation, GalT-KO porcine skin is a viable graft, which is not susceptible to loss by hyperacute rejection, and undergoes graft take and healing, prior to eventual rejection, comparable to cadaver allogeneic skin. In the current study we aimed to perform a detailed functional analysis of GalT-KO skin grafts in comparison to allogeneic grafts for temporary closure of full thickness wounds using our baboon dorsum wound model. Grafts were assessed by measurement of fluid loss, wound infection rate, and take, and healed appearance, of secondary autologous grafts following xenograft rejection. Comparison was also made between fresh and cryopreserved grafts. No statistically significant difference was identified between GalT-KO and allogeneic skin grafts in any of the assessed parameters, and graft take and function was not adversely effected by the freeze-thaw process. These data demonstrate that GalT-KO porcine grafts are functionally comparable to allogeneic skin grafts for temporary closure of full thickness wounds, and support their consideration as an alternative to cadaver allogeneic skin in the emergency management of large burns.
Collapse
Affiliation(s)
- D A Leonard
- TBRC Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, USA; Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA; Canniesburn Plastic Surgery and Burns Unit, Glasgow Royal Infirmary, Glasgow, UK.
| | - C Mallard
- TBRC Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - A Albritton
- TBRC Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - R Torabi
- TBRC Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, USA; Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - M Mastroianni
- TBRC Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, USA; Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - D H Sachs
- TBRC Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - J M Kurtz
- TBRC Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, USA; Department of Biology, Emmanuel College, Boston, USA
| | - C L Cetrulo
- TBRC Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, USA; Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| |
Collapse
|
9
|
Villani V, Bohnen JD, Torabi R, Sabbatino F, Chang DC, Ferrone CR. "Idealized" vs. "True" learning curves: the case of laparoscopic liver resection. HPB (Oxford) 2016; 18:504-9. [PMID: 27317954 PMCID: PMC4913127 DOI: 10.1016/j.hpb.2016.03.610] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 03/24/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Learning curves are believed to resemble an "idealized" model, in which continuous improvement occurs until a plateau is reached. We hypothesized that this "idealized" model would not adequately describe the learning process for a complex surgical technique, specifically laparoscopic liver resection (LLR). METHODS We analyzed the first 150 LLRs performed by a surgeon with expertise in hepatobiliary/laparoscopic surgery but with no previous LLR experience. We divided the procedures performed in 5 consecutive groups of 30 procedures, then compared groups in terms of complications, operative time, length of stay, and estimated blood loss. RESULTS We observed an increase in operative complexity (3.3% major operations in Group 1 vs. 23.3% in Group 5, p = 0.05). Complications decreased from Group 1 to Group 2 (20%-3%), but increased again as more complex procedures were performed (3% in Group 2-13% in Group 5). Similar improvement/regression patterns were observed for operative time and EBL. DISCUSSION The "true" learning curve for LLR is more appropriately described as alternating periods of improvement and regression until mastery is achieved. Surgeons should understand the true learning curves of procedures they perform, recognizing and mitigating the increased risk they assume by taking on more complex procedures.
Collapse
Affiliation(s)
- Vincenzo Villani
- Department of Surgery, Massachusetts General Hospital, Boston, MA, United States
| | - Jordan D Bohnen
- Department of Surgery, Massachusetts General Hospital, Boston, MA, United States
| | - Radbeh Torabi
- Department of Surgery, Massachusetts General Hospital, Boston, MA, United States
| | - Francesco Sabbatino
- Department of Surgery, Massachusetts General Hospital, Boston, MA, United States
| | - David C Chang
- Department of Surgery, Massachusetts General Hospital, Boston, MA, United States; Codman Center for Clinical Effectiveness in Surgery, Massachusetts General Hospital, Boston, MA, United States
| | - Cristina R Ferrone
- Department of Surgery, Massachusetts General Hospital, Boston, MA, United States.
