Autotransplantation

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Autotransplantation
Autotransplantation of wisdom tooth into unrestorable first permanent molar position.jpg
Autotransplantation of wisdom tooth
MeSH D014182

Autotransplantation is the transplantation of organs, tissues, or even particular proteins from one part of the body to another in the same person ( auto- meaning "self" in Greek [1] ).

Contents

The autologous tissue (also called autogenous, autogeneic, or autogenic tissue) transplanted by such a procedure is called an autograft or autotransplant. [2]

It is contrasted with allotransplantation (from other individual of the same species), syngeneic transplantation (grafts transplanted between two genetically identical individuals of the same species) and xenotransplantation (from other species).

A common example is the removal of a piece of bone (usually from the hip) and its being ground into a paste for the reconstruction of another portion of bone.

Autotransplantation, although most common with blood, bone, hematopoietic stem cells, or skin, can be used for a wide variety of organs. One of the rare examples is autotransplantation of a kidney from one side of the body to the other. Kidney autotransplantation is used as a treatment for nutcracker syndrome. [3]

Autologous blood donation

In blood banking terminology, autologous blood donation refers to a blood donation marked for use by the donor, typically for a scheduled surgery. (Generally, the notion of "donation" does not refer to giving to oneself, though in this context it has become somewhat acceptably idiomatic.) They are commonly called "autos" by blood bank personnel, and it is one major form of the more general concept of autotransfusion (the other being intraoperative blood salvage).

Some advantages of autologous blood donation are:

The disadvantages are:

Autologous blood is not routinely tested for infectious diseases markers such as HIV antibodies. In the United States, autologous blood is tested only if it is collected in one place and shipped to another.

There is also a risk that, in an emergency or if more blood is required than has been set aside in advance, the patient could still be exposed to donor blood instead of autologous blood. Autologous donation is also not suitable for patients who are medically unable to or advised not to give blood, such as cardiac patients or small children and infants. [5]

Bone autograft

Illustration depicting bone autograft Blausen 0072 Autograft.png
Illustration depicting bone autograft

In orthopaedic medicine, a bone graft can be sourced from a patient's own bone in order to fill space and produce an osteogenic response in a bone defect. However, due to the donor-site morbidity associated with autograft, other methods such as bone allograft and bone morphogenetic proteins and synthetic graft materials are often used as alternatives. Autografts have long been considered the "Gold Standard" in oral surgery and implant dentistry because it offered the best regeneration results. Lately, the introduction of morphogen-enhanced bone graft substitutes have shown similar success rates and quality of regeneration; however, their price is still very high.[ medical citation needed ]

Organ autotransplantation

Autotransplantation of selected organs is often preceded by ex vivo (also bench, back-table, or extracorporeal) surgery. [6] For example, ex vivo liver resection and autotransplantation is used in the treatment of selected cases of conventionally unresectable hepatic tumors. [7] It can also be implemented in rare scenarios of a blunt abdominal trauma. [8] Kidney autotransplantation is a method of a nephron-sparing renal tumor excision or complex renal artery aneurysm management. [9] [10] The uses of ex vivo surgery followed by autotransplantation were reported also for heart, lungs and intestines, including multivisceral approaches. [6]

Induced pluripotent stem cells (iPSCs), capable of differentiating into any cell type, have potential for solving the problem of donor organ shortage. Reprogramming technology would be used to obtain a personalized, patient-specific, cell product without problems related to histocompatibility of the transplanted tissues and organs. However, the ability to generate such tissues and organs will depend on successful strategies to overcome immunogenicity of the manipulated product. [11]

Hematopoietic stem cell autotransplantation

Autologous stem-cell transplantation involves harvesting peripheral blood mononuclear cells (PBMCs) by apheresis collection following mobilization of stem cells from the bone marrow into the peripheral blood. This is typically used for treatment of multiple myeloma or aggressive lymphoma. Stem cells are cryopreserved after collection for infusion after the patient undergoes high-dose chemotherapy. Stem cell rescue permits the use of higher doses of chemotherapy than would be tolerated otherwise. [12]

See also

Related Research Articles

<span class="mw-page-title-main">Organ transplantation</span> Medical procedure in which an organ is removed from one body and placed in the body of a recipient

Organ transplantation is a medical procedure in which an organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ. The donor and recipient may be at the same location, or organs may be transported from a donor site to another location. Organs and/or tissues that are transplanted within the same person's body are called autografts. Transplants that are recently performed between two subjects of the same species are called allografts. Allografts can either be from a living or cadaveric source.

