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Dissertations / Theses on the topic 'Transplantation'
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1
Vroemen, Joseph Pieter Anna Maria. "Hepatocyte transplantation." Maastricht : Maastricht : Rijksuniversiteit Limburg ; University Library, Maastricht University [Host], 1987. http://arno.unimaas.nl/show.cgi?fid=5364.
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Bour-Guichenez, Gisèle. "Les obstructions urétérales en transplantation rénale : à propos de 16 obstructions concernant 330 transplantations." Saint-Etienne, 1989. http://www.theses.fr/1989STET6220.
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Mari, Elisabeth Rose. "Factors affecting the induction of transplantation tolerance in bone marrow transplantation." Thesis, Imperial College London, 2012. http://hdl.handle.net/10044/1/9919.
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The engraftment of allogeneic haematopoietic stem cells (HSC) relies on the use partially or fully myeloablative regimens to condition the transplant recipient in order to “make space” in the bone marrow microenvironment and establish immunological tolerance to donor alloantigens. In murine models of bone marrow transplantation where donor-recipient pair differ for a single minor histocompatibility (H) antigen, HY, engraftment can be obtained using low-dose irradiation. Such conditioning favours the homeostatic expansion of regulatory (Treg) cells that play a crucial role in generating host versus graft tolerance (HvG). However, the HY model has some limitations because, in the clinical setting, HLA-matched donor and recipient still differ for several minor H antigens. Although there is evidence that immune responses across minor H differences concentrate on immunodominant epitopes, it was fundamental to understand whether increasing the number of donor antigenic disparities necessitated a proportional increment in the dose of conditioning to achieve engraftment. I utilised a bone marrow transplantation model in which donor and recipient differed for multiple minor H antigens and whereby immune responses were prominently skewed against a single immunodominant epitope. Recipient mice were C57BL/6 and bone marrow was obtained from BALB.B donors, whereby the immunodominant epitope was H60. My results showed that low-dose irradiation was not sufficient to obtained BALB.B donor cell engraftment but a fully myeloablative dose of (850cGy) was required. When the amount of antigenic determinants was decreased, by transplanting (BALB.BxC57BL/6) F1 cells, donor cell engraftment was achieved at an irradiation dose of 500cGy. These data show that the dose of conditioning regimen required for engraftment is proportional to the magnitude of the antigenic differences across donor and recipient. Different doses of myeloablation certainly bear different impacts on the depletion of lymphocyte subsets and lympho-haemopoietic reconstitution. Therefore, I investigated the kinetics and extent of Treg expansion. In all groups of transplanted mice the engrafted mice had significantly increased proportions of Treg cells which peaked during the second week post-transplant. When host Treg cells were depleted prior to transplantation with male C57BL/6 or (BALB.BxC57BL/6) F1 donor bone marrow under irradiated at 500cGy or 600cGy, the level of donor cell engraftment was not affected. However, there was a delay in the engraftment of (BALB.BxC57BL/6) F1 bone marrow, thus suggesting a marginal role for Treg cells using higher doses of conditioning. These data imply that the magnitude of antigenic disparities between the donor and recipient deeply impacts on the dose of irradiation required to obtain durable engraftment. The dose of irradiation does not correlate with the level of Treg cell expansion and Treg depletion only marginally affects engraftment. These data indicate that, in the presence of multiple antigenic disparities, depletion of T cell effecting HvG responses rather than induction of immune regulation is necessary.
4
Poyet, Pierre. "Les reflux vésico-urétéraux en transplantation rénale : A propos de 9 reflux concernant 408 transplantations." Saint-Etienne, 1990. http://www.theses.fr/1990STET6217.
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Huda, Amina. "Employment after liver transplantation." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2010. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3398878.
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Lord, Stephen. "Reinnervation after cardiac transplantation." Thesis, University of Oxford, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.410568.
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Schafer, Donna. "Hyperlipidemia post heart transplantation." Thesis, McGill University, 1993. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=69770.
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Hyperlipidemia is prevalent following heart transplantation, and may play a role in the development of late graft atherosclerosis. The charts of 35 heart transplant recipients (n = 32 males and 3 females) were reviewed retrospectively up until three years post transplantation, to describe a time-course of hypercholesterolemia after transplantation, and to determine the mechanisms involved in its pathogenesis. All patients received prednisone, cyclosporine, and azathioprine for immunosuppression. A progressive rise in both serum cholesterol (2.4 $ pm$ 0.4 mmol/l, p $<$ 0.01), and body weight (8.4 $ pm$ 1.6 kg, p $<$ 0.01) were observed during the first 8 and 10 months respectively. Levels stabilized thereafter, remaining above pretransplant levels. Triglyceride, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol concentrations were all above normal limits following transplantation. Tapering of prednisone dose had a significant effect on serum cholesterol levels, whereas diet had a beneficial effect on body weight. A randomized, controlled, dietary intervention study then followed to further assess the effect of dietary intervention on minimizing or preventing post transplantation hyperlipidemia and weight gain. Five patients were counselled the Step One Lipid-Lowering diet, two patients were controls. All study patients demonstrated a lower overall increase in serum cholesterol levels than other transplant recipients. Reported nutritional intakes were similar between both groups. Increases in body weight were related to increases in body fat. Patients in the diet group demonstrated improvements in their level of nutrition knowledge, which correlated with lower serum cholesterol levels. Changes in serum cholesterol were also associated with appetite, hunger, perceived interest, perceived benefits, perceived barriers, and attitudes toward food. Changes in body weight were associated with appetite, hunger, perceived barriers, and stress. As
8
Honey, Karen J. "Mechanisms of transplantation tolerance." Thesis, University of Oxford, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.301519.