| |
Collapse
|
10
|
Torabi R, Strong A, Hogan M, Dupin C, Tessler O, Lau F. Bone and Tendon Coverage via Dehydrated Human Amniotic/Chorionic Membrane and Split-Thickness Skin Grafting. J Reconstr Microsurg Open 2016. [DOI: 10.1055/s-0036-1571279] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Radbeh Torabi
- Division of Plastic and Reconstructive Surgery, Louisiana State University School of Medicine, New Orleans, Louisiana
| | - Amy Strong
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, New Orleans, Louisiana
| | - Mliss Hogan
- Division of Plastic and Reconstructive Surgery, Louisiana State University School of Medicine, New Orleans, Louisiana
| | - Charles Dupin
- Division of Plastic and Reconstructive Surgery, Louisiana State University School of Medicine, New Orleans, Louisiana
| | - Oren Tessler
- Division of Plastic and Reconstructive Surgery, Louisiana State University School of Medicine, New Orleans, Louisiana
| | - Frank Lau
- Division of Plastic and Reconstructive Surgery, Louisiana State University School of Medicine, New Orleans, Louisiana
| |
Collapse
|
11
|
Villani V, Yamada K, Scalea JR, Gillon BC, Arn JS, Sekijima M, Tasaki M, Cormack TA, Moran SG, Torabi R, Shimizu A, Sachs DH. Adoptive Transfer of Renal Allograft Tolerance in a Large Animal Model. Am J Transplant 2016; 16:317-24. [PMID: 26260215 PMCID: PMC4718904 DOI: 10.1111/ajt.13424] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 05/19/2015] [Accepted: 06/11/2015] [Indexed: 01/25/2023]
Abstract
Our recent studies in an inbred swine model demonstrated that both peripheral and intra-graft regulatory cells were required for the adoptive transfer of tolerance to a second, naïve donor-matched kidney. Here, we have asked whether both peripheral and intra-graft regulatory elements are required for adoptive transfer of tolerance when only a long-term tolerant (LTT) kidney is transplanted. Nine highly-inbred swine underwent a tolerance-inducing regimen to prepare LTT kidney grafts which were then transplanted to histocompatible recipients, with or without the peripheral cell populations required for adoptive transfer of tolerance to a naïve kidney. In contrast to our previous studies, tolerance of the LTT kidney transplants alone was achieved without transfer of additional peripheral cells and without strategies to increase the number/potency of regulatory T cells in the donor. This tolerance was systemic, since most subsequent, donor-matched challenge kidney grafts were accepted. These results confirm the presence of a potent tolerance-inducing and/or tolerance-maintaining cell population within LTT renal allografts. They suggest further that additional peripheral tolerance mechanisms, required for adoptive transfer of tolerance to a naïve donor-matched kidney, depend on peripheral cells that, if not transferred with the LTT kidney, require time to develop in the adoptive host.
Collapse
Affiliation(s)
- V Villani
- Transplantation Biology Research Center (TBRC) Laboratories, Center for Transplantation Sciences (CTS), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - K Yamada
- Transplantation Biology Research Center (TBRC) Laboratories, Center for Transplantation Sciences (CTS), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - J R Scalea
- Transplantation Biology Research Center (TBRC) Laboratories, Center for Transplantation Sciences (CTS), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - B C Gillon
- Transplantation Biology Research Center (TBRC) Laboratories, Center for Transplantation Sciences (CTS), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - J S Arn
- Transplantation Biology Research Center (TBRC) Laboratories, Center for Transplantation Sciences (CTS), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - M Sekijima
- Transplantation Biology Research Center (TBRC) Laboratories, Center for Transplantation Sciences (CTS), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - M Tasaki
- Transplantation Biology Research Center (TBRC) Laboratories, Center for Transplantation Sciences (CTS), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - T A Cormack
- Transplantation Biology Research Center (TBRC) Laboratories, Center for Transplantation Sciences (CTS), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - S G Moran
- Transplantation Biology Research Center (TBRC) Laboratories, Center for Transplantation Sciences (CTS), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - R Torabi
- Transplantation Biology Research Center (TBRC) Laboratories, Center for Transplantation Sciences (CTS), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - A Shimizu
- Transplantation Biology Research Center (TBRC) Laboratories, Center for Transplantation Sciences (CTS), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - D H Sachs
- Transplantation Biology Research Center (TBRC) Laboratories, Center for Transplantation Sciences (CTS), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| |
Collapse
|
12
|
Leto Barone AA, Kurtz JM, Albritton A, Mallard CA, Shanmugarajah K, Torabi R, Leonard DA, Randolph MA, Huang CA, Sachs DH, Cetrulo CL. Effects of Transient Donor Chimerism on Rejection of MHC-Mismatched Vascularized Composite Allografts in Swine. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/23723505.2015.1039692] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
