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Mariemadeleine Dolmans - One of the best experts on this subject based on the ideXlab platform.
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evaluation of ovarian Tissue Transplantation results from three clinical centers
Fertility and Sterility, 2020Co-Authors: Moran Shapira, Mariemadeleine Dolmans, Sherman J Silber, Dror MeirowAbstract:Objective To report ovarian Tissue autoTransplantation (AT) results and describe the relationship between technical and clinical factors and outcomes. Design Multicenter retrospective cohort study. Setting Tertiary medical centers. Patient(s) Infertile patients who had stored ovarian Tissue before sterilizing treatment and returned for AT with the aim of conceiving. Interventions(s) Ovarian Tissue cryopreservation (OTC) and AT, endocrine monitoring, in vitro fertilization. Main Outcome Measure(s) Endocrine performance, pregnancy and live-birth rates. Result(s) From 2004 to 2018, 70 patients underwent 87 ATs. Sixty patients undergoing 70 ATs met the inclusion criteria. After AT, menses returned in 94% of patients and median FSH dropped from 68 to 19 IU/mL. Fifty pregnancies and 44 deliveries were attained, with 50% of women achieving at least one pregnancy and 41.6% at least one delivery. Twelve patients underwent AT more than once and had their endocrine activity restored in case menses recurred after the first Transplantation. Repeated Transplantations yielded five live births in three patients, two of whom had already given birth after the first Transplantation. Preharvesting chemotherapy was not associated with inferior outcomes. Of seven patients whose pelvis was exposed to radiation before AT, four conceived and delivered. Neither Tissue dimensions nor surgical approach affected fertility outcomes. Conclusion(s) OTC is highly effective at restoring fertility in sterilized patients, and prior exposure to chemotherapy should not be considered a contraindication. Repeated AT should be contemplated in case of graft malfunction, especially if previous Transplantation was successful. In selected cases, conception and delivery may be feasible after pelvic exposure to radiation
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adipose Tissue derived stem cells in a fibrin implant enhance neovascularization in a peritoneal grafting site a potential way to improve ovarian Tissue Transplantation
Human Reproduction, 2018Co-Authors: D D Manavella, Mariemadeleine Dolmans, Jacques Donnez, Luciana Cacciottola, Celine M Desmet, Benedicte F Jordan, Christiani Andrade AmorimAbstract:STUDY QUESTION Do two different concentrations of human adipose Tissue-derived stem cells (ASCs) embedded inside a fibrin scaffold have the potential to differentiate into vessels and aid vascularization in a peritoneal grafting site intended for ovarian Tissue Transplantation? SUMMARY ANSWER Human ASCs in low and high concentrations differentiated into vessels when transplanted to mouse peritoneum inside a fibrin matrix, but only high ASC concentrations significantly increased human vessel area 14 days after Transplantation. WHAT IS KNOWN ALREADY ASCs have multilineage differentiation potential, including proangiogenic properties and have been used in Tissue engineering to enhance vascularization in transplanted Tissues. Fibrin has been studied and used as an ASC-compatible biomaterial. STUDY DESIGN, SIZE, DURATION In vivo experimental model using 22 severe combined immunodeficient mice. In total, 16 mice (eight per group) were intraperitoneally grafted with a fibrin scaffold loaded with two different human ASC concentrations (either 150 000 [L-ASC] or 1 500 000 [H-ASC] cells) and lithium phthalocyanine (LiPc) crystals as oxygen-sensitive probes. Six mice were grafted with an empty fibrin (EF) implant containing only LiPc and served as controls. Levels of partial pressure of oxygen (pO2) in implants were monitored in vivo by electron paramagnetic resonance oximetry (EPR). ASC identification, proliferation, and host and human vascularization were analyzed by immunohistochemistry (IHC). All analyses were performed on post-grafting Days 3, 7 and 14. PARTICIPANTS/MATERIALS, SETTING, METHODS Prospective experimental study conducted at the Gynecology Research Unit, Universite Catholique de Louvain. All materials were used to perform pO2 measurements (EPR oximetry), as well as histological (hematoxylin-eosin staining) and IHC (anti-human vimentin, anti-human Ki67, anti-mouse and human double CD34) analyses. MAIN RESULTS AND THE ROLE OF CHANCE A significant increase in pO2 in implants was observed in all groups between Days 3 and 7 (P < 0.001). ASC-loaded implants displayed a tendency towards increased pO2 levels from Days 7 to 14, not observed in EF implants. ASC-loaded implants showed differentiation into human CD34-positive