<span class="mw-page-title-main">Tissue engineering</span> Biomedical engineering discipline

Tissue engineering is a biomedical engineering discipline that uses a combination of cells, engineering, materials methods, and suitable biochemical and physicochemical factors to restore, maintain, improve, or replace different types of biological tissues. Tissue engineering often involves the use of cells placed on tissue scaffolds in the formation of new viable tissue for a medical purpose, but is not limited to applications involving cells and tissue scaffolds. While it was once categorized as a sub-field of biomaterials, having grown in scope and importance, it can is considered as a field of its own.

<span class="mw-page-title-main">Transplant rejection</span> Rejection of transplanted tissue by the recipients immune system

Transplant rejection occurs when transplanted tissue is rejected by the recipient's immune system, which destroys the transplanted tissue. Transplant rejection can be lessened by determining the molecular similitude between donor and recipient and by use of immunosuppressant drugs after transplant.

<span class="mw-page-title-main">Hematopoietic stem cell transplantation</span> Medical procedure to replace blood or immune stem cells

Hematopoietic stem-cell transplantation (HSCT) is the transplantation of multipotent hematopoietic stem cells, usually derived from bone marrow, peripheral blood, or umbilical cord blood, in order to replicate inside a patient and produce additional normal blood cells. HSCT may be autologous, syngeneic, or allogeneic.

<span class="mw-page-title-main">Graft-versus-host disease</span> Medical condition

Graft-versus-host disease (GvHD) is a syndrome, characterized by inflammation in different organs. GvHD is commonly associated with bone marrow transplants and stem cell transplants.

Allotransplant is the transplantation of cells, tissues, or organs to a recipient from a genetically non-identical donor of the same species. The transplant is called an allograft, allogeneic transplant, or homograft. Most human tissue and organ transplants are allografts.

<span class="mw-page-title-main">Kidney transplantation</span> Medical procedure

Kidney transplant or renal transplant is the organ transplant of a kidney into a patient with end-stage kidney disease (ESRD). Kidney transplant is typically classified as deceased-donor or living-donor transplantation depending on the source of the donor organ. Living-donor kidney transplants are further characterized as genetically related (living-related) or non-related (living-unrelated) transplants, depending on whether a biological relationship exists between the donor and recipient. The first successful kidney transplant was performed in 1954 by a team including Joseph Murray, the recipient's surgeon, and Hartwell Harrison, surgeon for the donor. Murray was awarded a Nobel Prize in Physiology or Medicine in 1990 for this and other work. In 2018, an estimated 95,479 kidney transplants were performed worldwide, 36% of which came from living donors.

<span class="mw-page-title-main">Cell therapy</span> Therapy in which cellular material is injected into a patient

Cell therapy is a therapy in which viable cells are injected, grafted or implanted into a patient in order to effectuate a medicinal effect, for example, by transplanting T-cells capable of fighting cancer cells via cell-mediated immunity in the course of immunotherapy, or grafting stem cells to regenerate diseased tissues.

<span class="mw-page-title-main">Bone grafting</span> Bone transplant

Bone grafting is a surgical procedure that replaces missing bone in order to repair bone fractures that are extremely complex, pose a significant health risk to the patient, or fail to heal properly. Some small or acute fractures can be cured without bone grafting, but the risk is greater for large fractures like compound fractures.

Transfusion-associated graft-versus-host disease (TA-GvHD) is a rare complication of blood transfusion, in which the immunologically competent donor T lymphocytes mount an immune response against the recipient's lymphoid tissue. These donor lymphocytes engraft, recognize recipient cells as foreign and mount an immune response against recipient tissues. Donor lymphocytes are usually identified as foreign and destroyed by the recipient's immune system. However, in situations where the recipient is severely immunocompromised, or when the donor and recipient HLA type is similar, the recipient's immune system is not able to destroy the donor lymphocytes. This can result in transfusion associated graft-versus-host disease. This is in contrast with organ/tissue transplant associated GvHD, where matching HLA reduces the incident of the complication.

Articular cartilage repair treatment involves the repair of the surface of the articular joint's hyaline cartilage, though these solutions do not perfectly restore the articular cartilage. These treatments have been shown to have positive results for patients who have articular cartilage damage. They can provide some measure of pain relief, while slowing down the accumulation of damage, or delaying the need for joint replacement surgery.