13
|
Mahjoubi F, Razazian F, Torabi R. CLINICAL FEATURES OF A CASE WITH 46,XX,del(18)(p11.1p11.3). Genet Couns 2015; 26:369-372. [PMID: 26625672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
|
14
|
Leto Barone AA, Mastroianni M, Farkash EA, Mallard C, Albritton A, Torabi R, Leonard DA, Kurtz JM, Sachs DH, Cetrulo CL. Genetically modified porcine split-thickness skin grafts as an alternative to allograft for provision of temporary wound coverage: preliminary characterization. Burns 2014; 41:565-74. [PMID: 25406888 DOI: 10.1016/j.burns.2014.09.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 08/29/2014] [Accepted: 09/02/2014] [Indexed: 01/28/2023]
Abstract
Temporary coverage of severely burned patients with cadaver allograft skin represents an important component of burn care, but is limited by availability and cost. Porcine skin shares many physical properties with human skin, but is susceptible to hyperacute rejection due to preformed antibodies to α-1,3-galactose (Gal), a carbohydrate on all porcine cells. Our preliminary studies have suggested that skin grafts from α-1,3-galactosyltransferase knock out (GalT-KO) miniature swine might provide temporary wound coverage comparable to allografts, since GalT-KO swine lack this carbohydrate. To further evaluate this possibility, eight non-human primates received primary autologous, allogeneic, GalT-KO, and GalT+xenogeneic skin grafts. Additionally, secondary grafts were placed to assess whether sensitization would affect the rejection time course of identical-type grafts. We demonstrate that both GalT-KO xenografts and allografts provide temporary coverage of partial- and full-thickness wounds for up to 11 days. In contrast, GalT+xenografts displayed hyperacute rejection, with no signs of vascularization and rapid avulsion from wounds. Furthermore, secondary GalT-KO transplants failed to vascularize, demonstrating that primary graft rejection sensitizes the recipient. We conclude that GalT-KO xenografts may provide temporary coverage of wounds for a duration equivalent to allografts, and thus, could serve as a readily available alternative treatment of severe burns.
Collapse
Affiliation(s)
- Angelo A Leto Barone
- Transplant Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States; Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Melissa Mastroianni
- Transplant Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States; Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Evan A Farkash
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Christopher Mallard
- Transplant Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Alexander Albritton
- Transplant Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Radbeh Torabi
- Transplant Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States; Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - David A Leonard
- Transplant Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States; Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Josef M Kurtz
- Transplant Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States; Department of Biology, Emmanuel College, Boston, MA, United States
| | - David H Sachs
- Transplant Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Curtis L Cetrulo
- Transplant Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States; Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
| |
Collapse
|
15
|
Scalea JR, Torabi R, Tena A, Tasaki M, Gillon BC, Moran S, Cormack T, Villani V, Shimizu A, Sachs DH, Yamada K. The rejuvenating effects of leuprolide acetate on the aged baboon's thymus. Transpl Immunol 2014; 31:134-9. [PMID: 25240733 DOI: 10.1016/j.trim.2014.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 09/02/2014] [Accepted: 09/05/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND We have previously demonstrated that the juvenile thymus plays an essential role in tolerance induced by both renal transplantation and a short course of calcineurin inhibitors. Aged thymi have a decreased ability to induce tolerance. Luteinizing hormone-releasing hormone (LHRH) is known to pharmacologically rejuvenate the thymus in rodents. In order to develop a clinically applicable regimen of transplantation tolerance in adults, we sought to determine if thymic rejuvenation would occur with LHRH agonism in non-human primates. METHODS AND RESULTS Thymic rejuvenation was evaluated by magnetic resonance imaging (MRI), histology, as well as in-vitro cellular and molecular tests. Four aged male hamadryas baboons underwent subcutaneous injection of a 3-month depot of Lupron (11.25mg; LI) and were followed for 3 months. Thymi increased volumetrically by MRI. After LI, thymic cellularity markedly increased within the cortical and medullary thymus. Additionally, a significant increase in the CD4(+)/CD45RA(hi+) population in the peripheral blood occurred for 50 days after LI, and flow cytometry of thymic tissue revealed a large increase in the percentage of CD4(+)/CD8(+) cells. TREC assay corroborated enhancement in thymic function. CONCLUSION These data indicate that LI is associated with thymic rejuvenation in baboons, and further confirm that extrinsic factors play an important role in thymic rejuvenation in a non-human primate model.
