Most Comprehensive Full Face Transplant video from University of Maryland

Most Comprehensive Full Face Transplant video from University of Maryland

Read more...

Stem Cell Transplantation Ppts

Stem Cell Transplantation Ppts

ABO Incompatible Stem Cell Transplantation
by Armin Ghobadi,  MD, Washington University  in St Louis
http://hematology.wustl.edu/conferences/presentations/Ghobadi20110304.ppt

Non-myeloablative Allogeneic Stem Cell Transplantation
http://hematology.wustl.edu/conferences/presentations/Vij20030905.ppt

Spermatogonial stem cells 
by Jayanti  Tokas, Rubina Begum, Shalini Jain and Hariom Yadav
http://www.pitt.edu/~super4/36011-37001/36391.ppt

Adult  Stem Cells as Regenerative  Medicine 
by Kanika  Varma1, Parul Rewari, Jayanti Tokas, Rubina Begum, Shalini Jain and Hariom Yadav
http://www.pitt.edu/~super4/36011-37001/36591.ppt

Updates in  Hematopoietic Stem Cell Transplantation
by: Richard  T. Maziarz, MD
http://www.ohsu.edu/health/_resources/uploads/knight_cme/Maziarz_ASH2011Updates%20in%20Hematopoietic%20Stem%20Cell%20Transplant.ppt

Bone  marrow transplantation in sickle cell disease 
by John  F. Tisdale, MD
http://www.sicklecell.howard.edu/documents/ScottHoward2009.ppt

Embryonic stem  cell transplantation
by Reshma Donthamsetty
https://netfiles.uiuc.edu/tespina2/course_work/v-fa07/mcb253/presentation/MCB253-Presentation.ppt

T  Regulatory Cells and Stem Cell Transplantation
by Armin Ghobadi,  MD, Washington University  in St Louis
http://hematology.wustl.edu/conferences/presentations/Ghobadi20100305.ppt

Dopamine  neurons derived from  embryonic stem cells  function in an animal  model of Parkinson’s  disease
http://fire.biol.wwu.edu/young/dopa.ppt

Stem Cells and Tissue Engineering
http://imaging.bioen.illinois.edu/yingxiao_wang/classes/BioE598_2008/Stem%20Cells%20and%20Tissue%20Engineering.ppt

Autologous  Stem Cell Transplantation for the Treatment  of Follicular NHL
by Amanda  F. Cashen, M.D.
http://hematology.wustl.edu/conferences/presentations/Cashen20071012.ppt

Umbilical  Cord Stem Cells
by Jayanti  Tokas, Puneet Tokas, Rubina Begum, Shailini Jain and Hariom Yadav
http://www.pitt.edu/~super4/37011-38001/37341.ppt

Read more...

The BioArtificial Liver

The BioArtificial Liver
By:Susana Candia
Jahi Gist
Hashim Mehter
Priya Sateesha
Roxanne Wadia

Biology of the Liver
Left lobe
Right lobe
Kidneys
Gallbladder
Falciform Ligament
Inferior Vena Cava
Abdominal Aorta

What does the Liver do?
Among the most important liver functions are:
* Removing and excreting body wastes and hormones as well as drugs and other foreign substances
* Synthesizing plasma proteins, including those necessary for blood clotting
* Producing immune factors and removing bacteria, helping the body fight infection

Other important but less immediate functions include:
* Producing bile to aid in digestion
* Excretion of bilirubin
* Storing certain vitamins, minerals, and sugars
* Processing nutrients absorbed from digestive tract

Why would someone need a BioArtificial Liver?
Liver Transplantation Now
* Patients are in waiting list ranked according to severity of disease and life expectancy among other variables.
* Can be from a cadaveric donor or from a live donor.
* Involves heavy use of immunosuppressants during and after surgery.
* The risk of rejecion is always present.