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Wise, Matt. "Mechanisms of transplantation tolerance." Thesis, University of Oxford, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.242039.
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Jamieson, N. V. "Liver preservation for transplantation." Thesis, University of Cambridge, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.605054.
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Scully, Ralph. "Mechanisms in transplantation tolerance." Thesis, University of Cambridge, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.321084.
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12
Bentall, Andrew John. "Antibodies in kidney transplantation." Thesis, University of Birmingham, 2015. http://etheses.bham.ac.uk//id/eprint/5817/.
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The aim of this thesis is to examine the effect of anti-donor antibodies in the clinical management and outcomes of antibody incompatible kidney transplantation. Initial studies were conducted to improve measurement of anti-ABO specific blood group antibodies. The specificity of antibody binding to blood group antigens (BGA) depended upon the assay platform and the nature of the core structure to which the BGA was bound. A standardised haemagglutination assay had excellent reproducibility, which was then applied to the analysis of samples derived from a study of 100 ABO incompatible kidney transplantation (ABOiKTx) in the UK where good clinical outcomes were achieved but there was wide variation reported in local assays quantifying BGA specific antibodies, without survival differences. In a highly sensitised HLA incompatible kidney transplant recipients (HLAiKTx), I demonstrated long term outcomes were poor compared to a compatible cohort, in particular with pre-formed donor specific anti-HLA Class II antibodies, in which histological injury of antibody damage occurred significantly earlier than with Class I antibodies. Further studies demonstrated that anti-HLA antibodies were associated with an inflammatory phenotype, but anti-donor ABO specific antibodies did not despite the activation of complement. Thus, inhibiting terminal complement activation, whilst reducing early antibody-mediated rejection did not abrogate all inflammation which was associated with the presence of IgM DSA. Reproducible and standardised assays are needed for antibody assessment in order to make good clinical decisions to improve patient outcomes. Further studies are needed to stop production or block mechanisms of ongoing cellular infiltrate to improve patient outcomes.
13
Desai, Rajeev Ramarao. "Organ transplantation related cancer." Thesis, University of Birmingham, 2016. http://etheses.bham.ac.uk//id/eprint/6907/.
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Cancer is an important cause of mortality among the recipients of organ transplantation. Cancer transmitted from the donors has poor outcome and the fear of such transmission results in non-acceptance of certain organs. Study of the recipients in the UK over 10 years identified 15 cases of transmitted cancers. The rate of cancer transmission was 0.05%.The risk of cancer transmission was 9 times higher from donors older than 45 years. A comparison of the organ donor data with the guidelines classifying the donor’s risk showed that a selected cohort of donors, who are classed as high risk of cancer transmission, could safely donate their organs resulting in valuable additional survival for the recipients, with low risk of cancer transmission. These results provide evidence, for modification of donor classification guidelines resulting in increased availability of safe organs for transplantation. The risk of recurrence after transplantation of cancers treated before transplantation was low in selected recipients undergoing transplantation after a 2 year-wait following the diagnosis of cancer. No association was found between the donor-recipient CMV status and the risk of post-transplant cancer. This research estimated the risk of cancer transmission to the organ transplant recipients enabling improved risk assessment in transplantation.
14
Fabre, Jean-Michel. "Métabolisme hépatique et transplantation." Montpellier 1, 1994. http://www.theses.fr/1994MON1T013.
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Legrand, Éric. "Polyglobulie apres transplantation renale." Nancy 1, 1991. http://www.theses.fr/1991NAN11192.
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Lepoivre, Hélène. "Grossesse après transplantation rénale." Caen, 1990. http://www.theses.fr/1990CAEN3085.
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Pummer-Verté, Lila. "Organ donation and transplantation /." Online version of thesis, 1995. http://hdl.handle.net/1850/12252.
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Wotherspoon, John Scott. "Studies in transplantation tolerance." Thesis, The University of Sydney, 1990. https://hdl.handle.net/2123/26352.
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The most fundamental function of the immune system is discrimination between the molecules that constitute "self" and those of foreign organisms, tissues or substances which the organism encounters during life. This immunological discrimination between self and non-self is vital to the maintenance of the biological integrity of the organism and is evident at the lowest phylogenetic levels (Hildemann et al., 1977). Encounters with molecules which are recognised as non-self trigger the immune system to initiate effector mechanisms by which the foreign molecules are eliminated. The diverse range of self molecules, however, does not apparently induce a similar response. The lack of responsiveness to self molecules, so called self-tolerance, is thought to be acquired during the development of the lymphoid system. As yet, the actual process by which the immune system distinguishes self and non-self molecules is not fully understood and remains a central issue of cellular immunology.
19
CLAYTON, Philip. "Outcomes of Kidney Transplantation." Thesis, The University of Sydney, 2014. http://hdl.handle.net/2123/10553.