Collapse
Affiliation(s)
- Joseph R Scalea
- Transplantation Biology Research Center, Massachusetts General Hospital, Boston, MA 02129, United States; Harvard Medical School, Boston, MA 02129, United States
| | - Radbeh Torabi
- Transplantation Biology Research Center, Massachusetts General Hospital, Boston, MA 02129, United States; Harvard Medical School, Boston, MA 02129, United States
| | - Aseda Tena
- Transplantation Biology Research Center, Massachusetts General Hospital, Boston, MA 02129, United States; Harvard Medical School, Boston, MA 02129, United States
| | - Masayuki Tasaki
- Transplantation Biology Research Center, Massachusetts General Hospital, Boston, MA 02129, United States; Harvard Medical School, Boston, MA 02129, United States
| | - Bradford C Gillon
- Transplantation Biology Research Center, Massachusetts General Hospital, Boston, MA 02129, United States; Harvard Medical School, Boston, MA 02129, United States
| | - Shannon Moran
- Transplantation Biology Research Center, Massachusetts General Hospital, Boston, MA 02129, United States; Harvard Medical School, Boston, MA 02129, United States
| | - Taylor Cormack
- Transplantation Biology Research Center, Massachusetts General Hospital, Boston, MA 02129, United States; Harvard Medical School, Boston, MA 02129, United States
| | - Vincenzo Villani
- Transplantation Biology Research Center, Massachusetts General Hospital, Boston, MA 02129, United States; Harvard Medical School, Boston, MA 02129, United States
| | - Akira Shimizu
- Transplantation Biology Research Center, Massachusetts General Hospital, Boston, MA 02129, United States; Harvard Medical School, Boston, MA 02129, United States
| | - David H Sachs
- Transplantation Biology Research Center, Massachusetts General Hospital, Boston, MA 02129, United States; Harvard Medical School, Boston, MA 02129, United States
| | - Kazuhiko Yamada
- Transplantation Biology Research Center, Massachusetts General Hospital, Boston, MA 02129, United States; Harvard Medical School, Boston, MA 02129, United States
| |
Collapse
|
16
|
Scalea JR, Okumi M, Villani V, Shimizu A, Nishimura H, Gillon BC, Torabi R, Cormack T, Moran S, LeGuern C, Sachs DH, Yamada K. Abrogation of renal allograft tolerance in MGH miniature swine: the role of intra-graft and peripheral factors in long-term tolerance. Am J Transplant 2014; 14:2001-10. [PMID: 25100613 PMCID: PMC4194165 DOI: 10.1111/ajt.12816] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 04/22/2014] [Accepted: 05/01/2014] [Indexed: 01/25/2023]
Abstract
We have previously demonstrated that long-term tolerance (LTT) of an MHC class-I mismatched renal allograft can be achieved with a short course of cyclosporine. In order to examine regulatory mechanisms underlying tolerance in this model, we assessed the contributions of factors within the graft and in the peripheral blood for their relative roles in the maintenance of stable tolerance. Twelve LTT recipients of MHC class-I mismatched primary kidneys were subjected to a treatment consisting of donor-specific transfusion followed by leukapheresis, in order to remove peripheral leukocytes, including putative regulatory T cells (Tregs). Following treatment, 2 controls were followed clinically and 10 animals had the primary graft removed and received a second, donor-MHC-matched kidney. Neither control animal showed evidence of rejection, while 8 of 10 retransplanted animals developed either rejection crisis or full rejection of the second transplant. In vitro assays confirmed that the removed leukocytes were suppressive and that CD4(+) Foxp3(+) Treg reconstitution in blood and kidney grafts correlated with return to normal renal function in animals experiencing transient rejection crises. These data indicate that components of accepted kidney grafts as well as peripheral regulatory components both contribute to the tolerogenic environment required for tolerance of MHC class-I mismatched allotransplants.