vessels. Total CD34-positive endothelial area was correlated to pO2 values obtained by EPR oximetry (r = 0.6506, P = 0.0019). In the H-ASC group, a greater human CD34-positive vascular surface area was found compared to the L-ASC group 14 days after Transplantation (P < 0.0049). LARGE SCALE DATA N/A. LIMITATIONS REASONS FOR CAUTION As demonstrated by our results, ASCs transplanted inside a fibrin matrix can differentiate into CD34-positive human vessels. However, other possible mechanisms involved in ASC angiogenic behavior remain to be investigated. WIDER IMPLICATIONS OF THE FINDINGS High concentrations of ASCs loaded inside a fibrin scaffold could serve as a substrate to prepare a peritoneal grafting site over 14 days, in order to enhance vascularization once human ovarian Tissue is grafted. Our proposed preparation of the grafting site would not only benefit ovarian Tissue Transplantation, but also other experimental avascular grafting procedures. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by grants from the Fonds National de la Recherche Scientifique de Belgique (FNRS-PDR Convention T.0077.14, Televie Grant no. 7.6515.16F awarded to DDM and Grant 5/4/150/5 awarded to M.M.D. [CAA is FRS-FNRS research associate]), Fonds Speciaux de Recherche, and Fondation St Luc, Foundation Against Cancer, and donations from the Ferrero family. None of the authors have any competing interests to declare.
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heterotopic ovarian Tissue Transplantation
2016Co-Authors: Michelle Soares, Mariemadeleine Dolmans, Jacques DonnezAbstract:Restoration of ovarian function has been consistently observed after Transplantation of ovarian Tissue to heterotopic sites, and recent reports now confirm that ovarian function following heterotopic Transplantation can last more than 7 years, depending on the initial ovarian reserve. The possibility of long-term restoration of ovarian function, combined with the advantage of a less invasive and more cost-efficient procedure (especially when considering repeated Transplantations), makes heterotopic Transplantation the technique of choice when the main goal of grafting is restoration of endocrine function.
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impact of the cryopreservation technique and vascular bed on ovarian Tissue Transplantation in cynomolgus monkeys
Journal of Assisted Reproduction and Genetics, 2015Co-Authors: Mariemadeleine Dolmans, Jacques Donnez, Maria Mercedes Binda, Sophie Jacobs, Jeanpaul Dehoux, Jeanluc Squifflet, Jerome Ambroise, Christiani Andrade AmorimAbstract:Purpose The aim of this study was to determine the best combination in terms of cryopreservation techniques and vascular bed preparation before grafting in order to obtain functional ovarian Tissue after Transplantation.
Ronald C Kahn - One of the best experts on this subject based on the ideXlab platform.
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Transplantation of adipose Tissue and stem cells role in metabolism and disease
Nature Reviews Endocrinology, 2010Co-Authors: Thien T Tran, Ronald C KahnAbstract:Adipose Tissue Transplantation is increasingly being explored as a treatment strategy for metabolic disease—to promote the beneficial metabolic effects of subcutaneous white adipose Tissue and brown adipose Tissue, as well as those of adipose-derived stem cells. This Review summarizes the current available data on the biology of different adipose Tissue depots and conceptualizes the future of adipose Tissue Transplantation and ongoing research. Humans and other mammals have three main adipose Tissue depots: visceral white adipose Tissue, subcutaneous white adipose Tissue and brown adipose Tissue, each of which possesses unique cell-autonomous properties. In contrast to visceral adipose Tissue, which can induce detrimental metabolic effects, subcutaneous white adipose Tissue and brown adipose Tissue have the potential to benefit metabolism by improving glucose homeostasis and increasing energy consumption. In addition, adipose Tissue contains adipose-derived stem cells, which possess the ability to differentiate into multiple lineages, a property that might be of value for the repair or replacement of various damaged cell types. Adipose Tissue Transplantation has primarily been used as a tool to study physiology and for human reconstructive surgery. Transplantation of adipose Tissue is, however, now being explored as a possible tool to promote the beneficial metabolic effects of subcutaneous white adipose Tissue and brown adipose Tissue, as well as adipose-derived stem cells. Ultimately, the clinical applicability of adipose Tissue Transplantation for the treatment of obesity and metabolic disorders will reside in the achievable level of safety, reliability and efficacy compared with other treatments.