What does a BioArtificial Liver need to do?
* Cellular components must be purified and every component in it must be clearly identified.
* The cellular preparation must be clearly shown to not transmit any infectious diseases of any kind.
* The cellular component must stay viable and active
* The synthetic component must be fully biocompatible, integrity of the material and parts must also be demonstrated
* The device must be able to introduce the therapeutic and regulatory molecules that a healthy liver provides, and it must also filter substances from the blood the way that the normal liver does.
* Must be immunocompatible.
* Blood must perfuse properly through system

Enabling Technologies
* Hemodialysis/hemofiltration hollow fibers- controlled interaction of cells and circulating fluids
* Maintenance and creation of a cell line
* Immortalizing cells
* Encapsulation-envelopment of hepatocytes in a polymeric matrix.
* Microcarriers- polymeric particles containing cells

Works in Progress: Points to Consider
Bioreactor designs/Membrane configurations
Cellular vs. Acellular system
Porcine vs. Human hepatocytes
Point in Development
Liver Dialysis Unit
* FDA approved in 1994
* Plate dialyzer with blood on one side, dialysate is a mixture of sorbents, activated charcoal being the essential component.
* For a substance to be removed, must be dialyzable and able to bind to charcoal.
* “Bridge to recovery” for treat acute hepatic encephalopathy and overdoses of drugs
* Post-market trials have shown the LDU to be effective in improving physiological and neurological status.

MARS®
* Limited to investigational use in US.
* Hollow fiber membrane hemodialyzer.
* Blood on one side, human albumin on other.
* Albumin recycled through circuit containing another dialyzer and carbon and anion exchanger adsorption columns.
* Removes both water-soluble and protein bound substances
* Keep valuable proteins
* Trial have found it safe and associated with clinical improvement

ELAD®
* Uses cultured human hepatocytes express normal liver-specific metabolic pathways. hollow fiber dialyzer.
* Dialyzer cartridge connected to continuous hemodialysis machines, like those used for renal therapy.
* Blood separated into a cellular component and a plasma component.
* Plasma through dialyzer, hepatocytes on outside of hollow fibers.
* Currently involved in a phase 2 clinical trial to evaluate the safety and efficiency.
BLSS
* Extracorporeal hemofiltration hollow fiber membrane bioreactor with 100 grams of primary porcine hepatocytes
* Whole blood is filtered
* Contains blood pump, heat exchanger, oxygenator to control oxygenation and pH, and hollow fiber bioreactor
* Currently undergoing phase I/II clinical trials
* Patients show some improvement

HepAssist 2000 System
* Four components: a hollow fiber bioreactor containing porcine hepatocytes, two charcoal filters, a membrane oxygenator, and a pump.
* Must be used in conjunction with a commercially available plasma separation machine
* Blood separated; plasma processed through charcoal filters to remove particulates, bacteria, then enters bioreactor
* Hepatocytes must be heated and oxygenated
* FDA mandated full Phase III trials
LIVERx2000
* Hollow fiber cartridge
* Primary porcine hepatocytes suspended in a cold collagen solution and injected inside fibers
* Blood circulates outside the hollow fibers
* Designed to treat both acute and chronic liver failure
* Phase I/II clinical trials are underway to test the safety of efficacy of this device
* Anyone treated with the LIVERx2000 will be monitored for PERV
MELS
* Parallel plate design
* Human hepatocytes attached to semipermeable membranes on parallel plate
* Plasma separator, then plasma passes into the bioreactor
* In the bioreactor, the plasma flows over the semipermeable membrane where the hepatocytes are adhered.
* Current trials in Europe show promise

Demographics and Cost
* Market for liver support is estimated to be substantial: $700 million in the United States and $1.4 billion worldwide.
* Liver transplants have more than doubled in the past ten years, with the transplant waitlist growing in a similar fashion

Current and Future Challenges
* GOAL: To produce a fully implantable bioartificial liver.

Problems:
Cell viability
Fibrosis around implanted capsules
Proteins greater than pore size cannot be released

To achieve density of cells needed to replace liver, an estimated 1000m of hollow fibers would be needed

The BioArtificial Liver.ppt

Read more...

