Advances in Tissue Banking

The following sections are included:

• ADVANCES IN TISSUE BANKING

• PREFACE

• CONTENTS

It was with great sadness that we learned of the death of Dr. Kenneth Sell this past year. Dr. Sell made many contributions to the field of transplantation and tissue banking in particular. It was through his leadership that many scientists, physicians and practitioners in tissue banking were introduced to the fields of Tissue Banking, Transplantation and Immunology. In 1975, Dr. Sell organised a tissue bank symposium honouring the 25th Anniversary of the US Navy Tissue Bank. For this meeting, he brought together physicians and scientists from around the world to discuss a variety of topics including: the development and progress of tissue banking; clinical results of transplantation of stored tissues and organs; techniques of viable low temperature tissue preservation; techniques of viable tissue and organ preservation; and the logistical and legal problems of tissue banking. Presentations were made by leaders who had established tissue banks during the previous 25 years, but also included practitioners of allotransplantation who relayed the benefit of tissue banking. (Tissue Banking for Transplantation, K.W. Sell and G.E. Friedlaender, eds., Grune & Stratton, Inc., New York, 1976.)…

The following sections are included:

• Wednesday, 29 April 1931 — According to the Bismarck Tribune of Bismarck, North Dakota

• Someone asked why I would make biographical remarks about Kenneth W. Sell?

• Individuals perform research — You'll just have to find them

• An architect of research environments

• 2 January 1991 — A visit with Ken Sell at Emory University in Atlanta

The following sections are included:

• Introduction

• Bone Marrow Research to Serve the Combat Casualty

• Controlling the Immune Response to Aid Battlefield Casualties

• Navy Leading the Way in Transplantation Research

• References

The following sections are included:

• The Present

• The Future

In 1960, Dr. Sell joined the Navy Tissue Bank and became involved in studies looking at new applications in tissue banking that same year. Navy investigators initiated studies on bone marrow retrieval from cadaver donors and on bone marrow storage, including cryopreservation and storage in nutrient media for as long as two weeks. The successful use of frozen, thawed autologous bone marrow was first reported by Navy scientists in 1963. Further advances in the recovery of bone marrow from cadaver donors were published by Navy scientists in the early 1980s utilising vertebral bodies from cadaver donors as a source of bone marrow. Bone marrow from such donors has now become a prominent interest in both organ transplantation and bone marrow transplantation. In organ transplantation, this has been a source of cells for the studies now being carried out on the induction of tolerance and the mixed chimeric state…

The following sections are included:

• Foreword

• Introduction

• Central blood volume, peripheral blood volume and total blood volume

• Transfusion trigger

• Summary

• Acknowledgements

• References

The following sections are included:

• Summary

• Background

• Beginning of Unrelated Donor Marrow Transplantation in the US

• Navy, C.W. Bill Young Marrow Donor Recruitment and Research Program

• References

The following sections are included:

• Introduction

• Background
  • Source of haematopoietic progenitor cells
  • Conditioning regimens
  • Recombinant cytokines

• Results of Clinical Stem Cell Transplantation
  • Transplants for haematologic malignancy
  • Transplants for non-malignant disorders
  • HLA-non-identical stem cell grafts

• Complications of Transplant
  • Regimen-related toxicities of transplant preparative regimens
  • Haematologic and immune recovery
  • Infections
  • Graft-versus-host disease
  • Graft-versus-tumour effects of allografting
  • Graft failure
  • Recurrence of malignancy

• Future Directions of Stem Cell Transplantation

• Acknowledgements

• References

Upon his return from England and after pursuing his Ph.D., Dr. Sell brought with him a profound interest in establishing immunology as it applies to a variety of specialties. He became prominent in attracting scientists to the field of transplantation immunology at the Navy. Several scientists were assigned to the responsibility of developing immunosuppressive therapy through generation of anti-thymocyte globulin. The report in chapter 1 by Dr. Contreras attests to the success of this approach and the continuing contributions of investigators at the Navy to this field. Dr. Sell was also instrumental in facilitating the development of histocompatibility testing during this time and was one of the contributors to the establishment of the American Society of Histocompatibility and Immunogenetics (ASHI). Many immunological techniques were also developed for monitoring patients undergoing transplantation. Dr. Sundstrom reports in this chapter on modern technology now being investigated using cardiac myocytes for monitoring immunological events and understanding the role of cells undergoing immunological attack. The application of immunological principles was also a major undertaking for the field of musculoskeletal tissue transplantation. Dr. Friedlaender reports on immunological principles as they relate to bone transplantation in both experimental and clinical settings.

