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F Gage

Publications and source records attributed to F Gage.

14 recordsLinked to original sources
PubMed2004

Pulsatile pump perfusion of pancreata before human islet cell isolation.

Machine pulsatile perfusion for whole pancreas preservation might improve yield, viability, and function of human islets recovered after prolonged cold ischemia times. Four human pancreata were procured from cadaver donors (1 non-heart-beating donor) and stored in cold University of Wisconsin (UW) solution for a mean 13 hours prior to placement on a machine pulsatile perfusion device. The four pancreata were perfused for 4 hours with UW solution before undergoing islet isolation. Islets were quantified, viability was assessed, and insulin secretion was measured. Results were compared with nonpumped islet isolations stratified for cold ischemia time (CIT) <8 hours or cold ischemia time >8 hours. The islet yield for the four pumped pancreata was 3435 (+/-1951) islet equivalents/gram pancreas tissue (IEQ/g), compared with a mean yield of 5134 (+/-2700) IEQ/g and 2640 (+/-1000) IEQ/g from pancreas with <8 hours and >8 hours CIT, respectively. The mean viability after machine pulsatile perfusion was 86% (vs 74% and 74% for the <8 hour and >8 hour CIT groups). The mean viable yield (total yield x viability) was 2937 IEQ/g for machine perfusion, compared with 3799 IEQ/g and 1937 IEQ/g from pancreata with <8 hours and >8 hours CIT, respectively. The insulin secretion index of islets after machine perfusion was 6.4, compared with indices of 1.9 and 1.8 for the <8 hour and >8 hour CIT groups. This preliminary data indicates that low-flow machine pulsatile perfusion of pancreata with prolonged cold ischemia time can result in excellent yield, viability, and function.

Adenosine↗
PubMed2001

Stem and progenitor cells: origins, phenotypes, lineage commitments, and transdifferentiations.

Multipotent stem cells are clonal cells that self-renew as well as differentiate to regenerate adult tissues. Whereas stem cells and their fates are known by unique genetic marker studies, the fate and function of these cells are best studied by their prospective isolation. This review is about the properties of various highly purified tissue-specific multipotent stem cells and purified oligolineage progenitors. We contend that unless the stem or progenitor cells in question have been purified to near homogeneity, one cannot know whether their generation of expected (or unexpected) progeny is a property of a known cell type. It is interesting that in the hematopoietic system the only long-term self-renewing cells in the stem and progenitors pool are the hematopoietic stem cells. This fact is discussed in the context of normal and leukemic hematopoiesis.

Animals↗
PubMed1999

Ablating the ischemia-reperfusion injury in non-heart-beating donor kidneys.

BACKGROUND: The objective of this study was to determine if allopurinol (AL) and/or trifluoperazine (TFP) added to the Belzer machine preservation solution (MPS) improves the function of non-heart-beating donor (NHBD) canine kidneys. METHODS: Anesthetized canines underwent bilateral dissection of the renal vessels, obtaining baseline flow. After removing one kidney (heart-beating donor [HBD]), the dog was exsanguinated. After remaining in situ for 120 min (30-min warm ischemia time, 90-min cold ischemia time), the second kidney was removed (NHBD), flushed, biopsied, and weighed. The kidneys were machine-perfused separately for 20 hr, and pressure, flow, and resistance were measured serially. The kidneys were randomly assigned to a perfusate group (G): G1=MPS, G2=MPS+TFP, G3=MPS+AL, and G4=MPS+TFP+AL. Kidneys were implanted separately into a single recipient dog. Flow, resistance, and urine output were measured serially for 4 hr. Blood and urine samples and kidney biopsies were then obtained. All measurements were standardized to 100 g of kidney weight. RESULTS: HBD kidneys functioned better than NHBD kidneys in all groups, as expected. Although perfusate G1 was the most effective solution for HBD kidneys, the TFP additive (perfusate G2) more effectively reversed the vasospastic effects of ischemia/reperfusion for NHBD than the MPS solution (G1) with or without other additives. In HBD kidneys, the addition of AL resulted in the best creatinine clearance; however, AL was less effective than MPS alone in NHBD kidneys. TFP+AL together were completely ineffective in preserving renal function, regardless of whether the kidneys were from HBD or NHBD. CONCLUSIONS: MPS+TFP more effectively protected renal function against reperfusion injury in the NHBD than MPS alone, AL, or AL+TFP. AL exerts a salutary effect on creatinine clearance in HBD but not in the NHBD. The TFP and AL combination should not be used together with the MPS in machine preservation of kidneys.