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Kidney transplantation is the preferred treatment for the majority of patients with end-stage kidney disease, offering improved survival and quality of life compared with dialysis at reduced cost. However, kidney transplantation remains a treatment rather than a cure. A good outcome requires appropriate donor and recipient selection, careful management of immunosuppression, and avoidance of long-term complications including death from cardiovascular disease or malignancy, and graft loss from chronic allograft nephropathy or recurrence of the primary kidney disease. Making use of data from the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, supplemented where necessary by other sources, this thesis contains a number of linked epidemiologic investigations: (1) a report of the risk profile of Australian and New Zealand living kidney donors over 2004-11; (2) simulations of the allocation of deceased donor kidneys in Australia over 2006-2010, and development of novel metrics for the utility and equity of each allocation system; (3) external validation of the US estimated post-transplant survival (EPTS) score; (4) study of the long-term consequences of early acute rejection; (5) 15 year follow-up of a randomised trial of mycophenolate vs azathioprine; and (6) analysis of the association between steroid use and graft loss from recurrent IgA nephropathy.
20
Quteineh, Lina. "Pharmacogénétique en transplantation rénale." Paris 6, 2008. http://www.theses.fr/2008PA066229.
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1) Étude du polymorphisme génétique de la vitamine K époxyde réductase (VKORC1) et le risque de surdosage en anti-vitamine K (AVK). Précédemment, nous avons réalisé une étude prospective de type cas-témoin dans le but de d’identifier des facteurs de risque de surdosage en AVK. La même population a été ré-analysée, en ajoutant un nouveau facteur génétique (VKORC1 1173C>T). Nous avons montré dans cette étude que le risque de surdosage est significativement plus important chez les patients 1173TT et les patients 1173CT comparativement aux patients 1173CC avec un risque relatif de 10,5 et 2,3 respectivement. 2) Étude des facteurs génétiques de survenue de rejet aigu et des facteurs prédictifs de la fonction à long terme du greffon en transplantation rénale. A partir d’une cohorte de 288 patients transplantés, nous avons montré, dans un premier temps, que la fonction à long terme des greffons était supérieure chez les patients porteurs de l’haplotype VKORC1*2/*2 que chez les non porteurs (HR: 0. 34, 95% CI: 0. 26 - 0. 87, P=0. 02). Dans un second temps, nous avons pu identifier une association entre le polymorphisme génétique de CYP3A5 et la posologie quotidienne du tacrolimus et la survenue de rejet aigu au cours de la première année de greffe. Dans une population de 136 patients transplantés rénaux, nous avons montré que les sujets porteurs d’au moins un allèle CYP3A5*1 avaient besoin une posologie plus importante du tacrolimus pour atteindre une concentration à l’état d’équilibre. A 1 mois post-greffe, l’incidence de rejet aigu était plus importante chez les sujets porteurs de deux allèles CYP3A5*1 que les non porteurs (38% et 10% respectivement).
21
POLLET, BEATRICE. "Transplantation cardiaque et grossesse." Lyon 1, 1991. http://www.theses.fr/1991LYO1M239.
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LACAILLE, VERONIQUE. "Hyperlipidemie apres transplantation cardiaque." Dijon, 1994. http://www.theses.fr/1994DIJOM075.
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Herjean, Marion Christine. "Les causes de mortalité en transplantation hépatique hors les récidives des pathologies initiales, à propos de 207 transplantations hépatiques." Bordeaux 2, 1996. http://www.theses.fr/1996BOR23071.
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Jansson, Monika. "Detection of donor cells in recipient tissues after stem cell transplantation using FISH and immunophenotypi Stem cell transplantationng /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-222-4/.
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Huang, C. C. "Pathophysiology of post-transplantation bone disease : mechanisms of bone loss after orthotopic liver transplantation." Thesis, University of Cambridge, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.604707.
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To enhance our understanding of the pathophysiology of bone disease associated with liver transplantation and of the mechanisms underlying bone loss in the three month period following transplantation, this prospective study was undertaken as follows: (1) bone pathophysiology was evaluated pre- and three months post-transplantation in transiliac biopsies using tetracycline-assisted histomorphometry; (2) cellular activities of bone formation and resorption pre- and post- transplantation were studied using quantitative enzyme cytochemistry in combination with histomorphometric methods; (3) cellular activities for markers of bone energy metabolism and biosynthesis and/or cell proliferation were investigated using quantitative enzyme cytochemistry; (4) plasma markers for bone metabolism were investigated at regular intervals in collaboration with other laboratories. It was concluded from this study that rapid bone loss early after transplantation is due both to increased bone turnover and a negative remodelling balance at the individual bone remodelling site. These changes were at least partially mediated by increased PTH levels secondary to a negative balance in plasma calcium. Cyclosporin A is known to increase intracellular calcium levels and inhibit calcium release from mitochondria. It also reduces glomerular filtration rate which could be sufficient to depress extracellular calcium levels and thereby cause the observed rise in PTH levels. The consequences of this for post transplant bone remodelling is a markedly enhanced risk of osteoporosis in these patients. Ensuring replete calcium and vitamin D levels pre-transplantation and supplementation of cyclosporin A treatment with vitamin D metabolites and calcium post-transplantation followed by careful monitoring of plasma calcium concentrations might offer a better overall outcome for preventing transplantation-associated osteoporosis at this early stage post transplantation.
26
BORIES, GUERIN EMMANUELLE. "Cancers secondaires apres transplantation : a propos d'un cas de cancer bronchique apres transplantation cardiaque." Rennes 1, 1993. http://www.theses.fr/1993REN1M071.
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Cortellazzi, Jacopo. "Code transplantation for adversarial malware." Master's thesis, Alma Mater Studiorum - Università di Bologna, 2018. http://amslaurea.unibo.it/17288/.
