BackgroundDespite universal prophylaxis, late cytomegalovirus (CMV) infection occurs in a high proportion of kidney transplant recipients. We evaluated whether a specific viral T-cell response allows for the better identification of recipients who are at high risk of CMV infection after prophylaxis withdrawal.MethodsWe conducted a prospective study in 19 pretransplant anti-CMV seronegative kidney graft recipients R- (18 from seropositive donors [D+] and one from a seronegative donor [D-]) and 67 seropositive recipients R(+) (59 from seropositive donors and eight from seronegative donors) who received antiviral prophylaxis with valganciclovir. The QuantiFERON-CMV (QF-CMV) assay was performed within the first and third months after transplantation. Blood samples were monitored for CMV DNAemia using a commercial quantitative nucleic acid amplification test (QNAT) that was calibrated to the World Health Organization International Standard.ResultsTwenty-one of the 86 patients (24%) developed CMV viremia after prophylaxis withdrawal within 12 months posttransplantation. In the CMV R(+) group, the QF-CMV assay yielded reactive results (QF-CMV[+]) in 51 of 67 patients (76%) compared with 7 of 19 patients (37%) in the CMV R(−) group (p = 0.001). In the CMV R(+) group, infection occurred in seven of 16 recipients (44%) who were QF-CMV(−) and eight of 51 recipients (16%) who were QF-CMV(+). In the CMV R(−) group, infection evolved in five of 12 recipients (42%) who were QF-CMV(−) and one of 7 recipients (14%) who were QF-CMV(+). No difference was found in the incidence of CMV infection stratified according to the QF-CMV results with regard to the recipients’ pretransplant CMV IgG serology (p = 0.985). Cytomegalovirus infection occurred in 15 of 36 patients (42%) with hypogammaglobulinemia (HGG) 90 days posttransplantation compared with two of 34 patients (6%) without HGG (p = 0.0004). Cytomegalovirus infection occurred in seven of 13 patients (54%) with lymphocytopenia compared with 14 of 70 patients (20%) without lymphocytopenia (p = 0.015). The multivariate analysis revealed that the nonreactive QuantiFERON-CMV assay was an independent risk factor for postprophylaxis CMV infection.ConclusionsIn kidney transplant recipients who received posttransplantation prophylaxis, negative QF-CMV results better defined the risk of CMV infection than initial CMV IgG status after prophylaxis withdrawal. Hypogammaglobulinemia and lymphocytopenia were risk factors for CMV infection.
Tissue engineering is a widely developing scientific field, which combines technological solutions with the biology of the living organism. Regenerative medicine that uses tools of tissue engineering offers alternative means of therapy enhancing damaged tissues or organs. One of the development directions of contemporary chemical engineering is the scientific description of novel technologies that will enable production of porous structures -with high utility for biomedical engineering. 3D printing is one of the most popular methods used to produce scaffolds for cell culture. Nowadays a research team, in which authors are currently working, is dealing with the problem of manufacturing 3D constructs that play the role of artificial organ, obtained via 3D bioprinting. In the current article we present the possibilities and limitations of 3D bioprinting method in the context of possible application of manufactured structures as fully functional organs.
StreszczenieInżynieria tkankowa stanowi dynamicznie rozwijającą się dziedzinę nauki łączącą rozwiązania techniki z biologią żywe-go organizmu. Medycyna regeneracyjna, korzystając z narzędzi inżynierii tkankowej, oferuje alternatywne podejście do terapii wspomagających odbudowę zniszczonych tkanek czy narządów. Jednym z kierunków rozwoju współczesnej inży-nierii chemicznej jest opracowanie nowoczesnych technologii umożliwiających wywarzanie struktur porowatych o wysokiej użyteczności w inżynierii biomedycznej. Wśród najbardziej popularnych metod wykorzystywanych do wytwarzania rusztowań do hodowli komórek jest technika druku 3D. Obecnie zespół badawczy, w którym pracują autorzy, opracowuje technikę wytwarzania za pomocą biodruku 3D konstruktów spełniających funkcję sztucznych narządów. W artykule przedstawiono zestawienie możliwości i ograniczeń omawianej metody biodruku 3D w kontekście możliwości zastosowania wytworzonych struktur jako funkcjonalnych sztucznych organów.
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