Adenosine↗
PubMed1997

A rapid organ recovery program for non-heart-beating donors.

We report a successful method for rapid organ recovery from the non-heart-beating donor, which can open a new resource of organs for transplantation. The RORP is not controversial, is simple in design and execution, and results in kidneys that are viable for transplantation. Special personnel and equipment are needed but are easily incorporated in the overall budget of an OPO or donor hospital. Clearly more research is needed to rebuild ischemically damaged cells ex vivo and to develop new agents/methods to minimize the reperfusion response. When these processes are better understood and managed, the full potential of the NHBD as a donor resource will be fully achieved. We agree with others that the donor shortage could be entirely relieved by routine organ recovery from NHBD trauma victims.

Creatinine↗
PubMed1996

New profile of cadaveric donors: what are the kidney donor limits?

The need for donor organs is increasing more rapidly than the number of organs available from present resources using today's techniques. While efforts to improve consent rates through education and various incentives should continue, and while recovery and utilization of kidneys from donors at the extremes of age can further improve, we believe that the greatest potential for future expansion of the donor resource lies in the non-heart-beating donor. The combination of effective in situ preservation and ex vivo pulsatile preservation allows donation to occur from uncontrolled asystolic donors and provides a mechanism for both evaluation and resuscitation of the recovered kidneys. This approach, if fully utilized, can double the number of kidneys available for transplantation.

Brain Death↗
PubMed1996

Immediate function and cost comparison between static and pulsatile preservation in kidney recipients.

During a 1-yr period between September 1993 and September 1994, 74 patients received cadaveric kidney transplants at our institution. Thirty nine (39) kidneys were cold stored (CS), while 35 received pulsatile preservation (PP) on the Water's Mox system using U.W. Machine Preservation Solution. A perfusionist maintained pressure, flows, pH, and osmolality, within accepted ranges. Vasodilators (Regitine, Stelazine, Verapamil) were routinely added to the machine preservation solution. Most kidneys on PP were from marginal donors, or were imported and had associated long ice storage times. The CS kidneys, however, were from "ideal donors" where immediate function (IF) was expected. The kidneys were transplanted using a common protocol by a variety of surgeons. PP was associated with higher IF rates, shorter hospital stay and decreased overall costs. The function of those kidneys was also compared with the mate kidneys, obtained through a telephone survey of the various transplant centers throughout the country. PP was again associated with higher immediate function rates.

Adenosine↗
PubMed1996

A new approach for increasing the organ supply.

The donation of organs and tissues for the benefit of another person is an altruistic act and one that is a guaranteed option for the next-of-kin through various national Required Request legislations. At the Washington Hospital Center we have developed an approach that permits organ recovery from non-heart beating donors. The focus is on victims of fatal trauma and assures that each family is empowered with the right to make a donation decision. In October 1993 a consensus conference was held on implementing a program to recover organs from fatal trauma victims. The participants recommended that safeguards be incorporated to assure ethical treatment of both the trauma victim and the next-of-kin. An Office of Decedent Affairs (ODA) was then established and implemented in September 1994. The ODA is staffed by Family Advocates who are on duty continuously and respond to all trauma and death events. Their mission is to consolidate all death events, provide support to decedent families, assure that required request mandates are fulfilled, interact with the local Organ Procurement Organization (OPO) in the consent process, and facilitate the implementation of the Rapid Organ Recovery Program (RORP). The RORP consists of two specific procedures: cannulation of the femoral arterial-venous system for flushing the kidneys with a preservative solution, and intubation of the peritoneum for in situ cooling using an ice/lavage process. In the 1-yr period since the ODA was established, organ and tissue donation has increased by more than 300%.

Decision Making↗