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In the nefarious fight against attackers, a wide range of smart algorithms have been introduced, in order to block and even prevent new families of malware before their appearance. Machine learning, for instance, recently gained a lot of attention thanks to its ability to use generalization to possibly detect never-before-seen attacks or variants of a known one. During the past years, a lot of works have tested the strength of machine learning in the cybersecurity field, exploring its potentialities and weaknesses. In particular, various studies highlighted its robustness against adversarial attacks, proposing strategies to mitigate them .
Unfortunately, all these findings have focused in testing their own discoveries just operating on the dataset at feature layer space, which is the virtual data representation space, without testing the current feasibility of the attack at the problem space level, modifying the current adversarial sample .
For this reason, in this dissertation, we will introduce PRISM, a framework for executing an adversarial attack operating at the problem space level. Even if this framework focuses only on Android applications, the whole methodology can be generalized on other platforms, like Windows, Mac or Linux executable files.
The main idea is to successfully evade a classifier by transplanting chunks of code, taken from a set of goodware to a given malware. Exactly as in medicine, we have a donor who donates organs and receivers who receive them, in this case, goodware applications are our donors, the organs are the needed code and the receiver is the targeted malware.
In the following work we will discuss about concepts related to a wide variety of topics, ranging from machine learning, due to the target classifier, to static analysis, due to the possible countermeasures considered, to program analysis, due to the extraction techniques adopter, ending in mobile application, because the target operating system is Android.
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Sáez, Giménez Berta. "Venous thromboembolism after lung transplantation." Doctoral thesis, Universitat Autònoma de Barcelona, 2018. http://hdl.handle.net/10803/666689.
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La enfermedad tromboembólica es una complicación frecuente tras el trasplante de órgano
sólido y, específicamente, tras el trasplante pulmonar. Los objetivos de nuestro trabajo fueron:
describir los factores de riesgo de la enfermedad tromboembólica, evaluar el impacto de un
protocolo de profilaxis extendido y describir los perfiles de coagulación antes y hasta 1 año
tras el trasplante pulmonar.
Con dicho objetivo llevamos a cabo dos estudios; el primero compara retrospectivamente una
cohorte estudio (n=138) que recibió profilaxis con enoxaparina 90 días post-trasplante y una
cohorte control histórica (n= 195) que recibió profilaxis únicamente durante el período de
hospitalización post-trasplante. El segundo estudio, es un estudio prospectivo para describir el
perfil de coagulación de 48 pacientes previamente al trasplante, en las primeras 24-72 horas
post-trasplante, a las 2 semanas, 4 meses y 1 año post-trasplante.
La incidencia de enfermedad tromboembólica en nuestra población fue del 15.3% (95% IC:
11.6-19.4). El tiempo medio del trasplante al evento fue de 40 (p25-75, 14-112) días. En este
estudio, los factores de riesgo que se asociaron a la enfermedad tromboembólica fueron el
género masculino y la enfermedad pulmonar intersticial difusa como enfermedad de base. La
profilaxis extendida con enoxaparina no disminuyó la incidencia de enfermedad
tromboembólica.
En el estudio que describe los perfiles de coagulación transcurrido 1 año tras el trasplante
pulmonar, encontramos que la mayor parte de marcadores de un estado procoagulante se
normalizan a las 2 semanas del trasplante; sin embargo, al año todavía encontramos algunos
pacientes niveles alterados de factor VIII y factor de Von Willebrand. Los pacientes que
presentaron alguna complicación trombótica en los primeros 4 meses tras el trasplante, tenían
niveles más elevados de factor VIII a las 2 semanas.
Se necesitarán estudios multicéntricos con mayor tamaño muestral para poder diseñar
estrategias profilácticas adecuadas.Venous thromboembolism is a frequent complication after solid organ transplantation and, specifically, after lung transplantation. The objectives of this study were to describe risk factors for venous thromboembolism, to assess the impact of an extended prophylaxis protocol and to describe coagulation profiles before and up to 1 year after lung transplantation. We performed 2 studies. The first study compared a cohort (n=138) that received 90-day extended prophylaxis with enoxaparin and a historical control cohort (n= 195) that received prophylaxis only during post-transplant hospitalization. The second study is a prospective study to describe the coagulation profiles of 48 patients before lung transplantation and at 24- 72 hours, 2 weeks, 4 months and 1 year after lung transplantation. The cumulative incidence of venous thromboembolism was 15.3% (95% CI: 11.6-19.4). Median time from transplant to the event was 40 (p25-75, 14-112) days. In this study, the risk factors associated with venous thromboembolism were male gender and interstitial lung disease. Ninety-day extended prophylaxis did not reduce the incidence of VTE. In the second study to describe coagulation profiles up to 1 year after lung transplantation, we found that most markers of a procoagulant state normalize at 2 weeks after lung transplantation and that abnormal values of factor VIII and Von Willebrand factor persist at 1 year. Patients with venous thromboembolism at 4 months had higher values of factor VIII at 2 weeks. Larger, multicenter studies are needed to confirm these results and to design appropriate prophylactic strategies.
29
Neal, David A. J. "Cardiovascular risk after liver transplantation." Thesis, University of Southampton, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.418005.
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ChacoÌn-Chaves, Ronald Alfredo. "Respiratory function after lung transplantation." Thesis, University of Newcastle upon Tyne, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.247836.
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Brice, Sarah Louise, and sarahlbrice@gmail com. "Regional Immunosuppression for Corneal Transplantation." Flinders University. Medicine, 2010. http://catalogue.flinders.edu.au./local/adt/public/adt-SFU20100811.113448.