Transplantable organs and tissues may refer to both organs and tissues that are relatively often transplanted, as well as organs and tissues which are relatively seldom transplanted. In addition to this it may also refer to possible-transplants which are still in the experimental stage.

In tissue engineering, neo-organ is the final structure of a procedure based on transplantation consisting of endogenous stem/progenitor cells grown ex vivo within predesigned matrix scaffolds. Current organ donation faces the problems of patients waiting to match for an organ and the possible risk of the patient's body rejecting the organ. Neo-organs are being researched as a solution to those problems with organ donation. Suitable methods for creating neo-organs are still under development. One experimental method is using adult stem cells, which use the patients own stem cells for organ donation. Currently this method can be combined with decellularization, which uses a donor organ for structural support but removes the donors cells from the organ. Similarly, the concept of 3-D bioprinting organs has shown experimental success in printing bioink layers that mimic the layer of organ tissues. However, these bioinks do not provide structural support like a donor organ. Current methods of clinically successful neo-organs use a combination of decellularized donor organs, along with adult stem cells of the organ recipient to account for both the structural support of a donor organ and the personalization of the organ for each individual patient to reduce the chance of rejection.

MIRA is a multidisciplinary and complementary method for treating many chronic diseases. The MIRA Procedure is a result of combining efforts from different medical fields developed in the University of Chicago in 1992. It basically consists in medically grafting live rejuvenated tissue in the form of autologous adipose adult stem cells to a damaged organ in order to restore it and improve its function. This method is currently approved by the U.S. Food and Drug Administration (FDA).

Nerve allotransplantation is the transplantation of a nerve to a receiver from a donor of the same species. For example, nerve tissue is transplanted from one person to another. Allotransplantation is a commonly used type of transplantation of which nerve repair is one specific aspect.

Facial Autologous Muscular Injection is also known as Fat Autograft Muscular Injection, as Autologous Fat Injection, as Micro-lipoinjection, as Fat Transfer and as Facial Autologous Mesenchymal Integration, abbreviated as FAMI. The technique is a non-incisional pan-facial rejuvenation procedure using the patient's own stem cells from fat deposits. FAMI is an Adult stem cell procedure used to address the loss of volume in the face due to aging or surgery repair in restoring facial muscles, bone surfaces and very deep fat pads. The procedure involves removing adult stem cells of fatty tissue from lower body, and refining it to be able to re-inject living adipose stem cells into specific areas of the face without incision. FAMI is an outpatient procedure and an alternative to artificial fillers, blepharoplasty or various face lifts. The procedure does not require general anesthesia and risks of an allergic reaction are minimal due to the use of the patient's own tissue used as the facial injection.

Regeneration in humans is the regrowth of lost tissues or organs in response to injury. This is in contrast to wound healing, or partial regeneration, which involves closing up the injury site with some gradation of scar tissue. Some tissues such as skin, the vas deferens, and large organs including the liver can regrow quite readily, while others have been thought to have little or no capacity for regeneration following an injury.

<span class="mw-page-title-main">Limbal stem cell</span>

Limbal stem cells, also known as corneal epithelial stem cells, are unipotent stem cells located in the basal epithelial layer of the corneal limbus. They form the border between the cornea and the sclera. Characteristics of limbal stem cells include a slow turnover rate, high proliferative potential, clonogenicity, expression of stem cell markers, as well as the ability to regenerate the entire corneal epithelium. Limbal stem cell proliferation has the role of maintaining the cornea; for example, by replacing cells that are lost via tears. Additionally, these cells also prevent the conjunctival epithelial cells from migrating onto the surface of the cornea.

<span class="mw-page-title-main">Shimon Slavin</span> Israeli professor of medicine

Shimon Slavin is an Israeli professor of medicine. He pioneered immunotherapy mediated by allogeneic donor lymphocytes and innovative methods for stem cell transplantation to cure hematological malignancies and solid tumors. He also used hematopoietic stem cells to induce transplantation tolerance to bone marrow and organ allografts.

Tissue transplantation is a surgical procedure involving the removal of tissue from a donor site or the creation of new tissue, followed by tissue transfer to the recipient site. The aim of tissue transplantation is to repair or replace tissues that are missing, damaged, or diseased, thereby improving patients' survival, functionality and quality of life.

References

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