Tissue banking, biovigilance and the notify library.

This issue is dedicated to the contributions of Professor Glyn O. Phillips to the field of tissue banking and the advancement of science in general. The use of ionizing radiation to sterilize medical products drew the interest of the International Atomic Energy Agency (IAEA). A meeting in 1976 in Athens Greece to present work on the effects of sterilizing radiation doses upon the antigenic properties of proteins and biologic tissues was my first introduction of Professor Phillips and the role that he was to play in Tissue Banking (Friedlaender, in Phillips GO, Tallentine AN (eds) Radiation sterilization. Irradiated tissues and their potential clinical use. The North E. Wales Institute, Clwyd, p 128, 1978). The IAEA sponsored subsequent meetings in the Republic of Korea, Czechoslovakia and Rangoon, the later including a visit to the tissue bank by Professor Phillips. His advocacy resulted in multiple workshops and teaching opportunities in a variety of countries, one of which led to the establishment of the Asia Pacific Surgical Tissue Banking Association in 1989 (Phillips and Strong, in Phillips GO, Strong DM, von Versen R, Nather A (eds) Advances in tissue banking, vol 3. World Scientific, Singapore, pp 403-417, 1999).

Regenerative medicine's historical roots in regeneration, transplantation, and translation.

Regenerative medicine is not new; it has not sprung anew out of stem cell science as has often been suggested. There is a rich history of study of regeneration, of development, and of the ways in which understanding regeneration advances study of development and also has practical and medical applications. This paper explores the history of regenerative medicine, starting especially with T.H. Morgan in 1901 and carrying through the history of transplantation research in the 20th century, to an emphasis on translational medicine in the late 20th century.

Voronoff to virion: 1920s testis transplantation and AIDS.

BACKGROUND: We address accusations linking AIDS with testis transplantation performed by a French surgeon, Serge Voronoff (1866-1951), and their implications in the future of animal-to-human organ transplantation. METHODS: Biographical literature on Voronoff and scientific literature on xenotransplantation and the origin of HIV were reviewed. RESULTS: IN the 1920s, Serge Voronoff transplanted testes from primates into humans to revitalize them sexually and physically, making him one of the first surgeons to perform xenotransplantation-transplanting live tissues between species. In recent years, some have postulated that Voronoff's transplants may have caused or contributed to the AIDS epidemic. However, consensus among virologists holds that HIV most likely originated from a chimpanzee virus known as simian immunodeficiency viruses (SIV) which many agree was transmitted to humans during the hunting of primates in the early 1900s. As these accusations have never been addressed, evidence is reviewed which refutes the claims. HIV isolate studies are summarized, which show that SIV was most likely transferred to humans from a chimpanzee species different from those used by Voronoff. Furthermore, literature suggests that Voronoff's experiments were performed in Europe and the United States, not central Africa. CONCLUSIONS: Over 100,000 people await organ transplants, making the prospect of using animal organs to meet demand increasingly favorable. The accusations against Voronoff and others have led to increased concern over cross-species disease transfer. The evidence presented refutes those claims and is used to explain the need for further research into xenotransplantation.

[Thomas Mann and the infectious diseases in the first half of 20th. century. Second part: Tuberculosis, cholera and transplants]. / Thomas Mann y las enfermedades infecciosas en la primera mitad del siglo XX. Parte II: Tuberculosis, cólera, trasplantes.

Surely Thomas Mann is today a forgotten writer, with only a little and selected group of readers between our young colleagues. However, perhaps could be useful for the others some knowledge about his vision of the infectious diseases in the first half of the twentieth century, when he wrote the novels here reviewed. Typhoid fever, meningitis, syphilis, tuberculosis and cholera are present in Mann's thematic from Buddenbrooks till Doktor Faustus, always with a personal focus, more on spirit -the will to live- rather than flesh and bones... or bacteria. One of his lasts and minor works let us throw an ironical glance over transplant, no so named, indeed, by Mann, who speaks of "exchange". In this second part we present tuberculosis, cholera and…transplant.

George (1830-72) and his son James Hogarth (1863-1941) Pringle: unsung surgical pioneers.