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Corneal transplantation is performed to restore vision or to relieve pain in patients with damaged or diseased corneas. However, approximately 40% of corneal allografts fail after 10 years. The most common cause of graft failure is irreversible immunological rejection, primarily mediated by CD4+ T cells, despite the topical application of glucocorticosteroids. The aim of this project was to investigate the anatomic site of antigen presentation during corneal transplantation in the rat, by using a lentiviral vector to express an anti-CD4 antibody fragment at potential sites of antigen presentation, including the donor corneal endothelium, the anterior segment of the eye and the cervical lymph nodes.
Dual-gene lentiviral vectors were constructed by inserting the 2A self-processing sequence between two transgenes. This allowed expression of two transgenes within a single open reading frame. In vitro characterisation of the dual-gene vectors was performed in cell culture experiments, which showed that transgenic proteins were expressed at lower levels from dual-gene vectors compared to the expression from single-gene vectors and expression was lowest when the transgene was situated downstream of the 2A self-processing sequence.
To locate the anatomic site of antigen presentation during corneal transplantation in rats, a lentiviral vector carrying an anti-CD4 antibody fragment was delivered to the corneal endothelium either immediately prior to corneal transplantation by ex vivo transduction of the donor corneas, or 5 days prior to corneal transplantation by anterior chamber injection into both the recipient and the donor rats. A separate group of recipient rats received intranodal injections of the lentiviral vector carrying an anti-CD4 antibody fragment into the cervical lymph nodes 2 days prior to corneal transplantation. Another group of rats underwent bilateral lymphadenectomy of the cervical lymph nodes 7 days prior to corneal transplantation. Corneal allografts were scored daily for opacity, inflammation and neovascularisation. Expression of the anti-CD4 antibody fragment from transduced tissues was detected using flow cytometry and polymerase chain reaction. Modest, but significant prolongation of corneal allograft survival was experienced by rats that received ex vivo transduction of the donor corneas with a lentiviral vector carrying an anti-CD4 antibody fragment immediately prior to corneal transplantation, but all grafts did eventually reject. Anterior chamber injection of the lentiviral vector carrying the anti-CD4 antibody fragment 5 days prior to corneal transplantation into both recipient and donor eyes did not prolong allograft survival. Intranodal injection of a lentiviral vector carrying an anti-CD4 antibody fragment did not prolong the survival of the corneal allografts, nor did bilateral lymphadenectomy of the cervical lymph nodes 7 days prior to corneal transplantation.
Neither expression of the anti-CD4 antibody fragment in the cervical lymph nodes nor the removal of these nodes was able to prolong corneal allograft survival in rats, suggesting that T cell sensitisation could potentially occur elsewhere in the body. However, expression of the anti-CD4 antibody fragment from the donor corneal endothelium was able to prolong corneal allograft survival, suggesting that some antigen presentation might occur within the anterior segment of the eye. Based on the findings described in this thesis and those of others, I propose that antigen presentation in the rat occurs within anterior segment of the eye and within the secondary lymphoid tissues such as the cervical lymph nodes, and that inhibiting antigen presentation at one of these sites will delay graft rejection. However, to completely abolish antigen presentation during corneal transplantation in the rat, I hypothesise that antigen presentation within both the anterior segment of the eye and within the secondary lymphoid tissues must be inhibited.
32
Ruers, Theodoor Jacques Marie. "Selective immunosuppression in organ transplantation." Maastricht : Maastricht : Rijksuniversiteit Limburg ; University Library, Maastricht University [Host], 1989. http://arno.unimaas.nl/show.cgi?fid=5415.
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Polak, Wojciech Grzegorz. "Technical aspects of liver transplantation." [S.l. : [Groningen : s.n.] ; University Library Groningen] [Host], 2008. http://irs.ub.rug.nl/ppn/.
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Marelli, Daniel. "Cell transplantation for myocardial repair." Thesis, McGill University, 1992. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=61231.
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It was hypothesized that skeletal muscle (SKM) satellite cells multiplied in vitro could be used to repair injured heart muscle. The purpose of this study was to test this hypothesis by auto-transplanting SKM satellite cells to a myocardial injury site. Fourteen dogs underwent explanation of the anterior tibialis muscle. Satellite cells were multiplied in vitro and their nuclei were labelled with tritiated thymidine 24 hours prior to implantation. The same dogs were then subjected to a myocardial injury by the application of a cryoprobe. The cells were suspended in serum free growth medium and implanted within the damaged muscle.There was persistence of the implantation channels in the experimental sites when compared to the controls. Macroscopically, muscle tissue completely surrounded by scar could be seen. Masson trichrome staining showed homogeneous scar in the control site, but not in the test site where a patch of muscle fibres containing intercalated discs (characteristic of myocardial tissue) was observed. In 2 dogs, specimens were taken at 14 weeks post-implantation. Muscle tissue could not be found. Electrically stimulated skeletal muscle regenerates did not show histological evidence of cardiac transformation.
These results support the hypothesis that SKM satellite cells can form neo-myocardium within an appropriate environment. The specimens failed to demonstrate the presence of myocyte nuclei. (Abstract shortened by UMI.)
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Qin, Shi-Xin. "Transplantation tolerance with monoclonal antibodies." Thesis, University of Cambridge, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.305697.
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Leong, Louise Yi Won. "Transplantation tolerance in the adult." Thesis, University of Cambridge, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.259603.
