Bone marrow stem cells develop into hematopoietic and mesenchymal lineages but have not been known to participate in production of hepatocytes, biliary cells, or oval cells during liver regeneration. Cross-sex or cross-strain bone marrow and whole liver transplantation were used to trace the origin of the repopulating liver cells. Transplanted rats were treated with 2-acetylaminofluorene, to block hepatocyte proliferation, and then hepatic injury, to induce oval cell proliferation. Markers for Y chromosome, dipeptidyl peptidase IV enzyme, and L21-6 antigen were used to identify liver cells of bone marrow origin. From these cells, a proportion of the regenerated hepatic cells were shown to be donor-derived. Thus, a stem cell associated with the bone marrow has epithelial cell lineage capability.

Allogeneic stem cell-based transplants may be limited by allograft rejection, as is seen with conventional organ transplantation. One way to avert such a response is to use autologous stem cells, but that may carry the risk of recurrence of the original disease, particularly in the context of a genetic defect. We investigated the potential for gene modification of autologous stem cells to avoid both problems, using recombinant adenoassociated virus vector expressing human al-antitrypsin in murine liver progenitor cells. We showed that recombinant adenoassociated virus 1 was the most efficient vector for liver progenitor cell transduction among five different serotypes of recombinant adenoassociated virus vectors. Ex vivo infected green fluorescent protein-positive liver progenitor cells from C57BL/6 mice with recombinant adenoassociated virus 1-vector-expressing human a1 antitrypsin were transplanted into the liver of monocrotaline-treated and partial-hepatectomized C57BL/6 recipients. Using green fluorescent protein as a donor marker, we were able to determine that at From the Departments of 'Pharmaceutics, 2Pathology, and 3Pediatrics, and

Allogeneic stem cell-based transplants may be limited by allograft rejection, as is seen with conventional organ transplantation. One way to avert such a response is to use autologous stem cells, but that may carry the risk of recurrence of the original disease, particularly in the context of a genetic defect. We investigated the potential for gene modification of autologous stem cells to avoid both problems, using recombinant adenoassociated virus vector expressing human al-antitrypsin in murine liver progenitor cells. We showed that recombinant adenoassociated virus 1 was the most efficient vector for liver progenitor cell transduction among five different serotypes of recombinant adenoassociated virus vectors. Ex vivo infected green fluorescent protein-positive liver progenitor cells from C57BL/6 mice with recombinant adenoassociated virus 1-vector-expressing human a1 antitrypsin were transplanted into the liver of monocrotaline-treated and partial-hepatectomized C57BL/6 recipients. Using green fluorescent protein as a donor marker, we were able to determine that at From the Departments of 'Pharmaceutics, 2Pathology, and 3Pediatrics, and

Oral Abstracts2 3 6 WEDNESDAY Supplement to Transplantation July 27, 2008, Volume 86 Number 2S angiogram, consisted in two arteries and one single venous trunk on each side. The HK lower poles were fused together in a parenchymal bridge at the level of aortic carrefour and inferior vena cava, which was joined by an accessory vein on each side. The urographic phase of angiogram revealed the presence of a single ureter on the left side while the right ureter was duplicated, with the two pelvis clearly separated. The HK was approached through a midline laparotomy; the right half was isolated and a total selective vascular control was achieved then the parenchymal junction was divided along its midline. The transplant was performed in the right iliac fossa; the renal arteries and the vein were anastomosed to the external iliac vessels, while the connection between the ureter and bladder was obtained by an uretero-vesical anastomosis according to Gregoire-Lich and intubated by a JJ stent. Postoperative course was uneventful for either patients and no delayed complication has been noted so far. One-year donor and recipient creatinine levels are 1.7 mg/dl and 1.3 mg/ dl, respectively. Conclusions: When vascular and urologic anatomy are suitable, live renal donation may still be considered even in the presence of a HK. Background: Laparoscopic donor nephrectomy has gained wide acceptance among transplant surgeons as it proved to be safe and provides similar graft function to open nephrectomy. Minimally invasive donor nephrectomy can be performed either totally laparoscopic or Hand-assisted. Hand-assisted donor nephrectomy is thought to be safer in regards to immediate control of intraoperative bleeding. In this video we show clips of emergency intra-operative arterial and venous bleeding during nephrectomy that were controlled by the hand. Method: DVD recording of all donor nephrectomy patients that had intraoperative bleeding were reviewed and representative clips were collected in one DVD for presentation. Results: This video demonstrates emergency intra-operative arterial and venous bleeding during nephrectomy, and maneuvers used for the control of bleeding by the surgeon's hand. No patient required blood transfusion and blood loss was minimal as control was immediate. Most bleeding was controlled by compression only (either by the hand or by inserting a gauze) and dissection was carried out uneventfully thereafter. Only one patient required conversion to open, but with the surgeon's fi nger controlling bleeding from the renal artery stump as the team was preparing for the conversion. Conclusion: Hand-assisted donor nephrectomy approach provides immediate control of bleeding which allows the surgeon ample time to reassess the situation and manage accordingly minimizing blood loss, the need for blood transfusion, and the need to convert to open nephrectomy. Hand transplantation is a multifaceted procedure that involves a specialized staff and support system. Because the limbs are not traumatized, the technical aspect o...