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Transplantation of adipose Tissue and stem cells role in metabolism and disease
Nature Reviews Endocrinology, 2010Co-Authors: Thien T Tran, Ronald C KahnAbstract:Humans and other mammals have three main adipose Tissue depots: visceral white adipose Tissue, subcutaneous white adipose Tissue and brown adipose Tissue, each of which possesses unique cell-autonomous properties. In contrast to visceral adipose Tissue, which can induce detrimental metabolic effects, subcutaneous white adipose Tissue and brown adipose Tissue have the potential to benefit metabolism by improving glucose homeostasis and increasing energy consumption. In addition, adipose Tissue contains adipose-derived stem cells, which possess the ability to differentiate into multiple lineages, a property that might be of value for the repair or replacement of various damaged cell types. Adipose Tissue Transplantation has primarily been used as a tool to study physiology and for human reconstructive surgery. Transplantation of adipose Tissue is, however, now being explored as a possible tool to promote the beneficial metabolic effects of subcutaneous white adipose Tissue and brown adipose Tissue, as well as adipose-derived stem cells. Ultimately, the clinical applicability of adipose Tissue Transplantation for the treatment of obesity and metabolic disorders will reside in the achievable level of safety, reliability and efficacy compared with other treatments.
Kutluk Oktay - One of the best experts on this subject based on the ideXlab platform.
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robot assisted orthotopic and heterotopic ovarian Tissue Transplantation techniques surgical advances since our first success in 2000
Fertility and Sterility, 2019Co-Authors: Kutluk Oktay, Enes Taylan, T Kawahara, Giulia M CilloAbstract:Objective To demonstrate the technical advances since the time we reported the first successful case in 2000 and our modern approach to autologous Transplantation of frozen-thawed human ovarian Tissue. Design A step-by-step video demonstration of three surgical approaches was created by editing the surgical footage obtained during ovarian Transplantation procedures. Setting Academic. Patient(s) Three patients who previously underwent ovarian Tissue harvesting and cryopreservation before gonadotoxic cancer treatments or radical cancer surgery are presented. Intervention(s) The illustrated techniques include robot-assisted orthotopic (technique 1) and heterotopic (technique 2) approaches using the da Vinci Xi (Intuitive Surgical) robotic system and a decellularized human extracellular Tissue matrix (Alloderm; LifeCell Corp.) as a Tissue scaffold, as well as a percutaneous autoTransplantation approach (technique 3). Main Outcome Measure(s) Successful completion of procedures without complications and ovarian graft function with demonstration of E2 production and follicle development. Result(s) All cases were completed without complications. Ovarian graft function was confirmed by E2 production, follicle growth by 10–14 weeks after Transplantation, and later embryo development. Conclusion(s) Since our first report of successful restoration of ovarian function after orthotopic Transplantation of frozen-banked ovarian Tissue in 2000 (1) , followed by our first reports of subcutaneous heterotopic Transplantation techniques 2 , 3 , ovarian Tissue cryopreservation followed by subsequent Transplantation has become a promising fertility preservation option for young women with cancer who do not have sufficient time to undergo oocyte or embryo cryopreservation and for prepubertal girls 4 , 5 . The same approach also has the advantage of restoring ovarian endocrine function and fertility without a need for assisted reproduction 6 , 7 . In the very first successful procedure that we reported in 2000, we used conventional laparoscopy, and the Tissues were reconstructed and mounted on a polycellulose scaffold (Surgicel) 1 , 7 . Since then, we have made significant modifications in our surgical approach with potential improvements in outcomes. Here we illustrate three main techniques of ovarian Tissue Transplantation resulting in the restoration of ovarian function in all cases. In the first two cases, we illustrated the robot-assisted orthotopic and heterotopic approaches using Alloderm. Robotic ovarian Transplantation may increase precision, provide more delicate graft handling, and reduce the time from Tissue thawing to Transplantation 6 , 8 . Alloderm is regenerated de-epithelized human cadaver skin, which consists of several extracellular matrix components. It has been safely used in the surgery and dentistry fields for enhancing Tissue regeneration and vascularization 10 , 9 . Furthermore, our earlier laboratory work indicated the critical role of extracellular matrix in primordial follicle growth initiation and preantral follicle growth 11 , 12 . Prior to our use of Alloderm as part of ovarian transplant procedures, we tested it in human ovarian xenograft models and found Alloderm to incorporate well with ovarian Tissue (8) . Only after