Short- and long-term outcomes of every graft recovered during a multi-organ procurement procedure including the intestine.

BACKGROUND: The development of intestinal transplant (Tx) programs introduces thymoglobulin donor treatment as well as an almost complete warm dissection of the abdominal organs to allocate them to different recipients. Our aim is to assess the reproducibility and feasibility of the surgical technique of multi-organ procurement with the use of thymoglobulin donor pre-treatment and report the short- and long-term outcomes of every graft harvested as part of multi-organ procurement (MTOp), including the intestine. METHODS: Data were collected of all organs harvested from MTOp, including the intestines allocated to our center from March 2006 to July 2011. Data from 92 recipients and 116 organs procured from 29 MTOp were analyzed. Twelve hearts, 2 lungs, and 1 cardio-pulmonary block were transplanted; primary graft dysfunction developed in 4 of the 12 hearts and in the cardio-pulmonary block. RESULTS: The survival rate was 75% and 100% for hearts and lungs, respectively. Nineteen livers, 9 kidney-pancreas, 19 kidneys, and 29 intestines were transplanted. Delayed graft function (DGF) of the pancreas developed in 3 of 9 kidney-pancreas, and the other 3 exhibited DGF of the kidney; 4 of 19 Tx kidneys had DGF. The survival was 84%, 78%, 95%, and 65.5% for livers, kidney-pancreas, kidneys, and intestines, respectively. CONCLUSIONS: Organs procured during MTOp including the intestine can be safely used, increasing organ availability and transplant applicability without compromising allocation, quality, and long-term results of the non-intestinal-procured organs.

[Potentiation of the antiblastic activity of mafosfamide by GM-CSF and interleukin-3: a possible use in the treatment of acute myeloblastic leukemia]. / Potenziamento dell'attività antiblastica della mafosfamide mediante GM-CSF e interleuchina-3: una possibile applicazione nel trattamento delle leucemie acute mieloblastiche.

The low activity of antiblastic drugs on tumor cells in the G0 phase is an important limitation in the therapy of malignancies. Cells in the G0 phase are able to enter in cycle any time after chemotherapy treatment, causing relapse of the disease. The use of colony stimulating factors (for example granulocyte-macrophage stimulating factor-GM-CSF and interleukin 3-IL-3) permits the recruitment in cycle of myeloblastic leukemic cells in the G0 phase and thus a cellular population sensitive to chemotherapy. We evaluated the in vitro activity of GM-CSF and IL-3 in fresh myeloblastic leukemic cells: after 96 h of incubation with GM-CSF (500 U/mL), IL-3 (500 U/mL), and GM-CSF + IL-3 (500 + 500 U/mL), 10(6) cells were treated with mafosfamide (30 microgram/mL x 30 min); 10(6) cells were simultaneously treated with mafosfamide without preincubation with colony stimulating factors. The sensitivity of leukemic cells preincubated with GM-CSF and IL-3 to the cytotoxic action of mafosfamide was greater than that of the control cells treated with mafosfamide alone. No enhancement of cytotoxic activity of mafosfamide was observed with GM-CSF + IL-3 combined treatment. The use of colony stimulating factors may effectively increase the number of leukemic cells sensitive to alkylating drugs.

[Use of immunoglobulins in AIDS]. / Uso delle immunoglobuline in corso di AIDS.

Fourteen AIDS patients with constitutional symptoms without a known etiology were treated with intravenous immunoglobulins (IVIG). The dosage regimen was 300 mg/kg per day three times weekly for two weeks followed by 300 mg/kg per day once weekly for ten weeks. All patients improved clinically after treatment with IVIG. The reason for the clinical improvement in our cases is as yet unclear, but it is possible that immunoglobulins have had a therapeutic effect on the underlying immunologic disturbance.