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Graça, LuiÌs. "Mechanisms of peripheral transplantation tolerance." Thesis, University of Oxford, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.249470.
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Titus, Thomas T. "Studies on pancreatic islet transplantation." Thesis, University of Oxford, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270180.
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Stovold, Rachel. "Gastric aspiration and lung transplantation." Thesis, University of Newcastle Upon Tyne, 2009. http://hdl.handle.net/10443/1709.
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Lung transplantation has become a viable therapeutic option for patients with end-stage lung disease, however, despite improvements in surgical techniques and post-operative management long term survival is poor when compared to those of other solid organ transplants. The long term success is limited by the onset of obliterative bronchiolitis (08) and its clinical correlate bronchiolitis obliterans syndrome (80S). Obliterative bronchiolitis is a chronic pathology involving inflammation and airway fibrosis causing allograft dysfunction. It is thought to occur as a response to both immunological and non-immunological mechanisms, and there is increasing evidence to suggest that gastro-oesophageal reflux with subsequent aspiration is a contributing factor. lhe aims of this project were to investigate whether gastric aspiration is occurring in lung transplant recipients and whether it can predispose a patient to the development of chronic rejection (08/80S). This was investigated using the gastric protease pepsin as a biomarker for gastric aspiration in the bronchoalveolar lavage (8AL) of lung transplant recipients. In addition, to further understand the link between aspiration and the development of OB/BOS the effects of pepsin on mucus and cytokine production from primary bronchial epithelial cells from lung transplant patients and goblet cells were investigated. From cross-sectional analyses pepsin levels were found to be elevated in lung transplant recipients compared to normal and disease controls, with the highest levels been found in the acute rejection (grade ~A2) group (normal: median, 1.1, range 0- 2.3ng/ml vs. all transplant: median 8.3, range 0-51.7ng/ml, P =0.02). Further analysis involving a longitudinal cohort of patients also confirmed that pepsin was present in the BAL of lung transplant recipients. A cut off value for a 'high' pepsin level was Prospectively determined using a separate and 'clinically well' stable transplant control group (75th percentile pepsin level, 10.4ng/ml). These subjects were documented to be free from rejection, infection or any clinical problems commonly associated with transplantation. Patients with early elevated levels of 8AL pepsin (Le. above 10.4ng/ml at 3 months post-transplant) were estimated to develop BOS at 3.0 times the rate of those with low early BAL pepsin. This is the first longitudinal study of BAL pepsin in lung transplant recipients which shows a trend for decreased survival in patients with early elevated BAL pepsin levels (60% BOS free in those with high early BAL pepsin vs. 80% BOS free in those with low early BAL pepsin at 3 years post-transplant). This shows a need for further investigations with increased patient numbers to reach statistical significance and confirm these results. The effect of pepsin and gastric juice on bronchial epithelial and goblet cell cultures was also investigated. The viability of the cells was not affected with the addition of pepsin, however the addition of whole gastric juice did cause a significant reduction in epithelial cell viability. In addition, mucin production from goblet cells was significantly increased at 72h on addition of 50l-lg/ml pepsin at pH 7.4 (median values pH 7.4; 163.4l-1g/ml and pH 7.4 & pepsin; 448.9I-1g/ml, P=0.038) and at pH 7.0 (median values pH 7.0; 55.3I-1g/ml and pH 7.0 & pepsin; 327.2I-1g/ml, P=0.016). Previous investigations from our group have shown that interleukin-8 (IL-8) can stimulate the production of mucin from goblet cells in vitro, therefore media from epithelial and goblet cells stimulated with pepsin was measured for IL-8, however there was no significant increase in production from either cell type. This suggests that the increase in mucin production in cells stimulated with pepsin is not mediated through an IL-8 pathway, therefore other mechanisms should be investigated. This thesis supports the hypothesis that gastric aspiration may be an important injury in lung transplantation and that pepsin is a potentially useful biomarker that may be associated with chronic allograft damage.
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Hardstaff, Ruth. "Compliance post solid organ transplantation." Thesis, University of Newcastle Upon Tyne, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.493240.
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The twentieth century was a time of a lot of advances in medicine, none more so than in the field of transplantation. Thanks to the pioneering work of many different people in a variety of different fields it is now possible to transplant bone marrow and solid organs. Transplantation is a truly multidisciplinary specialty where patient care is shared between physicians and surgeons. As in all medical specialties good nursing care is essential and requires a high degree of specialisation. Pathologists are key in post operative management in order to promptly diagnose problems so that treatment can be commenced with the minimum of delays.
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Eckoldt, Stephanie Martina. "Glycaemic control after pancreas transplantation." Thesis, University of Bristol, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.633150.
