Abstract
Skin allografts from cadaver donors are an important resource for treating extensive burns, slow-healing wounds and chronic ulcers. A high level of cell viability of cryopreserved allografts is often required, especially in burn surgery, in Italy. Thus, we aimed to determine which conditions enable procurement of highly viable skin in our Regional Skin Bank of Siena. For this purpose, we assessed cell viability of cryopreserved skin allografts procured between 2011 and 2013 from 127 consecutive skin donors, before and after freezing (at day 15, 180, and 365). For each skin donor, we collected data concerning clinical history (age, sex, smoking, phototype, dyslipidemia, diabetes, cause of death), donation process (multi-tissue or multi-organ) and timing of skin procurement (assessment of intervals such as death-harvesting, harvesting-banking, death-banking). All these variables were analysed in the whole case study (127 donors) and in different groups (e.g. multi-organ donors, non refrigerated multi-tissue donors, refrigerated multi-tissue donors) for correlations with cell viability. Our results indicated that cryopreserved skin allografts with higher cell viability were obtained from female, non smoker, heartbeating donors died of cerebral haemorrhage, and were harvested within 2 h of aortic clamping and banked within 12 h of harvesting (13–14 h from clamping). Age, cause of death and dyslipidaemia or diabetes did not appear to influence cell viability. To maintain acceptable cell viability, our skin bank needs to reduce the time interval between harvesting and banking, especially for refrigerated donors.
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References
Banyard DA, Bourgeois JM, Widgerow AD, Evans GR (2015) Regenerative biomaterials: a review. Plast Reconstr Surg 135(6):1740–1748
Blackburn JH, Boemi L, Hall WW et al (1998) Negative-pressure dressings as a bolster for skin grafts. Ann Plast Surg 40(5):453–457
Bravo D, Rigley TH, Gibran N, Strong DM, Newman-Gage H (2000) Effect of storage and preservation methods on viability in transplantable human skin allografts. Burns 26(4):367–378
Castagnoli C, Alotto D, Cambieri I et al (2003) Evaluation of donor skin viability: fresh and cryopreserved skin using tetrazolium salt assay. Burns 29:759–767
Cleland H, Wasiak J, Dobson H et al (2014) Clinical application and viability of cryopreserved cadaveric skin allografts in severe burns: a retrospective analysis. Burns 40(1):61–66
EU guidelines to good manufacturing practice medicinal products for human and veterinary use—Annex 1, Ed. 2008
Franchini M, Zanini D, Bosinelli A et al (2009) Evaluation of cryopreserved donor skin viability: the experience of the regional tissue bank of Verona. Blood Transfus 7:100–105
Gaucher S, Jarraya M (2014) Cryopreserved human skin allografts: efficacy and viability. Burns 40(3):526–527
Gaucher S, Elie C, Verola O, Jarraya M (2012) Viability of cryopreserved human skin allografts: effects of transport media and cryoprotectants. Cell Tissue Bank 13:147–155
Greenleaf G, Hansbrough JF (1994) Current trends in the use of allograft skin for patients with burns and reflections on the future of skin banking in the United States. J Burn Care Rehabil 15(5):428–431
Hermans MHE (2011) Preservation methods of allografts and their (lack of) influence on clinical results in partial thickness burns. Burns 37(5):873–881
Kua EHJ, Goh CQ, Ting Y et al (2012) Comparing the use of glycerol preserved and cryopreserved allogenic skin for the treatment of severe burns: differences in clinical outcomes and in vitro tissue viability. Cell Tissue Bank 13:269–279
Leon-Villapalos J, Eldardiri M, Dziewulski P et al (2010) The use of human deceased donor skin allograft in burn care. Cell Tissue Bank 11(1):99–104
Li Z, Overend C, Maitz P, Kennedy P (2012) Quality evaluation of meshed split-thickness skin grafts stored at 4 °C in isotonic solutions and nutrient media by cell cultures. Burns 38(6):899–907
Linee guida per il prelievo, la processazione e la distribuzione dei tessuti a scopo di trapianto (2013) Centro Nazionale per i Trapianti (CNT). Linee guida Centro Nazionale Trapianti 10 luglio 2013, LG190607. http://www.trapianti.salute.gov.it
May SR, Roberts DP (1988) Development of a passive device for freezing large amounts of transplantable skin at one time in a −70 °C mechanical refrigerator. Cryobiology 25:186–196
Pianigiani E, Ierardi F, Cherubini F et al (2005) Skin bank organization. Clin Dermatol 23(4):353–356
Pianigiani E, Ierardi F, Cuciti C et al (2010) Processing efficacy in relation to microbial contamination of skin allografts from 723 donors. Burns 36:347–351
Pianigiani E, Ierardi F, Fimiani M (2013) Importance of good manufacturing practices in microbiological monitoring in processing human tissues for transplant. Cell Tissue Bank 14(4):601–607
Pirnay JP, Verween G, Pascual B et al (2012) Evaluation of a microbiological screening and acceptance procedure for cryopreserved skin allografts based on 14 day cultures. Cell Tissue Bank 13(2):287–295
Robb EC, Bechmann N, Plessinger RT et al (2001) Storage media and temperature maintain normal anatomy of cadaveric human skin for transplantation to full-thickness skin wounds. J Burn Care Rehabil 22(6):393–396
Rooney P, Eagle M, Hogg P et al (2008) Sterilisation of skin allograft with gamma irradiation. Burns 34(5):664–673
Saffle JR (2009) Closure of the excised burn wound: temporary skin substitutes. Clin Plast Surg 36(4):627–641
Schiozer WA, Gemperli R, Mühlbauer W et al (2013) An outcome analysis and long-term viability of cryopreserved cultured epidermal allografts. Assessment of the conservation of transplantable human skin allografts. Acta Cirúrgica Brasileira 28(12):824–832
See P, Phan TT, Chua JJ et al (2001) Our clinical experience using cryopreserved cadaveric allograft for the management of severe burns. Cell Tissue Banking 2:113–117
Udoh Y, Yanaga H, Tai Y et al (2000) Long-term viability of cryopreserved cultured epithelial grafts. Burns 26(6):535–542
Verbeken G, Verween G, De Vos D et al (2012) Glycerol treatment as recovery procedure for cryopreserved human skin allografts positive for bacteria and fungi. Cell Tissue Bank 13(1):1–7
Walcerz DB, Karow AM (1996) Cryopreservation of cells for tissue engineering. Tissue Eng 2(2):85–96
Wang H, Liu X, Umino T et al (2001) Cigarette smoke inhibits human bronchial epithelial cell repair processes. Am J Respir Cell Mol Biol 25(6):772–779
Wood JM, Soldin M, Shaw TJ, Szarko M (2014) The biomechanical and histological sequelae of common skin banking methods. J Biomech 47(5):1215–1219
Yang GY, Zhang CL, Liu XC et al (2013) Effects of cigarette smoke extracts on the growth and senescence of skin fibroblasts in vitro. Int J Biol Sci 9(6):613–623
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Pianigiani, E., Tognetti, L., Ierardi, F. et al. Assessment of cryopreserved donor skin viability: the experience of the regional tissue bank of Siena. Cell Tissue Bank 17, 241–253 (2016). https://doi.org/10.1007/s10561-016-9550-0
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DOI: https://doi.org/10.1007/s10561-016-9550-0