that test did we adopt it for use in ovarian transplants. The utility of the extracellular Tissue matrix may thus enhance our ovarian autoTransplantation techniques by facilitating ovarian reconstruction and potentially improving neovascularization. In fact, we have seen improved follicle growth and response to ovarian stimulation with the use of Alloderm in our first cases (8) . We use heterotopic ovarian Transplantation when the pelvis is not suitable for autoTransplantation due to past radiation or scarring or when there are other medical contraindications for Transplantation in the pelvis. The third technique we illustrated was percutaneous heterotopic ovarian autoTransplantation. This is a simple approach that can be used in surgically high-risk patients, as it is done with local anesthesia or IV sedation and without entering abdominal cavity. Additionally, same approach can be utilized when there is heightened concern that the ovarian Tissue may harbor a disease that can recur, requiring close surveillance and easier removal of the ovarian graft. While ovarian endocrine function and follicle growth are restored with efficiency using the percutaneous ovarian transplants, our initial experience suggests that oocyte quality may be impaired in SC locations 13 , 2 , 3 . Hence that technique may be more suitable when the only purpose is restoration of ovarian endocrine function. However, we have encountered recurrent live births from spontaneous conceptions following SC ovarian transplants, prompting the question of whether the grafted Tissue can augment the function of in situ menopausal ovary 13 , 14 . While ovarian cryopreservation and Transplantation may no longer be considered experimental, there are many exciting questions remaining to be answered on the full potential of this procedure.
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orthotopic and heterotopic ovarian Tissue Transplantation
Best Practice & Research in Clinical Obstetrics & Gynaecology, 2010Co-Authors: Murat Sonmezer, Kutluk OktayAbstract:Although still experimental, cryopreservation and Transplantation techniques for ovarian Tissue have been well described, and a number of successful human pregnancies have occurred. Ovarian cryopreservation is the only fertility preservation procedure that can be offered to prepubertal children, and when cytotoxic treatment is urgent. There are two main approaches for autoTransplantation of human ovarian Tissue. In the heterotopic Transplantation, cortical fragments can be grafted subcutaneously at various sites whereas in orthotopic Transplantation cortical pieces are transplanted into its original location. Both approaches have their own advantages and disadvantages. While natural pregnancy can occur in orthotopic Transplantation, heterotopic Transplantation may be indicated if the pelvis is not suitable for Transplantation due to previous radiation or severe scar formation. Furthermore, Tissue monitoring may be easier in the heterotopic site. In this article, we reviewed the indications, limitations, risks and Transplantation techniques for ovarian Tissue.
Thien T Tran - One of the best experts on this subject based on the ideXlab platform.
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Transplantation of adipose Tissue and stem cells role in metabolism and disease
Nature Reviews Endocrinology, 2010Co-Authors: Thien T Tran, Ronald C KahnAbstract:Adipose Tissue Transplantation is increasingly being explored as a treatment strategy for metabolic disease—to promote the beneficial metabolic effects of subcutaneous white adipose Tissue and brown adipose Tissue, as well as those of adipose-derived stem cells. This Review summarizes the current available data on the biology of different adipose Tissue depots and conceptualizes the future of adipose Tissue Transplantation and ongoing research. Humans and other mammals have three main adipose Tissue depots: visceral white adipose Tissue, subcutaneous white adipose Tissue and brown adipose Tissue, each of which possesses unique cell-autonomous properties. In contrast to visceral adipose Tissue, which can induce detrimental metabolic effects, subcutaneous white adipose Tissue and brown adipose Tissue have the potential to benefit metabolism by improving glucose homeostasis and increasing energy consumption. In addition, adipose Tissue contains adipose-derived stem cells, which possess the ability to differentiate into multiple lineages, a property that might be of value for the repair or replacement of various damaged cell types. Adipose Tissue Transplantation has primarily been used as a tool to study physiology and for human reconstructive surgery. Transplantation of adipose Tissue is, however, now being explored as a possible tool to promote the beneficial metabolic effects of subcutaneous white adipose Tissue and brown adipose Tissue, as well as adipose-derived stem cells. Ultimately, the clinical applicability of adipose Tissue Transplantation for the treatment of obesity and metabolic disorders will reside in the achievable level of safety, reliability and efficacy compared with other treatments.