Fetal Tissue Transplants

Fetal Tissue Transplants
By:Michelle Gomez

Words You May Need To Know
* Definitions-
+ Fetal tissue transplants
+ Parkinson’s Disease (PD)
+ Huntington’s Disease (HD)
+ Dopamine (DA)

Development of the Fetus
First Month (conception to 6 weeks)
Second Month (7-10 weeks)
Third Month (11-14 weeks)
Fourth Month (beginning of second trimester)
Fifth month (19- 22 weeks)
Seventh Month (beginning of third trimester 27-30 weeks)
Sixth Months (23-26 weeks)
Eighth month (31-34 weeks)
Ninth month (35 weeks to delivery)

History
Fun Facts
* The History of Fetal Tissue Transplants

Parkinson’s Disease
* Parkinson’s Disease
Huntington’s Disease
What does it treat?
* Parkinson’s Disease
* Huntington’s Disease
* Retina Repair
* Future:
o Epilepsy
Biological Concepts

The Process: Cell Therapy Development in PD
* Parkinson’s Disease-
o Graft Efficiency has to be increased and variability reduced
+ Patient selection
+ Graft Placement
+ Composition and Preparation of the Graft Tissue
+ Developing immunological mechanisms

2 Years After Transplantation
The Process: Cell Therapy Development in PD
Evidence and Experiments
Society for Neuroscience-
* October 24, 1999- a study was presented at the Society for Neuroscience’s annual meeting, showing that the fetal cells can produce a critical neurotransmitter, reducing patient's tremors and paralysis. (Helmuth, 886)
Retina Repair-
o The procedure that Elisabeth Bryant, from the previous slide, underwent was retinal repair. Robert Aramant at the University of Louisville in Kentucky developed the transplant technique with Magdalene Seiler. (image on next slide)

Fetal tissue inserted here
Frontier Issues
Cost and Finances
* Surgery Alone- $43,500
* Pre-Operative Costs- $4,000
* Total- Approx.- $50,000
Controversy
Pro-life vs. Fetal Tissue Transplant Supporters
Ethical Issues
* It takes six fetuses to provide enough material to treat one Parkinson’s patient.
* Who is donating?
* Cell supply is limited.
* Better areas for transplantation?
Politics
Bibliography/ References
* Barinaga, M. “Fetal neuron grafts pave the was for stem cell therapies.” Science. 5 Feb 2000 287:5457 p.1421-2. General Science Index. COSLibrary, Visalia, CA. 19 Sept 2005
* Björklund, Anders and Olle Lindvall. “Cell Therapy in Parkinson’s Disease.” NeuroRx. Oct 2004. the American Society for Experimental Therapeutics, Inc. Lund, Sweden. 13 Oct 2005. http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=534947
* Cimons, Marlene. “Bush is a threat to US stem-cell research”. Nature Medicine. 2001. COS Library, Visalia, CA. 24 Oct. 2005. http://www.nature.com/nm/journal/v7/n3/full/nm0301_263a.html
* “Dopamine.” Columbia Encyclopedia, 6th Edition. 2005. 19 Sept 2005 http://www.encyclopedia.com
* Dunnett, Stephen B. and Anne E Rosser. “Cell Therapy in HD.” NeuroRx. Oct 2004. American Society for Experimental NeuroTherapeutics, Inc. Wales, UK. 13 Oct 2005. http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=534947

Bibliography/ References
* Fackelmann, K.A. “Study sizes up fetal cells for transplant.” Science News. 7 Jan 1995. 149:1 p.6. Academic Abstracts. COS Library, Visalia, CA. 15 Sept 2005
* "Fetal Tissue Implant." Columbia Encyclopedia, 6th Edition. 2005. 19 Sept. 2005 http://www.encyclopedia.com
* Hawaleshka, Dan. “The debate over fetal tissue. (cover-story).” Maclean’s. 1996 109:4 p.48. Academic Abstracts. COS Library, Visalia, CA. 15 Sept 2005
* Helmuth, L. “Fetal cells Help Parkinson’s patients.” Science. 29 Oct 1999. 286:5441 p.886-7. General Science Index. COS Library, Visalia, CA. 19 Sept 2005
* Hopkins, John. About Huntington's Disease and Related Disorders. 2002. John Hopkins Medicine. 24 Oct 2005. http://www.hopkinsmedicine.org/bhdc/about/
* “Huntington’s Disease.” Columbia Encyclopedia, 6th Edition. 2005. 19 Sept. 2005 http://www.encyclopedia.com
* “Introduction.” Parkinson’s Disease: Hope Through Research. Sept 2003. National Institute of Neurological Disorders and Stroke. 22 Sept 2005. http://www.ninds.nih.gov/disorders/parkinsons_disease/detail_parkinsons_disease.htm
* Rae, Scott B. “The Ethics of Fetal Tissue Transplantation.” CHRISTIAN RESEARCH INSTITUTE. 2005. Talbot School of Theology. 24 Oct 2005. http://www.equip.org/free/DE192.htm