Collapse
|
17
|
Tasaki M, Shimizu A, Hanekamp I, Torabi R, Villani V, Yamada K. Rituximab treatment prevents the early development of proteinuria following pig-to-baboon xeno-kidney transplantation. J Am Soc Nephrol 2014; 25:737-44. [PMID: 24459229 DOI: 10.1681/asn.2013040363] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
We previously reported life-supporting α1,3-galactosyltransferase knockout (GalTKO) thymokidney xenograft survival of >2 months in baboons. However, despite otherwise normal renal function, recipients developed proteinuria with morphologic changes (podocyte effacement), a condition that presents a major obstacle to long-term studies in this model. A recent clinical study showed that rituximab therapy after allogeneic transplant prevented proteinuria possibly associated with loss of sphingomyelin phosphodiesterase acid-like 3b (SMPDL-3b). Here, we demonstrate that rituximab prevents the disruption of pig podocytes in an SMPDL-3b-dependent manner in vitro and the early development of proteinuria after xenogeneic kidney transplantation in baboons. Immunofluorescence showed SMPDL-3b expression in pig glomerular epithelium; immunoprecipitation demonstrated rituximab binding to SMPDL-3b in glomeruli. Culture of isolated pig podocytes with naive baboon sera, which has preformed antipig natural antibodies, reduced SMPDL-3b expression, disrupted podocyte morphology, and decreased podocyte proliferation, whereas pretreatment with rituximab prevented these effects. Six baboons received rituximab before transplantation to deplete B cells and again in the peri-transplant period; 18 baboons treated only before transplantation served as historical controls. The onset of post-transplant proteinuria was significantly delayed in a B cell-independent manner in the animals that received peri-transplant rituximab treatment. Although further optimization of this protocol is required, these data provide intriguing clues to the mechanisms of post-transplant proteinuria in xenogeneic kidney transplantation and a potential strategy for its prevention.
Collapse
Affiliation(s)
- Masayuki Tasaki
- Transplantation Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | | | | | | |
Collapse
|
18
|
Mahjoubi F, Razazian F, Torabi R. A case with 46,XX,del(11)(q23.2) karyotype and poor vision with literature review. Genet Couns 2014; 25:277-287. [PMID: 25365850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Here we describe clinical and cytogenetic data on a female child whom had been referred to our laboratory suspected to have Turner syndrome since she had webbed neck. Cytogenetic analysis revealed that she had deletion at 11q23.2 to 11q terminal so her karyotype was ascertained as 46,XX,del(11)(q23.2). Her parents had normal karyotypes. In addition to many clinical features of del(11q ) syndrome the case had poor vision which is not common for this syndrome. Clinical features of this case and a few published cases will be reviewed briefly.
Collapse
|
19
|
Mahjoubi F, Rahnama M, Torabi R. Partial trisomy 13q in a blind and deaf baby boy. Genet Couns 2013; 24:93-94. [PMID: 23610871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
|
20
|
Leto Barone AA, Leonard DA, Torabi R, Mallard C, Glor T, Scalea JR, Randolph MA, Sachs DH, Cetrulo CL. The gracilis myocutaneous free flap in swine: an advantageous preclinical model for vascularized composite allograft transplantation research. Microsurgery 2012; 33:51-5. [PMID: 22707437 DOI: 10.1002/micr.21997] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 04/13/2012] [Indexed: 11/09/2022]
Abstract
Vascularized composite allotransplantation (VCA) has become a clinical reality, prompting research aimed at improving the risk-benefit ratio of such transplants. Here, we report our experience with a gracilis myocutaneous free flap in Massachusetts General Hospital miniature swine as a preclinical VCA model. Fourteen animals underwent free transfer of a gracilis myocutaneous flap comprised of the gracilis muscle and overlying skin, each tissue supplied by independent branches of the femoral vessels. End-to-end anastomoses were performed to the common carotid artery and internal jugular vein, or to the femoral vessels of the recipients. Thirteen of fourteen flaps were successful. A single flap was lost due to compromise of venous outflow. This model allows transplantation of a substantial volume of skin, subcutaneous tissue, and muscle. The anatomy is reliable and easily identified and harvest incurs minimal donor morbidity. We find this gracilis myocutaneous flap an excellent pre-clinical model for the study of vascularized composite allotransplantation.