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Background: Pancreas transplantation is considered in patients with type 1 diabetes in whom usual medical management is not able to provide adequate glycaemic control or causes frequent severe episodes of hypoglycaemia. Benefits of transplantation in terms of correction of glycaemia (hyper- and hypoglycaemia) must be weighed carefully against risks associated with surgery and lifelong immunosuppression. Improved long-term graft survival would tip the risk-benefit balance in favour of transplantation. It is not clear what factors determine longterm metabolic graft function and there is currently no clinical measure to monitor graft function or identify dysfunction Methods: Glycaemic control, insulin secretion and insulin resistance was prospectively measured in patients awaiting pancreas and islet transplantation and in a cohort of pancreas transplant recipients (n=34) at 3 months after transplantation and yearly thereafter. Islet (n=2) transplant recipients were studied at 3 monthly intervals after transplantation. Results: Patients awaiting transplantation tend to be insulin sensitive. Pancreas transplantation normalises glycaemic control and restores insulin responses. Islet transplantation improves glycaemia to a lesser degree and partially restores insulin responses. Graft function appears to decline with time after transplantation with worsening glycaemia and gradual deterioration of insulin responses. A proportion of patients have clinical and sub-clinical abnormalities in glycaemic control, which may put them at risk of future decline in graft function. A fasting plasma glucose of > 5.5 mmol/L identifies patients who are at risk of future graft decline. In these patients a three-sample oral glucose tolerance test (OGTT) can confirm whether beta cell function is deteriorating. Conclusions: Although in the short term pancreas transplantation normalises glucose homeostasis, graft function declines over time. Fasting plasma glucose and OGTT are the easiest way of identifying graft dysfunction. Identification and further investigation of dysfunction may allow 'development of interventions to support graft function and prevent long-term decline.
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Sieunarine, Krishen. "The feasibility of uterine transplantation." Thesis, Imperial College London, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.497648.
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Agorogiannis, Eleftherios. "TH17 cells in transplantation biology." Thesis, University of Oxford, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.540084.
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Hosgood, Sarah Anne. "Normothermic perfusion in renal transplantation." Thesis, University of Leicester, 2012. http://hdl.handle.net/2381/10924.
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One of the main causes of early graft dysfunction in kidney transplantation is ischaemia reperfusion (I/R) injury. This unavoidable event occurs immediately when oxygenated blood is re-introduced into the transplanted kidney. Its severity is influenced by many predetermined factors. However, the condition under which an organ is preserved has a significant bearing on the outcome. Traditionally, organs are preserved using hypothermic temperatures, to reduce metabolism and the requirement for oxygen. Although practical and simple, hypothermic conditions are not entirely favourable and over time the depletion of energy substrates causes substantial cellular injury. This is thought to be a particular problem in kidneys from marginal donors, which are often exposed to a period of warm ischaemia (WI) prior to retrieval. The aim of this thesis was to determine the effects of varying degrees of the combined insults of warm and cold ischaemic injury and to develop a technique of normothermic perfusion (NP) to reduce ischaemic injury. The effects were assessed using ex-vivo and in-vivo porcine kidney models before translation of NP into clinical practice for marginal donor kidneys. This research demonstrated that prolonging the hypothermic preservation period after a minimal and a substantial degree of WI injury increased the severity of acute I/R injury and graft dysfunction. A short period of NP after hypothermic preservation was able to resuscitate the kidney, replenish ATP and reverse some of the detrimental effects of cold ischaemic injury. When translated into an autotransplant model, NP was found to be a safe and feasible method of preservation. NP was then adapted for use in clinical practice for kidneys from marginal donors. This first in man clinical series of 15 cases has demonstrated the safety and feasibility of NP for marginal kidneys. Although, the high rate of initial graft function is notable, further comparative studies are required to assess the effects on delayed graft function.
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勞錦輝 and Kam-fai Simon Lo. "Cytomegalovirus and bone marrow transplantation." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1997. http://hub.hku.hk/bib/B31215609.
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Al-Muzairai, Ibrahim Abdulaziz. "Antiidiotypic antibodies in renal transplantation." Thesis, University of Aberdeen, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.280624.
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Blood transfusion given before transplantation may improve subsequent allograft survival but the mechanism of action remains unknown. Several groups have postulated that the blood transfusion effect in renal transplantation is mediated through idiotypic- antiidiotypic antibody interactions which result in specific immunosuppression. These antibodies were found to be directed towards both class I & II MHC antigens. Cyclosporin has been shown to be effective in abrogating a primary immune response (if administered concomitantly with blood transfusions) but not an established response. Recent studies have shown that antiidiotypic activity may be enhanced by cyclosporin, but the mechanism remains unknown. The main aims of the studies presented in this thesis were to investigate the idiotypic-antiidiotypic antibodies interaction in renal transplantation. Potentiating activity ('anti-antiidiotypic antibodies:Ab3') was also detected in non-cytotoxic sera from patients who were previously sensitised. Ab3 activity was induced following DST, but all patients who had this activity underwent successful transplantation. Cytotoxic sera were also found to contain Ab3 activity after absorption with platelets. The presence of Ab3 activity prior to transplantation or its subsequent development had no effect on graft survival or rejection episodes. These studies suggest that one mechanism by which blood transfusions improve graft survival is the development of antiidiotypic antibodies. Cyclosporin may enhance Ab2 activity if given during blood transfusion programmes.
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Targett, Michael Peter. "Investigations into glial cell transplantation." Thesis, University of Cambridge, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.627550.
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Renshaw, A. "Clinical considerations in facial transplantation." Thesis, University College London (University of London), 2011. http://discovery.ucl.ac.uk/1322991/.