The achievements of the Hogarth Pringles, father and son, represent a remarkable story of surgical innovation; remarkable not only for the range and significance of their contributions but also because neither of them has been given appropriate recognition for their pioneering work. George Hogarth Pringle introduced antiseptic surgery to Australia. His son James performed the first autologous vein graft in Britain and the first excision with en bloc nodal dissection for malignant melanoma, both of which procedures were successful. He was also one of the earliest exponents of hindquarter amputation, was a national authority on fracture management and an early supporter of women in medicine.

Fifty years of organ transplants: the successes and the failures.

More than fifty years have now passed since the first successful human organ transplant. During that time, substantial progress has been made in both surgical techniques and immunosuppressive drug therapy. As a result, transplant success rates have improved dramatically, and thousands of recipients of kidneys, hearts, livers, and lungs have been granted both longer and healthier lives. At the same time, however, many more thousands of patients have died while waiting in vain for a cadaveric donor organ to become available due to a severe and persistent shortage of such organs. That shortage, in turn, is directly attributable to the National Organ Transplant Act of 1984, which proscribes payment to potential organ donors, even if that would increase supply. This atavistic policy and the shortage and deaths it has spawned provides a stirring example of the tendency for public policy to lag behind technological advancement, particularly in the medical field. But the tide of medical opinion may be turning on this issue, and some form of donor payments may soon emerge.

Graft/host relationships in the developing and regenerating CNS of mammals.

A new light was shed on the utility of neural grafts when it was recognized that donor tissues and cells offer more than a source of immature progenitors potentially capable of cell replacement: First, they have the inherent capacity to produce multiple trophic and tropic factors promoting cell survival and tissue plasticity often characteristic of the immature central nervous system (CNS). Second, by their interaction with the host microenvironment via cell/cell and cell/ECM interactions, these grafts are capable of re-establishing homeostasis, which can be, for example, reflected in rescue and protection of host elements from harmful influences. This second capacity of donor cells relies, in part, also on a "dormant" but still present regenerative capacity of mature or even aged CNS and on the possibility of its mobilization in the damaged nervous system by neural grafts. For this to occur efficiently after transplantation, a bi-directional dialogue between donor and host cells must gradually be established, in which both "partners" transmit signals (cell/cell contact, molecular messengers), "listen to" and "understand" each other and are able to react by modifying their own plasticity- and development-related programs. Thus, for the best possible recovery of functionality in the injured adult and aged nervous system, neurotransplantation must always try to find optimal conditions for all three of the mentioned qualities of neural grafts, especially for the protection and/or reactivation of neural circuitry embedded in non-neurogenic CNS areas. Once fully understood, this newly recognized aspect of neurotransplantation (and topic of this review) might, someday, even allow the recovery of systems that would otherwise be doomed, such as cognition- and experience-related circuitry.

Tacrolimus and transplantation: a decade in review.

The concept of replacing failing organs or tissues with healthy ones is as old as civilization itself, but it was not until 1954 that the first successful human kidney transplant was performed. Since then, improved surgical techniques and organ preservation, greater understanding of immunologic barriers, and the development of newer and more potent immunosuppressives have combined to make human organ transplantation relatively routine. Key to the success of transplantation is tacrolimus, originally known as FR000506. The compound, which suppresses interleukin-2 production associated with T-cell activation, inhibits differentiation and proliferation of cytotoxic T cells. Today, it is recognized worldwide as the cornerstone of immunosuppressant therapy.

[Gerontology and endocrinology at the beginning of the 20th century: Dr. Voronoff (1866-1951)]. / Contribution à l'histoire de la gérontologie et de l'endocrinologie du début du XXéme siécle: le Docteur Voronoff (1866-1951) et ses essais de rajeunissement par les greffes animales.

Rejuvenation by monkey testicle transplanting was terribly fashionable in Paris, between years 1925-1930. The manual miracles done by a group of very well-known surgeons, in Paris, (especially Serge Voronoff and Dartigues) rooted in the head of a too credulous public the idea according to it was possible to be made scientifically younger by genital graftings. The "Etude sur la vieillesse et la rajeunissement par la greffe" (1926), written by Voronoff, provided the clinical, histological and iconographical proofs of a such rejuvenation. The paper analyses that was put forward as "proofs", situated in the scientific and cultural context of the time. A possible link between youth, sexual vigour and animality sends back to a mythic history of gerontology and endocrinology, two medical fields which however became scientific specialties in the beginning of the twentieth century.

