PubMed · 16134266
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B Carey. Sperm, Inc.. https://pubmed.ncbi.nlm.nih.gov/16134266/
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Accurate preoperative prediction of functional donor and remnant hemiliver volumes in live donor liver transplantation is essential in preventing postoperative liver failure and optimizing safety. Our aim was (1) to evaluate volume variability associated with multiphasic CT imaging and (2) to determine over- or under-estimations of 3-D CT graft-volume assessments based on 'largest' versus 'smallest' CT phases with respect to intraoperative findings. Native, arterial and venous phase CT images from 83 potential live liver donors were subject to 3-D CT liver volume calculations and virtual 3-D liver partitioning. Estimates were compared to intraoperative volumes obtained in 43 cases. Calculated (preoperative) graft-volume-body-weight-ratios (GVBWR) versus measured (intraoperative) graft-weight-body-weight-ratios (GWBWR) were analyzed. Significant differences in total liver volume- and in graft-liver volume calculations were found among the largest (venous) and smallest (native) CT phases. High significant overestimations were observed in graft-volume determinations and in GVBWR-calculations based on the 'largest' CT phase when compared to intraoperatively obtained graft-weight and -GWBWR values. In contrast, differences among intraoperative measurements and preoperative calculations based on the 'smallest' CT phase yielded less significant overestimations. While 3-D CT volumetry based on the 'largest' (venous) CT phase is associated with considerable overestimation, 3-D volumetry based on the 'smallest' (native) CT phase accurately matches the intraoperative findings.
Production of the anti-inflammatory cytokine IL-10 by monocytes has been implicated as a probable negative regulator of graft-versus-host disease (GvHD) in patients undergoing allogeneic stem cell transplants (SCT). Monocytes from G-CSF-mobilized peripheral blood stem cell (gmPBSC) collections have been reported to produce more IL-10 than unmobilized monocytes in response to proinflammatory factors such as LPS. Why this should occur is unclear. In this study, monocyte phenotype and IL-10 localization and release were investigated in PB mononuclear cells (MNC) from 27 healthy donors mobilized for allogeneic SCT and from 13 patients with hematological malignancies mobilized for autologous SCT. All isolates contained elevated total percentages of monocytes in comparison with unmobilized PB, a high proportion of which displayed an immature phenotype. Stimulation of gmPB MNC with an inflammatory stimulus [fixed Staphylococcus aureus cells (SAC)] induced rapid up-regulation of CD14, indicating conversion to mature status. Localization studies indicated that IL-10 was predominantly present, bound on the surface of CD64(+)/CD14(low/neg) immature monocytes. Inflammatory stimuli (LPS, polyinosinic:polycytidylic acid, or SAC) induced release of variable quantities of IL-10 from the cell surface. MNC, separated into surface IL-10-positive or -negative fractions, differed in their ability to stimulate alloreactivity in MLR, and IL-10(+) MNC induced significantly lower levels of proliferation than IL-10(-) MNC. Thus, the subset of immature monocytes carrying surface-bound IL-10 in gmPB has the potential to modulate alloreactivity and GvHD after allogeneic SCT through cell-to-cell contact and released IL-10.
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