Primary liver transplantation vs transplant after Kasai portoenterostomy in children with biliary atresia: A retrospective Brazilian single-center cohort.

BACKGROUND: Biliary atresia (BA) is the most common indication for pediatric liver trans plantation, although portoenterostomy is usually performed first. However, due to the high failure rate of portoenterostomy, liver transplantation has been advocated as the primary procedure for patients with BA. It is still unclear if a previous portoenterostomy has a negative impact on liver transplantation outcomes. AIM: To investigate the effect of prior portoenterostomy in infants un dergoing liver transplantation for BA. METHODS: This was a retrospective cohort study of 42 pediatric patients with BA who underwent primary liver transplantation from 2013 to 2023 at a single tertiary center in Brazil. Patients with BA were divided into two groups: Those under going primary liver transplantation without portoenterostomy and those undergoing liver transplantation with prior portoenterostomy. Continuous variables were compared using the Student's t-test or the Kruskal-Wallis test, and categorical variables were compared using the χ2 or Fisher's exact test, as appropriate. Multivariable Cox regression analysis was performed to determine risk factors for portal vein thrombosis. Patient and graft survival analyses were conducted with the Kaplan-Meier product-limit estimator, and patient subgroups were compared using the two-sided log-rank test. RESULTS: Forty-two patients were included in the study (25 [60%] girls), 23 undergoing liver transplantation without prior portoenterostomy, and 19 undergoing liver transplantation with prior portoenterostomy. Patients with prior portoenterostomy were older (12 vs 8 months; P = 0.02) at the time of liver transplantation and had lower Pediatric End-Stage Liver Disease scores (13.2 vs 21.4; P = 0.01). The majority of the patients (35/42, 83%) underwent living-donor liver transplantation. The group of patients without prior portoenterostomy appeared to have a higher incidence of portal vein thrombosis (39 vs 11%), but this result did not reach statistical significance. Prior portoenterostomy was not a protective factor against portal vein thrombosis in the multivariable analysis after adjusting for age at liver transplantation, graft-to-recipient weight ratio, and use of vascular grafts. Finally, the groups did not significantly differ in terms of post-transplant survival. CONCLUSION: In our study, prior portoenterostomy did not significantly affect the outcomes of liver transplantation.

Neovascularized implantable cell homing encapsulation platform with tunable local immunosuppressant delivery for allogeneic cell transplantation.

Cell encapsulation is an attractive transplantation strategy to treat endocrine disorders. Transplanted cells offer a dynamic and stimulus-responsive system that secretes therapeutics based on patient need. Despite significant advancements, a challenge in allogeneic cell encapsulation is maintaining sufficient oxygen and nutrient exchange, while providing protection from the host immune system. To this end, we developed a subcutaneously implantable dual-reservoir encapsulation system integrating in situ prevascularization and local immunosuppressant delivery, termed NICHE. NICHE structure is 3D-printed in biocompatible polyamide 2200 and comprises of independent cell and drug reservoirs separated by a nanoporous membrane for sustained local release of immunosuppressant. Here we present the development and characterization of NICHE, as well as efficacy validation for allogeneic cell transplantation in an immunocompetent rat model. We established biocompatibility and mechanical stability of NICHE. Further, NICHE vascularization was achieved with the aid of mesenchymal stem cells. Our study demonstrated sustained local elution of immunosuppressant (CTLA4Ig) into the cell reservoir protected transcutaneously-transplanted allogeneic Leydig cells from host immune destruction during a 31-day study, and reduced systemic drug exposure by 12-fold. In summary, NICHE is the first encapsulation platform achieving both in situ vascularization and immunosuppressant delivery, presenting a viable strategy for allogeneic cell transplantation.

Using body donor demographics to assist the implementation of donation programs in Brazil.

The use of human material in anatomy education depends upon the generosity of body donors. However, little is known regarding the demographics of body donors in Brazil, where voluntary body donation is a relatively rare phenomenon. Hence, the aim of the present study was to elucidate the demographic profile of applicants to the Body Donation Program (BDP) at the Federal University of Health Sciences of Porto Alegre in Brazil, as well as to assess whether the observed characteristics of body donors are unique to that sample, or if they merely reflect the characteristics of the regional population. Information derived from the specific forms filled out by donors between January 2008 and June 2016 at the time of registration were collected. Data from 416 forms were analyzed. Based on this study, the typical applicant in Brazil is typically a white female (67.4%), over 60 years of age (60.3%), unmarried or single (70.6%), affiliated with a religious group (89.1%), of middle class background (40.4%), who has completed high school and/or holds a university degree (93.8%). The motivation of donors was, in most cases, an altruistic gesture, represented by the desire to help society and science. Elucidating these demographic characteristics of potential donors may help identify the target public to which information regarding body donation campaigns could be directed. Anat Sci Educ 10: 475-486. © 2017 American Association of Anatomists.

Comparison of alpha-tocopherol microparticles produced with different wall materials: pea protein a new interesting alternative.

Alpha-tocopherol is a radical chain breaking antioxidant that can protect the integrity of tissues and play an important role in life process. Microparticles containing alpha-tocopherol were produced by spray drying technique using pea protein (PP), carboxymethylcellulose(CMC) and mixtures of these materials with maltodextrin (PP-M and CMC-M) as wall materials. The microparticles produced were characterised as regards the core retention (high performance liquid chromatography), the morphology (scanning electron microscopy) and size distribution (laser diffraction). The retention of alpha-tocopherol within all microparticles was above 77%. They showed a spherical shape and roughness at varied degrees. Their mean particles size remained below 7 microm, and the smallest sizes were found in PP and CMC-M microparticles. The results obtained in this work show that the pea protein use for alpha-tocopherol microencapsulation is a promising system for further application in food.