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Facial transplantation has emerged as the next step on the reconstructive ladder for severe facial disfigurement. Clinical issues surrounding facial tissue donation are examined, comprising pre-transplant facial vessel delineation; pre-operative aesthetic matching; and attitudes towards donation. An anatomical study of 200 consecutive facial and transverse facial vessels was performed using colour Doppler ultrasound. Facial vessels were measured at three landmarks and their branching pattern documented. The facial artery main branch was detected at the lower mandibular border in 99.5% of cases, the accompanying facial vein in 97.5%. The transverse facial artery was present in 75.5% of cases, the vein found in 58%. When the facial artery was undetectable, there was transverse facial artery dominance. When the facial vein was absent it was replaced with a transverse facial vein. This provides valuable pre-operative information regarding vessel status. A quantitative eleven point skin tonal matching scheme is described using digital analysis of facial imagery. Attitudes towards tonal mismatch in facial and hand transplantation are examined in two representative skin types. There was more scope for skin tonal mismatching in skin tone 2 (slightly tanned white) than in skin tone 6 (light golden brown) participants. Tonal mismatches were more tolerated in facial than in hand transplant simulations in both groups. More acceptable donor tonal groups exist for males than females. Targeted matching of skin tone is thus required. Attitudes and beliefs of 170 transplant professionals were examined. Areas of concern included the organ retrieval process; impact on the retrieval team and donor family. In-depth analysis of a transplant donor focus group was performed; provision of information, posttransplant contact, and post-retrieval donor facial appearance was deemed important. A method of fabricating a donor-specific artificial prosthesis within the time frame of facial graft retrieval is described. Finally, a method of framing the informed consent process is described.
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Kerby, Alan. "Immunoisolation approaches for islet transplantation." Thesis, King's College London (University of London), 2013. https://kclpure.kcl.ac.uk/portal/en/theses/immunoisolation-approaches-for-islet-transplantation(dbea18df-91a3-41c8-b9ba-24666a2a889f).html.
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The widespread use of islet transplantation as a treatment for type 1 diabetes is limited in part by the necessity for long term immunosuppression. The principle of immunoisolation is to create a physical barrier surrounding the islets to prevent immune destruction after implantation, therefore removing the requirement for immunosuppression. Alginate microcapsules are the most commonly used immunoisolation device which are typically implanted intraperitoneally. Intraperitoneal microencapsulated islet grafts are suboptimal, requiring at least double the number of islets to reverse hyperglycaemia compared to non-encapsulated islet grafts. The large size of microencapsulated islet grafts also restricts the selection of implantation site. We aimed to determine if the subcutaneous site is a suitable alternative site to the intraperitoneal site for microencapsulated islet grafts. It was discovered that equivalent microencapsulated islet grafts that were efficacious at the intraperitoneal site were ineffective at the subcutaneous site. Helper cells can be used to improve islet transplantation by secreting beneficial factors. L cells produce glucagon-like peptide-1 which is known to have several positive effects on islets. Co-encapsulation of islets with L cells increased islet insulin secretion but did not improve graft outcome. Mesenchymal stem cells (MSCs) can be co-transplanted to improve the graft outcome of non-encapsulated grafts. Islets co-encapsulated with MSCs had improved insulin secretion and also improved graft outcome. Immunoisolation of islets by conformal coating has the potential to maximise the diffusion of vital molecules and minimise the graft volume, enabling transplantation to preferred sites. Using allogeneic islets implanted at the kidney subcapsular site it was found that non-encapsulated grafts rejected whereas a novel conformal coating protected grafts from rejection in 5/7 of recipients. In summary, immunoisolated graft efficacy can be optimised by the selection of site, the use of helper cells, and with a novel conformal coating approach.
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Gingell-Littlejohn, Marc. "Cellular senescence and renal transplantation." Thesis, University of Glasgow, 2014. http://theses.gla.ac.uk/4986/.
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With the current crisis of organ shortage and an increasing number of dialysis patients,studies directed at ameliorating such a substantial organ discrepancy are of considerable importance to the transplant community. The use of extended criteria donation has helped to compensate the disparity of organs however, we are still a long way from achieving satisfactory targets. Still there are many organs from older donors that are discarded primarily on the basis of chronological age. It is here that biological age may display a crucial role in allowing the transplant team to characterize donor organs with greater accuracy. Indeed both biological and chronological age are very closely related and ECD criteria are based very much on the latter, albeit with other clinical variables. However the biomarker of ageing CDKN2A which is suitably represented by Baker and Sprott’s criteria, displays closer variabilities with post-operative transplant function, at least up to one year. Telomere length known as the “Gold standard” biomarker of ageing does not display as robust a role in predicting organ function as CDKN2A. The classification of organs represented in this text from category I-IV serves merely as a guide to future studies and is yet to be validated in larger clinical trials. It is however a simple and rapid assessment tool (Gingell-Littlejohn et al PLOS One 2013). Relatively advanced cellular senescence was displayed in the mutant AS/AGU rat kidney when compared to the parent AS strain. This was exploited in a unique animal model to study the effects of ischaemia reperfusion injury on the mutant kidney, hence mimicking to a certain degree the transplant related injuries in ECD kidneys. Although ischaemic times in the model were moderate in nature, there was nonetheless a difference in the tolerance to IR injury between parent and mutant strain as evidenced by increased p16 and p21 staining in AS/AGU rats. Such a model therefore is exclusive in that interventions to improve ECD renal function post-transplantation can accurately and conveniently be represented and studied at a pre-clinical level. Anti-ischaemic compounds have been the subject of much debate over the years, however a single “Holy Grail” compound able to completely abolish the injurious effects of IR injury has never been elicited. mTOR inhibitors however, display several cellular effects and act as potent immunosuppressants. They (AZ-6) have also been shown to partially mediate the detrimental effects of IR injury on the native kidneys of AS rats in a specifically designed animal model as shown. Further studies encompassing transplanted kidneys from mutant AS/AGU rats exposed to such a promising agent would be of undoubted importance to the clinical field of transplantation, potentially leading to immeasurable economic and patient benefits.