Images-
* “Development of the Fetus.” Illustration. 1998. Development of the Baby. Parents Magazine. 24 Oct 2005 http://www.csulb.edu/divisions/students2/departments/Health_Resource_Center/pregnancy.htm
* Levivier, Marc. “PET scan in patient with PD after transplantation of human fetal neurons (before and after)”. Illustration. 7 July 2003. Neural Transplants in Parkinson’s Disease: do they work?. Lancet Neurology. 6 Oct 2005 http://www.thelancet.com/journals/laneur/article/PIIS1474442203004423/fulltext.
* Rowe, Duncan. “Retina Repair.” Illustration. 31 Jan 2003. Fetal Tissue Transplants Improve Adult Sight. New Scientist Magazine. 6 Oct 2005. http://www.newscientist.com/article.ns?id=dn3319

Fetal Tissue Transplants.ppt

Read more...

Future of transplantation - video

Transplantation: The Cerberus of the 21st Century

Dr. Nancy Ascher, chair of the UCSF Department of Surgery, has devoted her career to organ transplants and transplant research. Explore how new technology may affect the future of transplantation. App. one hour video.

Read more...

Liver Transplant for HIV Positive - video

Liver Transplant: HIV; Progress in Immunosupression

Dr. Peter Stock of UCSF presents an update on liver transplants for HIV positive patients a practice that has been considered experimental. In the second segment, Dr. Sandy Feng presents and update on the progress in immunosupression for liver transplantation. App. one hour video

Read more...

Donation After Cardiac Death

Donation After Cardiac Death
Presentation by: Barb Nelson-Agnew, Hospital Liaison
Andrea Tighe, RN, CPTC
Organ & tissue donation & transplantation.

Federally designated organ procurement organization

Transplantation Works…
The Growing Need For Transplantable Organs
HHS - Organ Donation & Transplantation Breakthrough Collaboratives
Conversion/Donation Rates
HRSA Medal of Honor
LifeSource Donation Activity
Organs transplanted from Local Donors
Donation after Cardiac Death Donor Profile
Devastating Brain Injury / Ventilator Dependent
BRAIN DEATH EXAMINATION
Surgical recovery

Patient evaluated as potential DCD candidate
Patient Evaluation for DCD Suitability
Respiratory Drive Assessment
Operating Room Set-up and Instrumentation
Withdrawal of Treatment / Roles
Organ Recovery
Recovery Team
Operating Room Staff
Donation Coordinators
Case Review #1
Case Review #2
Case Review # 3

Donation After Cardiac Death.ppt

Read more...

Recent Developments In Allogeneic Hematopoietic Cell Transplantation

Recent Developments In Allogeneic Hematopoietic Cell Transplantation
Presentation by:Steven M Devine M.D.
Director, Blood and Marrow Transplant Program


Annual Numbers of Blood and Marrow Transplantations, 1970-2006

HEMATOPOIETIC STEM CELL TRANSPLANTS AT OSU BY CALENDAR YEAR
Indications for Hematopoietic Stem Cell Transplantation in North America
Allogeneic HSC Transplantation

Definitions

* Allogeneic
o Refers to the use of bone marrow, mobilized blood, or cord blood from a genetically different donor (family member, unrelated volunteer, banked cord blood)
* Autologous
o Refers to the use of the patients own bone marrow or mobilized blood
Allogeneic Versus Autologous Stem Cell
Benefits of Allogeneic Transplantation
Drawbacks of Allogeneic Transplantation
Who are Allogeneic Stem Cell Transplant Candidates?
Complications of Allogeneic Transplantation
Causes of Death after Transplantations Done in 2001-2006
Age of HSCT recipients
Trends in Allogeneic Transplantation
Current Challenges

* Reducing Regimen Related Toxicity
* Reducing Risk of GVHD and Rejection
* Enhancing Immune Reconstitution
* Expanding Options for Patients Without Matched Sibling Donors
* Refining Criteria for Transplantation