Trasplante uterino: resultados actuales. Preparación de un equipo multidisciplinario en Argentina / Uterine transplant: current results. Preparation of a multidisciplinary team in argentina

El factor uterino absoluto como causa de infertilidad, ya sea la ausencia de útero o la presencia de útero no funcional, es actualmente una patología con posibilidad de tratamiento. El primer intento de trasplante uterino en humanos fue en el año 2000, este falló y el útero necrótico tuvo que ser removido luego de 99 días. Este caso pionero inspiró a varios grupos de investigación alrededor del mundo para comenzar estudios en animales para investigar el trasplante uterino en relación a cirugía, inmunosupresión, rechazo y resultados obstétricos. El primer estudio clínico de trasplante uterino comenzó en Suecia en el año 2013 donde se realizaron nueve procedimientos a partir de donantes vivas. El primer nacido vivo en el mundo a partir de un trasplante uterino se reportó en septiembre del año 2014, luego se comunicaron dos nacimientos más en noviembre de ese mismo año. Desde ese momento se han reportado nacimientos de trasplantes uterinos en Suecia, Estados Unidos y Brasil. El caso de nacido vivo en Brasil es el primer y único nacimiento en el mundo cuya donante fue cadavérica. Todos los casos publicados de trasplante uterino y nacidos vivos serán revisados en detalle en este artículo. En el año 2016 se realizó el primer simposio de trasplante uterino en América Latina bajo el auspicio de la Asociación Latinoamericana de Medicina Reproductiva (ALMER). En ese encuentro, el equipo de la Universidad de Gotemburgo, Suecia, compartió su experiencia en trasplante uterino en humanos. Este fue nuestro puntapié para comenzar un trabajo colaborativo entre nuestro equipo en Rosario y el equipo de Suecia, con la intención de preparar un estudio científico de trasplante uterino en Argentina. Los pasos importantes para este procedimiento serán revisados en este artículo (AU)

Absolute uterine factor infertility, due to absence or non-function of the uterus, is now treatable. The first attempt of human uterus transplantation was in year 2000, but it failed and a necrotic uterus had to be removed after 99 days. This pioneering case inspired several research groups around the globe to initiate animal-based studies to investigate uterus transplantation in relation to surgery, immunosuppression, rejection and pregnancy outcome. The first clinical trial of uterus transplantation was initiated in Sweden in 2013 and involved nine live donor procedures. The world ́s first live birth was reported from that trial in September 2014 and this was followed by two more births within the trial in November 2014. Births after uterus transplantation has since then been reported from Sweden, USA and Brazil. The live birth in Brazil is the first and only birth from a deceased donor so far. All published cases of uterus transplantation and the live births will be review in detail.In 2016 there was the first symposium on uterus transplantation in Latin-America under the auspice of ALMER. At the meeting, the Swedish team shared their experiences of human uterus transplantation. This was the starting point for a collaboration work between our team in Rosario and the Swedish team, with the aim to prepare for a scientific trial of uterus transplantation in Argentina. The important steps in this procedure will be reviewed (AU)

Historia del soporte de la experimentación animal en el desarrollo de los trasplantes / History of the support of animal experimentation in the development of transplants

Se realiza en el trabajo una descripción histórica del empleo de otras especies especial animales, como soporte de la experimentación en el desarrollo y puesta a punto de las diferentes trasplantes. La mayoría de las aportaciones referenciadas constituyen a hitos en relación a la realización de forma pionera de las técnicas. En otros casos el apunte histórico se refiere a experimentos realizados de forma rutinaria que sirvieron para lograr aportaciones en algún campo puntual y también en el adiestramiento técnico quirúrgico para realizar los trasplantes. Hay referencia también al empleo de animales para la obtención de las vísceras como injertos en su aplicación en el ser humano lo que constituyen los xenoinjertos

A historical description of the use of other animals species, is carried out in the work as a support for the experimentation in the development and implementation of the different transplants. The majority of the referenced contributions constitute milestones in relation to the realization of a pioneering technique. In other cases the historical record refers to routinely performed experiments that served to achieve contributions in a specific field and also in the surgical technical training to perform the transplants. There is also reference to the use of animals for obtaining the viscera as grafts in their application in the human being what constitute the xenografts

