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Biomedical subjects

L Brasile

Publications and source records attributed to L Brasile.

At least 19 recordsLinked to original sources
PubMed1994

Organ preservation without extreme hypothermia using an Oxygen supplemented perfusate.

All methods of organ preservation depend upon hypothermia to depress metabolism during storage. Yet, hypothermia may represent the rate-limiting factor in organ preservation. A new perfusate has been developed which supports organ preservation without extreme hypothermia. The perfusate consists of a complex fluid supplemented with an oxygen carrying perfluorocarbon emulsion, Oxygent (Alliance Pharmaceutical Corp,). The perfusate was used to preserve canine kidney autografts using pulsatile preservation at 32 degrees C and static storage at 25 degrees C. Upon autografting the dogs produced urine within minutes of reperfusion. These results indicate the new perfusate may have significant potential in organ preservation without extreme hypothermia.

Animals↗
PubMed1994

Postmortem organ salvage using an Oxygen supplemented perfusate.

The world-wide shortage of organs for clinical transplantation is caused by the limited existing donor pool of heartbeating cadavers. Attempts to expand into the nonheartbeating cadaver population have been hindered by warm ischemic damage. We evaluated if a new Oxygent (Alliance Pharmaceutical Corp.) supplemented perfusate could be used to salvage canine kidneys postmortem. The kidneys preserved in the Oxygent perfusate could be maintained in situ for time points ranging from one-eight hours postmortem; enough time to declare death and obtain consent for organ donation. In contrast, the control kidneys yielded abnormal histologic findings and impaired flow dynamics. These results suggest that new perfusate may have significant potential to expand the existing organ donor pool.

Adenosine↗
PubMed1989

Identification of an autoantibody to vascular endothelial cell-specific antigens in patients with systemic vasculitis.

PURPOSE: Although immunologic mechanisms have been postulated in the pathogenesis of vasculitis, an autoimmune process directed against specific autologous vascular wall antigens has not been previously documented. We examined the role of an immunologic response to vascular endothelial cell (VEC) antigens in patients with vasculitis, because of the observed immunogenicity of VECs in renal and cardiac allograft recipients. PATIENTS AND METHODS: The study patients included 21 with systemic vasculitis and four with hypersensitivity vasculitis. A healthy, normal control group consisted of 51 young subjects and 61 older subjects. Thirty-two patients with connective tissue diseases were also evaluated. The presence of autoantibody to autologous monocytes and other cell types was determined with previously described standard crossmatch techniques. Patient sera exhibiting autoantibody to autologous monocytes were screened against a panel of allogeneic cells. The cell panel consisted of concordant T and B lymphocytes, monocytes, and VECs from 16 umbilical cord donors. Sera from four patients were analyzed for specificity to the vascular endothelium of frozen sections of vessels. RESULTS: An autoantibody to VEC antigens was detected in 18 of the 21 patients (86%) with confirmed systemic vasculitis, not of the hypersensitivity type. This autoantibody was highly cytotoxic, complement-fixing, and specific for antigens on the surface of the VEC. Findings on allogeneic VEC panel analysis support the existence of multiple allotypes in the VEC antigen system. In three patients, fluctuations in the titer of the autoantibody generally correlated with clinical symptoms. In the four patients screened for the specificity of the autoantibody to anatomically different cadaveric blood vessels, specific anatomic patterns of reactivity were observed. Autoantibody to VEC antigens was not found in young controls and was documented in low frequency in older controls and in patients with connective tissue diseases. The autoantibody was seen in one of four patients (25%) with hypersensitivity vasculitis. CONCLUSION: Our results indicate that an autoantibody to VEC antigens may be involved in the pathogenesis of systemic vasculitis or may be a diagnostic marker for the disease process.

Adolescent↗
PubMed1988

The significance of a donor-specific vessel crossmatch in renal transplantation.

Very early graft rejection is usually attributed to pretransplant sensitization to HLA antigens represented on the lymphocyte. However, it is possible that such rejection episodes are secondary to antibody to a transplant-relevant system that is not represented on the lymphocyte but is represented within the allograft. This study suggests that sensitization to antigens on the VEC is detrimental to allograft success and can occur in the absence of sensitization to HLA antigens on the T or B cell or monocyte. When antibody to donor VEC is not present pretransplant, almost all patients (95%) will have a very benign posttransplant clinical course. When anti VEC antibody is present, early graft rejection or severe rejection episodes occur with a very high frequency (80%) in the nondiabetic patient. These observations, therefore, suggest that the pretransplant presence of antibody to VEC is detrimental to graft survival, and that such antibody can develop in the absence of anti HLA antibody. While the presence of such antibody is not an absolute contraindication to transplantation it does appear to represent a significant risk factor for immunological graft loss.

Cytotoxicity Tests, Immunologic↗