The following sections are included:

• Introduction

• T Cell Recognition of Antigenic Determinants on Non-Antigen Presenting Cells

• T Cell Responses to Allo-Antigen Versus Nominal Antigen

• Ability of Cardiac Myocytes to Process and Present Nominal Antigen

• Constitutive and Induced Expression of Genes Associated with Antigen Processing and Presentation in Cardiac Myocytes

• Pulse-Chase Studies

• Summary

• References

The following sections are included:

• Introduction

• Bone Biology

• Immune Responses
  • In general
  • Animal-derived data
  • Human-derived information

• Conclusions

• References

Dr. Sell's growing interest in clinical transplantation during the 1960s led to additional applications in organ and tissue preservation technology based at the Navy Tissue Bank. Various protocols were developed for the cryopreservation and storage of tissues such as bone marrow, tendons, kidneys, hearts, and heart valves. For example, scientists at the Navy became leaders in the field of organ perfusion preservation. Dr. Ronald Filo, who has contributed to this chapter, was one of the leaders of the group developing perfusion preservation of kidneys. At that time tissue bank technicians were trained not only in tissue recovery and processing, but also in organ retrieval and perfusion preservation. The increased interest led this group along with other Navy scientists to participate in the establishment of yet another society called the Society for Cryobiology.

The following sections are included:

• Introduction

• Freezing Injures Cells and Tissues in Four Ways
  • Extracellular ice
  • Intracellular ice
  • Mechanical injury
  • Cold denaturation of proteins

• Discussion

• Acknowledgement

• References

The following sections are included:

• Introduction

• Background

• Analysis

• Conclusion

• Acknowledgement

• References

The following sections are included:

• Introduction

• Methods

• Results

• Discussion

• References

The following sections are included:

• Introduction

• Materials and Methods
  • Specimen preparation
  • Experimental groups
  • Tendon failure testing
  • Calculation of failure stress, modulus and energy to failure
  • Data analysis

• Results
  • Lateral vs. medial halves of the same allograft tendon
  • Cryopreserved vs. frozen allografts
  • Irradiated frozen vs. frozen allografts

• Discussion

• Summary

• Acknowledgements

• References

The Navy's successful experience with freeze drying bone allografts during the 1970s led investigators at the Navy to develop this application for a variety of other tissues as well. In addition, with the breakout of the Korean War in 1950, there was a growing demand for tissues. As reports of the success of these various applications appeared in the medical literature, civilian institutions began to request access to tissues. A logical extension to this programme was developed to enable both Navy and civilian physicians to reciprocally benefit through collaboration. A “graft registry” was established in 1952 to collect clinical data and access the benefits of tissue transplantation. This was also the beginning of many collaborations throughout the United States. In this chapter two of these major collaborators report on progress in their fields. Dr. Henry Mankin pioneered the use of large osseous and osteochondral allografts in the replacement of bone for management of bone tumours. More recently, Dr. Alan Gross, also an early collaborator, has pioneered the use of “fresh” osteochondral allografts for osteochondral defects of the knee. Dr. Gross was a contributor in the 1975 proceedings of the Navy Tissue Bank, and both Drs. Mankin and Gross were contributors at the 1997 Symposium in honour of Dr. Sell.

