surgical-perfusion-isolation-porcine-pancreas-for-islet

Surgical Perfusion and Isolation of the Porcine Pancreas for Islet Isolation

Pancreatic islet transplantation is an emerging treatment for type I diabetes; however, it is limited by donor matching and availability. Porcine islet ...

Washington University School of Medicine

Geographic and temporal patterns of growth in the utilization of donation after circulatory death donors for lung transplantation in the United States.

Transplantation continues to be the only treatment option for end-stage organ failure when other interventions have failed. Although short-term outcomes have improved due to advances in perioperative care, long-term outcomes continue to be adversely affected by chronic rejection. Little is known about the role microbiota play in modulating alloimmune responses and potentially contributing to graft failure. Initial data have identified a correlation between specific changes of the recipient and/or donor microbiota and transplant outcomes. In this review, we will focus on recent findings concerning the complex interplay between microbiota and the innate immune system after heart and lung transplantation.

Microbiota in heart and lung transplantation: implications for innate-adaptive immune interface.

Since the initial report of long-term survival after lung transplantation (LT) in 1983, there has been remarkable progress in the field and LT is now the gold-standard therapy for patients with end-stage lung disease. It confers a significant survival advantage and improves the quality of life in patients who often have few other treatment options. However, LT remains a complex undertaking and establishing and maintaining an LT program is resource intensive with multiple potential barriers. In this article, we focus on disparities in LT and the potential solutions to improving access to LT.

Disparities in Lung Transplantation.

A primer for students regarding advanced topics in cardiothoracic surgery, part 1: Primer 6 of 7.

Endovascular surgical procedures require the navigation of catheters and wires through the vasculature to reach distal target sites. Quantitative frameworks for device selection hold the potential to improve the tracking of endovascular devices through vascular anatomy by personalizing the device flexural rigidity to an individual's anatomy. However, data are lacking to facilitate this technology, in part because typical endovascular devices have intricate spatial variations in mechanical properties that are challenging and tedious to quantify repeatably. We therefore developed a three-point bend test methodology using a custom rig and applied it to measure lengthwise flexural rigidity profiles of endovascular devices that are used to target the cerebral vasculature. The methodology demonstrated high repeatability and was able to characterize transition zones. We applied the methodology to generate the first comprehensive, quantitative library of device flexural rigidities, spanning guidewires, intermediate guides, and long sheaths. We observed that these three classes of device have properties that fall into distinct ranges. Additional plots examining relationships between flexural rigidity, device diameter, and length revealed application-specific trends in flexural properties. This methodology and the data allow for standardized characterization and comparisons to aid device selection, and have the potential to both enhance surgical planning and inform future innovation.

Quantification of the flexural rigidity of endovascular surgical devices using three-point bending tests.

The study establishes a rapid, technically straightforward, and reproducible porcine large animal model for acute iliocaval deep vein thrombosis (DVT). The procedure can be performed with basic endovascular skillsets. With its procedural efficiency and consistency, the platform is promising for comparative in vivo testing of venous thrombectomy devices in a living host, and for future verification and validation studies to determine efficacy of novel thrombectomy devices relative to predicates.

In Vivo Porcine Model of Acute Iliocaval Deep Vein Thrombosis.

Open decannulation from femoral venoarterial extracorporeal membrane oxygenation (VA-ECMO) carries high risk of morbidity, including groin wound infection. This study evaluated the impact of percutaneous decannulation on rates of groin wound infection in patients decannulated from femoral VA-ECMO.

Percutaneous decannulation reduces procedure length and rates of groin wound infection in patients on venoarterial extracorporeal membrane oxygenation.

Article	Year
Geographic and temporal patterns of growth in the utilization of donation after circulatory death donors for lung transplantation in the United States. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation\| PubMed ID: 32921583	2020
Microbiota in heart and lung transplantation: implications for innate-adaptive immune interface. Current opinion in organ transplantation\| PubMed ID: 34561360	2021
Disparities in Lung Transplantation. Thoracic surgery clinics\| PubMed ID: 34801195	2022
A primer for students regarding advanced topics in cardiothoracic surgery, part 1: Primer 6 of 7. JTCVS open\| PubMed ID: 37425465	2023
Quantification of the flexural rigidity of endovascular surgical devices using three-point bending tests. Research square\| PubMed ID: 38168215	2023
In Vivo Porcine Model of Acute Iliocaval Deep Vein Thrombosis. Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists\| PubMed ID: 38357736	2024
Percutaneous decannulation reduces procedure length and rates of groin wound infection in patients on venoarterial extracorporeal membrane oxygenation. JTCVS open\| PubMed ID: 38690437	2024

Sophia H. Roberts

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