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Transplantation of adipose Tissue and stem cells role in metabolism and disease
Nature Reviews Endocrinology, 2010Co-Authors: Thien T Tran, Ronald C KahnAbstract:Humans and other mammals have three main adipose Tissue depots: visceral white adipose Tissue, subcutaneous white adipose Tissue and brown adipose Tissue, each of which possesses unique cell-autonomous properties. In contrast to visceral adipose Tissue, which can induce detrimental metabolic effects, subcutaneous white adipose Tissue and brown adipose Tissue have the potential to benefit metabolism by improving glucose homeostasis and increasing energy consumption. In addition, adipose Tissue contains adipose-derived stem cells, which possess the ability to differentiate into multiple lineages, a property that might be of value for the repair or replacement of various damaged cell types. Adipose Tissue Transplantation has primarily been used as a tool to study physiology and for human reconstructive surgery. Transplantation of adipose Tissue is, however, now being explored as a possible tool to promote the beneficial metabolic effects of subcutaneous white adipose Tissue and brown adipose Tissue, as well as adipose-derived stem cells. Ultimately, the clinical applicability of adipose Tissue Transplantation for the treatment of obesity and metabolic disorders will reside in the achievable level of safety, reliability and efficacy compared with other treatments.
Xiaoxue Yuan - One of the best experts on this subject based on the ideXlab platform.
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brown adipose Tissue Transplantation ameliorates polycystic ovary syndrome
Proceedings of the National Academy of Sciences of the United States of America, 2016Co-Authors: Xiaoxue Yuan, Chuanhai Zhang, Han Zhao, Yuanyuan Huang, Jun Lin, Hanlin Zhang, Gang Wei, Huiqiao Zhou, Meng DongAbstract:Polycystic ovary syndrome (PCOS), which is characterized by anovulation, hyperandrogenism, and polycystic ovaries, is a complex endocrinopathy. Because the cause of PCOS at the molecular level is largely unknown, there is no cure or specific treatment for PCOS. Here, we show that Transplantation of brown adipose Tissue (BAT) reversed anovulation, hyperandrogenism, and polycystic ovaries in a dehydroepiandrosterone (DHEA)-induced PCOS rat. BAT Transplantation into a PCOS rat significantly stabilized menstrual irregularity and improved systemic insulin sensitivity up to a normal level, which was not shown in a sham-operated or muscle-transplanted PCOS rat. Moreover, BAT Transplantation, not sham operation or muscle Transplantation, surprisingly improved fertility in PCOS rats. Interestingly, BAT Transplantation activated endogenous BAT and thereby increased the circulating level of adiponectin, which plays a prominent role in whole-body energy metabolism and ovarian physiology. Consistent with BAT Transplantation, administration of adiponectin protein dramatically rescued DHEA-induced PCOS phenotypes. These results highlight that endogenous BAT activity is closely related to the development of PCOS phenotypes and that BAT activation might be a promising therapeutic option for the treatment of PCOS.
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brown adipose Tissue Transplantation reverses obesity in ob ob mice
Endocrinology, 2015Co-Authors: Xiaomeng Liu, Chuanhai Zhang, Jun Lin, Meng Dong, Siping Wang, Yilin You, Minghui Meng, Zongji Zheng, Qianwei Zhao, Xiaoxue YuanAbstract:Increasing evidence indicates that brown adipose Tissue (BAT) Transplantation enhances whole-body energy metabolism in a mouse model of diet-induced obesity. However, it remains unclear whether BAT also has such beneficial effects on genetically obese mice. To address this issue, we transplanted BAT from C57/BL6 mice into the dorsal subcutaneous region of age- and sex-matched leptin deficient Ob/Ob mice. Interestingly, BAT Transplantation led to a significant reduction of body weight gain with increased oxygen consumption and decreased total body fat mass, resulting in improvement of insulin resistance and liver steatosis. In addition, BAT Transplantation increased the level of circulating adiponectin, whereas it reduced the levels of circulating free T3 and T4, which regulate thyroid hormone sensitivity in peripheral Tissues. BAT Transplantation also increased β3-adrenergic receptor and fatty acid oxidation related gene expression in subcutaneous and epididymal (EP) white adipose Tissue. Accordingly, BAT Transplantation increased whole-body thermogenesis. Taken together our results demonstrate that BAT Transplantation may reduce obesity and its related diseases by activating endogenous BAT.