Thomas Mann y las enfermedades infecciosas en la primera mitad del siglo XX. Parte II: Tuberculosis, cólera, trasplantes / Thomas Mann and the infectious diseases in the first half of 20th. century: second part: tuberculosis, cholera and transplants

Resumen Con seguridad Thomas Mann es hoy en día un escritor olvidado, para los infectólogos y para todo el mundo, con apenas un selecto grupo de poquísimos lectores entre nuestros jóvenes colegas. No les hará mal, a éstos y a aquéllos, sin embargo, adquirir algún conocimiento de las ideas sobre las enfermedades infecciosas en la primera mitad del siglo XX, período en que Mann escribió las obras aquí comentadas: por el contrario puede resultarles particularmente útil si este conocimiento les llega a través de la visión muy personal del germano, quien pone el foco más en el espíritu -la voluntad, el alma en suma- que en el componente físico de la enfermedad, en la miseria corporal, ignorando de paso, desdeñosamente, a las bacterias causantes.

Surely Thomas Mann is today a forgotten writer, with only a little and selected group of readers between our young colleagues. However, perhaps could be useful for the others some knowledge about his vision of the infectious diseases in the first half of the twentieth century, when he wrote the novels here reviewed. Typhoid fever, meningitis, syphilis, tuberculosis and cholera are present in Mann's thematic from Buddenbrooks till Doktor Faustus, always with a personal focus, more on spirit -the will to live- rather than flesh and bones... or bacteria. One of his lasts and minor works let us throw an ironical glance over transplant, no so named, indeed, by Mann, who speaks of "exchange". In this second part we present tuberculosis, cholera and…transplant.

Fifty years in the vineyard of transplantation: looking back.

The past 5 decades have documented remarkable advances in basic knowledge and clinical expertise in transplantation. The first 12 years of this half century of my participation in the enterprise were consumed with the isolation, chemical characterization, and application of histocompatibility antigens purified from mouse, guinea pig, and human tissues, demonstrating that their specificity was based on unique amino acid sequences in protein structures. Initial unsuccessful attempts to use native molecules to induce tolerance in rat renal or heart transplantation models were followed by limited success when they were administered with a brief perioperative course of cyclosporine (CsA). Production of allochimeric constructs of class I major histocompatibility complex molecules bearing donor-type amino acid substitutions into the host-type C-terminal portion of the α1 helix yielded tolerogens whose activity was not dependent on conditioning with CsA or total lymphoid irradiation (TLI). The allochimeric molecules serve as altered peptide ligands that induce an aberrant T-cell signal 1 response producing transplantation tolerance. The potent activity of CsA in this experimental model was extended to clinical settings. Pharmacologic tools were employed to explore intra- and interindividual variations in drug exposure leading to the development of a better drug formulation. However, the intrinsic nephrotoxicity of CsA necessitated marked 80% reductions in de novo drug exposure as were achieved by exploiting the synergistic pharmacodynamic and pharmacokinetic interactions of CsA with sirolimus. The final decade in this 50-year experience includes editorship of this journal with marked changes in its direction. These experiences have afforded insights into future avenues for preclinical exploration and therapeutic drug development.

Bone grafting: historical and conceptual review, starting with an old manuscript by Vittorio Putti.

Vittorio Putti has been recognized as one of the founders of orthopedic science. He wrote a number of original papers on different topics from his vast experience of orthopedics. In a paper on bone grafting dated 1912, Putti demonstrated his modern way of thinking by his ability to study past experiences critically and by his willingness to compare his own experiences with those of other orthopedic surgeons. Putti's paper proposes principles that still apply today, and which can be considered as the basis of the modern science of grafting. The results of his work can be summarized as follows: a) The uniformity of bone graft integration processes, and a marked reduction in integration capacity in heteroplastic grafts. b) The osteogenetic incapability of the graft as opposed to the osteogenetic capability of the periosteum. c) Marked reduction in the biological capability of bone that has been treated with preservatives, boiled, or macerated. d) The importance of the quality of the tissues in which the bone graft is inserted, including the mechanical characteristics of the graft and its fixation. e) The importance of asepsis. f) The importance of functional exercise. These important experiences were achieved without Putti having any knowledge of immunology, vascular surgery, tissue preservation or non decalcified histology techniques.