The following sections are included:

• Introduction

• Background

• Bone Banking

• The Patient Series

• Results

• Discussion

• Conclusions

• References

The following sections are included:

• Introduction

• Procurement

• Surgical Technique

• Materials

• Results

• Discussion

• References

As described in the introduction to the previous chapter, many investigators benefited from collaborations with the United States Navy and from the ensuing development of applications in their own particular specialties. Dr. Donald Prolo, who reports in this chapter on neurosurgical applications of allogeneic tissue, is an example of such a collaborator. Dr. Prolo also received funding by the Navy during his early experimentation with allogeneic tissue and was a major contributor to the understanding of sterilisation effects on tissues…

The following sections are included:

• Introduction

• Delayed Cranioplasty/Remodelling of Skull

• Ethylene Oxide Sterilisation

• Neurosurgeon's Role in Transplantation; Morality of Brain Death Determinations

• Allografts in Anterior Cervical Fusion

• Yellow Bone/Tetracycline

• Experimental Canine Cranioplasty

• Sterilisation/Osteoinduction in Skull

• Canine Cranioplasty with AAA Grafts

• Composite Autogeneic Human Cranioplasty

• Human Skull Allografts

• Nonosteoclastic Resorption of Skull

• Human Skeletal Growth and Development

• Contributions on Bone Healing in Spinal Fusion and Human Cranioplasty

• Evaluating Results of Lumbar Spine Operations

• Evolutionary Healing of Cranial Grafts: Fresh Autograft, Demineralised Autolysed Antigen-extracted Allografts (AAA) and AAA Bone Powder

• Observations with Bone Morphogenetic Protein (BMP) in Cranial Defects at Six Months

• Preliminary Long-term Results of over 300 Patients Undergoing Posterior Lumbar Interbody Fusion (PLIF)

• Conclusion

• References

The following sections are included:

• Introduction

• Factors Important in the Function of Cardiovascular Grafts

• Immunogenicity of Cardiovascular Grafts

• Preservation of Cardiovascular Grafts

• Acknowledgments

• References

Many aspects of tissue banking had been included in Volume I of ADVANCES, with the exception of SKIN BANKING. This omission is rectified in this volume. Inclusion of papers dealing with this subject has a particular relevance to the tribute we seek to present for the life and work of Kenneth Sell. It was not until 1949, with the United States Tissue Bank, that modern day skin banking was heralded. This success, of course, drew upon the pioneering work of Thomas Gibson, Rupert Billingham and Peter Medawar in Glasgow and Oxford, UK, who demonstrated, for the first time, that allograft rejection was an immunological phenomenon, which Medawar terms as “actively acquired immunity.” A simple experiment has shown that a “second set” of skin grafts from a parent to a burned child were rejected more quickly than the first set. Dr. Billingham was a good friend to Dr. Sell and was also a presenter at the 1975 Symposium. Dr. Kagan, whoreviews human skin banking in this chapter, was a presenter at the 1997 Symposium…

The following sections are included:

• Skin Banking: Past

• Skin Banking: Present
  • Clinical uses of allograft skin
    • Coverage of extensive fill thickness wounds
    • Coverage of widely meshed skin autograffs
    • Healing of partial thickness wounds
    • Testing for later acceptance of autograft
    • Template for delayed application of keratinocytes
    • Micrografting techniques
  • Potential disadvantages of allograft skin use
    • Infection
    • Rejection
  • The growth of skin banking
  • Role of the american association of tissue banks
  • Technical aspects of skin banking
    • Donor screening
    • Skin recovey
    • Skin processing
      • Processing environment
      • Microbiologic testing
      • Maintenance of viability
    • Lyophilisation
      • Skin storage
      • Transport
      • Rewarming

• Skin Banking: Future
  • Allograft-based skin products

• References

The following sections are included:

• Introduction

• Dermoepidermal Autografts

• Dermoepidermal Allografts

• Dermoepidermal Xenografts

• Skin Banking Technologies

• Composite Grafts

• Conclusions

• References

The following sections are included:

• Introduction

• Patients and Methods

• Results

• Conclusions

• References

The following sections are included:

• Introduction

• Materials and Methods

• Results

• Discussion

• Summary

• References

The following sections are included:

• Introduction

• Materials And Methods
  • Cell culture
  • AlloDerm® Dermal matrix
  • Keratinocyte/AlloDerm® dermal matrix in vitro coculture
  • Preparation of polyurethane-HK grafts
  • Athymic mouse grafting model
  • Histological analysis of tissues
  • Electron microscopic analysis

• Results
  • Histology of AlloDerm matrix prior to grafting
  • AlloDerm/HK composite in vitro graft
  • Gross appearance of grafted wounds
  • Wound contraction
  • Histological examination of healed wounds
  • Ultrastructural findings

• Discussion

• Acknowledgement

• References