BMT vs Conventional Tx for AML with poor risk cytogenetics

GVL in Leukemia
Considerations for allograft candidates
Stem cell sources
Summary of randomized trials comparing graft source
Cord Blood Transplantations
Reduced Intensity Stem Cell Transplantation
Allogeneic Transplantations using Reduced Intensity Conditioning by Donor Type Registered
High Intensity versus Low
GVL Effect after non-myeloablative transplantation
Transplantation Considerations in patients with AML
Balancing Regimen efficacy with toxicity
Balancing efficacy and toxicity
Reduced Intensity Allogeneic Transplantation
Considerations for allograft candidates
Acute GVHD Prophylaxis
What are the benefits of T-cell depletion?
What are the drawbacks of T-cell depletion?
Transplantation Considerations in patients with AML
Graft versus Tumor Effects
Current Challenges

* Enhancing Immune Reconstitution
* Reducing Risk of GVHD and Rejection
* Reducing Regimen Related Toxicity
* Expanding Options for Patients Without Matched Sibling Donors
* Refining Criteria for Transplantation

Alternative Donor Allograft Sources
Refining Criteria for Transplantation
Clinical Research Activity in BMT

Recent Developments In Allogeneic Hematopoietic Cell Transplantation.ppt

Read more...

Umbilical Cord Blood transplantation in acute leukemias

Umbilical Cord Blood transplantation in acute leukemias
Presentation by: Pablo Ramirez, M.D.
DiPersio Lab
Grand Rounds, March 2009

Topics covered are:
Clinical case
High risk cytogenetics: matched donor vs chemo
Impact of HLA mismatch on OS
Unrelated cord donor
Cord blood-derived stem cell source
First human infusion
Collection, processing and storage of UCB
Biology UCBT:
more questions than answers
Transplantation with UCB: children
Outcomes unrelated UCB vs BM: children with acute leukemia CIBMTR-USA
Probability of LFS
Transplantation with UCB: adults
Comparison between UCBT-uBMT:
European database analysis
Neutrophil recovery
Comparison between UCBT-uBMT American database analysis
Neutrophil recovery
Platelet recovery
Comparison of uBM, PB and UCB:
Conclusions from these studies and other databases
Approaches to improve rates and kinetics of engraftment
Transplantation of 2 partially HLA-matched UCB units (U of MN):
Myeloablative
Demographics
Neutrophil engraftment
Always one cord predominated: Potential contributors
GVHD
Hematologic recovery
Netrophils
Platelets
Chimerism
Higher incidence of grade II-IV aGVHD
Risk factors for TRM
Conclusions
Unresolved questions in UCBT


Umbilical Cord Blood transplantation in acute leukemias.ppt

Read more...

Pregnancy & Renal Transplantation

Pregnancy & Renal Transplantation
Presentation by:Alicia Notkin

Case Study:

A 30 year old female w/ ESRD, s/p LDRT from her mother 3 years prior, comes to clinic for f/u. She is fully compliant with her regimen of prednisone 5mg daily, tacro 3mg q12h, and MMF 1g q12h. Her renal function has been stable, with a Cr ~ 1.2 mg/dl and a negative UA. She wishes to become pregnant. How should she be advised & managed?


Outline

* Pregnancy in patients with chronic kidney disease
* Pregnancy in patients on dialysis
* Pregnancy in renal transplant patients
* Transplantation medications in pregnancy
* Recommendations
* Other issues: graft dysfunction in pregnancy, donor & pregnancy, male fertility

Pregnancy in patients with chronic kidney disease: patient considerations
Pregnancy in patients with chronic kidney disease: other patient considerations
Pregnancy in patients with chronic kidney disease: fetal outcomes
Pregnancy in patients on dialysis
Pregnancy in renal transplant patients: outcomes
Transplant medications: steroids
Transplant medications: cyclosporine
Transplant medications: tacrolimus
Transplant medications: sirolimus
Transplant medications: mycophenolate mofetil
Transplant medications: azathioprine
AST Consensus Conference on Reproductive Issues & Transplantation 2005
Recommendations: key points
Graft dysfunction in pregnancy
OK to biopsy??
Issues for donor & male recipient

References

Pregnancy & Renal Transplantation.ppt

Read more...