Part 24 The world, from the past to the present, retold from the timelines.

Part 24

Article: Biotechnology My Blog Title: The world, from the past to the present, retold from the timelines.

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2023: [10.23] The first successful transplant of a functional cryopreserved mammalian kidney was reported. The study demonstrated a "nano-warming" technique for vitrification for up-to-100 days preservation of transplant organs. Sourced from [frontiersin.org] titled: “Supercooling: a promising technique for prolonged preservation in solid organ transplantation, and early perspectives in vascularized composite allografts.” This recent entity started with the first successful forearm allotransplantation in 1998 by Dubernard, followed by the first partial face transplantation led by Devauchelle and Lengelé in 2005 in France. Since then, a few teams had performed more than 130 upper limb transplants, 47 face transplants, 6 penis transplants, and more recently, uterus transplants allowing full-term births. The uterus is where a fetus (unborn baby) develops and grows. Also called womb. If the commitment of these pioneering teams had allowed the restoration of some aesthetic and functional units, chronic immune rejection had become a major challenge for the long-term function of these grafts. ‘Aesthetic’ is defined as “concerned with beauty or the appreciation of beauty” and more specifically as “giving or designed to give pleasure through beauty. If up to 89% of patients receiving a VCA “Vascularized Composite Allotransplantation” developed acute rejection episodes, certain immunosuppression protocols allowed optimal long-term tolerance, up to 20% of patients who had undergone face or upper limb transplants were faced with rejection phenomena in the first 10 years, leading to graft loss. Acute transplantation rejection occurs days to weeks after transplantation. The immune system recognizes the grafted organ as foreign and mounts an immune response, resulting in organ rejection and destruction. An acute rejection episode is the consequence of an immune response of the host to destroy the graft. Immunosuppressive therapy reduces cell-mediated immunity to prevent rejection of transplant and graft versus host disease. Moreover, current challenges in transplantation research involved improving the organ supply to poorly served areas and enhancing the match between the donor and recipient to allow a better long-term balance between organ function and immunosuppressive drug tolerance. In the specific case of VCAs, this matching concerned not only Human Leukocyte Antigen (HLA), but also skin color, age, and gender. HLA is a type of molecule found on the surface of most cells in the body. Human leukocyte antigens play an important part in the body's immune response to foreign substances. They make up a person’s tissue type, which varies from person to person. Human leukocyte antigen tests are done before a donor stem cell or organ transplant, to find out if tissues match between the donor and the person receiving the transplant. Also called HLA and human lymphocyte antigen. In addition, the functional aspect of these reconstructive surgeries raised an ethical debate concerning the benefit-risk ratio of immunosuppression, which was less discussed in solid organ transplantation due to its vital nature. With the increasing longevity of organ transplant recipients, it became crucial to address not only the short-term but also the long-term severe side effects that can significantly impact both the quality and quantity of life years. This emphasized the need for better preservation techniques to increase the pool of available grafts, improve matching, and minimize the impact of an extended ex-vivo journey. A few teams had been interested in importing Hypothermic (HMP) and SubNomorthermic (SNMP) machine perfusion from solid organs to VCAs, to decrease IRI “ischemia reperfusion injury” (of the muscle, primarily), and thus improve functional outcomes over time. However, the preliminary results on VCA “Vascularized Composite Allotransplantation” machine-perfusion were not able to extend preservation beyond a few days, as it might be necessary to optimize immune tolerance protocols (>2 days needed). An attractive alternative that might overcome these current limitations was supercooling preservation, which had been evaluated in solid organ preservation and had recently shown astounding results in allowing human liver preservation for up to 44 hrs.

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1:https://media.springernature.com/full/springer-static/image/art%3A10.1038%2Fs41467-023-38824-8/MediaObjects/41467_2023_38824_Fig1_HTML.png?as=webp

2:https://www.science.org/cms/10.1126/sciadv.abe2101/asset/f01163f9-7227-4678-a231-4cc6922c4274/assets/graphic/abe2101-f1.jpeg

3:https://www.frontiersin.org/files/Articles/1269706/frtra-02-1269706-HTML/image_m/frtra-02-1269706-g003.jpg

4:https://media.springernature.com/full/springer-static/image/art%3A10.1038%2Fs41598-024-63041-8/MediaObjects/41598_2024_63041_Fig2_HTML.png?as=webp

5:https://media.springernature.com/full/springer-static/image/art%3A10.1038%2Fs41598-024-63041-8/MediaObjects/41598_2024_63041_Fig3_HTML.png?as=webp

6:https://www.taipeitimes.com/News/feat/archives/2021/07/13/2003760759