Collapse
Affiliation(s)
- Angelo A Leto Barone
- Transplantation Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Chakraborty P, Chakravarty BN, Kabir SN, Goswami SK, Yenicesu O, Gulerman C, Ozyer S, Cakar E, Sarikaya E, Mollamahmutoglu L, Daponte A, Deligeoroglou E, Pournaras S, Tsezou A, Garas A, Skentou H, Messinis IE, Chakravarty BN, Ganesh A, Chowdhuri K, Shyam T, Ghosh S, Chattopadhyay R, Banerjee P, Pasricha P, Chakravarty BN, Chaudhury K, Kuji N, Kitamura S, Mochimaru Y, Yamada M, Hamatani T, Kawakami M, Hirayama A, Sugimoto M, Soga T, Tomita M, Yoshimura Y, Tabibi A, Tarahhomi M, Roghayee M, Bayatsarmadi H, Zolghadri J, Younesi M, Bug S, Solfrank B, Pricelius J, Craig A, Botcherby M, Stecher M, Bingemann S, Becker B, Nevinny-Stickel-Hinzpeter C, Kuroda K, Venkatakrishnan R, Salker MS, Quenby S, Brosens JJ, Rahmati M, Petitbarat M, Dubanchet S, Chaouat G, Ledee N, van den Berg M, van Maarle MC, van Wely M, Goddijn M, Telli P, Erdem M, Bozkurt N, Oktem M, Yirmibes K. M, Karabacak O, Erdem A, Kim CH, Lee KH, Kim SH, Chae HD, Kang BM, Jung KS, Johnson S, Godbert S, Perry P, Parkinson P, Vink-Ranti CQJ, Van Os HC, Tucker KE, Kapiteijn K, Heijdra PMA, Jansen CAM, Matsumoto H, Sato Y, Suginami K, Horie A, Fujiwara H, Konishi I, Yamada S, Kataoka N, Ogata S, Mukai M, Inai K, Hashimoto H, Tokura Y, Mizusawa Y, Matsumoto Y, Okamoto E, Kokeguchi S, Shiotani M, Mariee N, Li TC, Laird SM, Refaat B, Simpson H, Ledger W, Confino E, Williams A, Grabar V, Feskov A, Feskova I, Blazhko E, Horie A, Fujiwara H, Sato Y, Suginami K, Matsumoto H, Maruyama M, Konishi I, Hattori A, Chi HB, Qiao J, Wang HN, Hong TP, Gao HW, Abdelnaby El Gelany SAA, Nady Abdelmegeed A, Markoff A, Rogenhofer N, Engels L, Bogdanova N, Tuettelmann F, Thaler C, Seckin B, Sarikaya E, Sargin Oruc A, Celen S, Cicek N, Zarei S, Torabi R, Zeraati H, Zarnani AH, Akhondi MM, Hadavi R, Savadi-Shiraz E, Jeddi-Tehrani M, Sugiura-Ogasawara M, Ozaki Y, Katano K, Suzumori N, Kitaori T, Mizutani E, Al-Gubory KH, Bolifraud P, Angele K, Grange S, Puillet-Anselme L, Garrel C. EARLY PREGNANCY. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
22
|
Komenaka IK, Torabi R, Hsu C, Bouton ME. Predictors of margin status after breast-conserving operations for breast cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e11078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
23
|
Torabi R, Shams E, Zolfigol MA, Afshar S. Anodic Stripping Voltammetric Determination of Lead(II) with a 2‐Aminopyridinated‐Silica Modified Carbon Paste Electrode. ANAL LETT 2006. [DOI: 10.1080/00032710600755371] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|