Importance of Donor Chondrocyte Viability for Osteochondral Allografts.

BACKGROUND: Osteochondral allograft (OCA) transplantation provides a biological treatment option for functional restoration of large articular cartilage defects in multiple joints. While successful outcomes after OCA transplantation have been linked to viable donor chondrocytes, the importance of donor cell viability has not been comprehensively validated. PURPOSE: To use a canine model to determine the importance of donor chondrocyte viability at the time of implantation with respect to functional success of femoral condylar OCAs based on radiographic, gross, cell viability, histologic, biochemical, and biomechanical outcome measures. STUDY DESIGN: Controlled laboratory study. METHODS: After approval was obtained from the institutional animal care and use committee, adult female dogs (N = 16) were implanted with 8-mm cylindrical OCAs from male dogs in the lateral and medial femoral condyles of 1 knee. OCAs were preserved for 28 or 60 days after procurement, and chondrocyte viability was quantified before implantation. Two different storage media, temperatures, and time points were used to obtain a spectrum of percentage chondrocyte viability at the time of implantation. A successful outcome was defined as an OCA that was associated with graft integration, maintenance of hyaline cartilage, lack of associated cartilage disorder, and lack of fibrillation, fissuring, or fibrous tissue infiltration of the allograft based on subjective radiographic, gross, and histologic assessments at 6 months after implantation. RESULTS: Chondrocyte viability ranged from 23% to 99% at the time of implantation. All successful grafts had >70% chondrocyte viability at the time of implantation, and no graft with chondrocyte viability <70% was associated with a successful outcome. Live-dead stained sections and histologic findings with respect to cell morphological features suggested that successful grafts were consistently composed of viable chondrocytes in lacunae, while grafts that were not successful were composed of nonviable chondrocytes with infiltration of fibroblasts from the surrounding recipient tissues. In situ polymerase chain reaction (fluorescence in situ hybridization [FISH]) assays were performed in an attempt to distinguish donor (male) cells from recipient (female) cells. Unfortunately, this technique was exceptionally difficult to perform on intact articular cartilage sections, and consistent, repeatable data could not be obtained from this testing. However, the data did support histologic and live-dead data, which strongly suggested that successful grafts retained viable donor (male) chondrocytes and unsuccessful grafts degraded and were replaced by fibrous tissue populated with recipient (female) fibroblasts. CONCLUSION: Viable chondrocytes in OCAs at the time of transplantation are primarily responsible for maintenance of donor articular cartilage health in the long term. CLINICAL RELEVANCE: Optimizing chondrocyte viability in all aspects of OCA transplantation-including procurement, processing, storage, transportation, and surgical implantation-needs to be a primary focus for OCA clinical use.

Perfil de doadores de órgãos de um hospital público do oeste de Santa Catarina / Perfil de donantes de órganos en un hospital público en el oeste de Santa Catarina / Profile of organ donors in a public hospital in western Santa Catarina

Objective: To learn the epidemiologic profile of human organ and tissue donors of a public hospital in western Santa Catarina.mMethod: Documentary retrospective descriptive analysis, being a sample of medical records of patients that donated organs in the period from 2005 to 2010, and who met the donation effectiveness criteria. A semi-structured instrument used for data collection. Results: The results showed a predominance of male donors with 68%; aged 20 to 30 years (54%), level of education 48% had incomplete primary education, religion, 73% were Catholic, 52% of the diagnosis head trauma; most donated organs were the liver and kidney, both with 52%, with 42% heart. Conclusion: The majority of donors were male, young adult, low education, TBI being the main causeof death.

Objetivo: Conhecer o perfil epidemiológico dos doadores de órgãos e tecidos humanos de um hospital público do Oeste de Santa Catarina. Método: Análise documental descritiva, retrospectiva, sendo a amostra constituída por prontuários de pacientes que efetivaram doação de órgãos no período de 2005 a 2010, e que se encaixaram nos critérios de efetivação da doação. Utilizou-se um instrumento semi-estruturado para coletados dados. Resultados: Os resultados mostraram predominância de doadores do sexo masculino com 68%; na faixa etária de 20 à 30 anos (54%); grau de instrução 48% possuíam ensino fundamental incompleto; religião, 73% eram católicos; o diagnóstico 52% de trauma crânio encefálico; os órgãos mais doados foram fígado e rim, ambos com 52%; coração com 42%. Conclusão: A maioria dos doadores constitui-se do sexo masculino, adulto jovem, baixa escolaridade, sendo a causa a principal de morte o traumatismo crânio encefálico (TCE).

Objetivo: Conocer el perfil epidemiológico de los donantes de órganos y tejidos humanos de un hospital público en el oeste de Santa Catarina. Método: El análisis de documentos descriptivo, retrospectivo, y una muestra de historias clínicas de pacientes que hemos logrado la donación de órganos en el período de 2005 a 2010, y que cumplían con los criterios de eficacia de la donación. Se utilizó un instrumento semi-estructurado para recoger datos. Resultados: Los resultados mostraron un predominio de los donantes masculinos con 68% de entre 20 a 30 años (54%), el nivel de educación 48% tenían educación primaria incompleta, la religión, el 73% son católicos, el 52% de los diagnósticos trauma en la cabeza, la mayoría de los órganos donados fueron el hígado y el riñón, ambos con un 52%, con un 42% corazón. Conclusión: La mayoría de los donantes constituye un adulto macho, joven, bajo nivel de educación, siendo la principal causa de muerte TBI.