Multifunctional hybrid hydrogel for the prevention of post-surgery tumor recurrence.

In this study, we present a multifunctional hybrid hydrogel (MFHH) for the prevention of postoperative tumor recurrence. MFHH consists of two components; component A - containing a gelatin-based cisplatin, which destroys the residual cancer after surgery, and component B - containing macroporous gelatin microcarriers (CultiSpher) loaded with freeze-dried bone marrow stem cells (BMSCs), which activates the wound healing process. We also evaluated the effects of MFHH in a subcutaneous Ehrlich tumor mouse model. MFHH acted as a local delivery system by directly supplying cisplatin to the tumor environment, resulting in excellent anti-cancer effects and minimal side effects. MFHH released cisplatin gradually to destroy the residual tumors, thereby preventing loco-regional recurrence. We have also demonstrated that BMSCs are able to inhibit residual tumor growth. Moreover, CultiSpher loaded with BMSCs acted as an injection 3D scaffold and easily filled the wound defect formed by tumor removal, and the paracrine factors of the freeze-dried BMSCs accelerated the wound healing process. The components of the MFHH can be used both separately and together. However, for the successful application of MFHH in clinical practice, it is necessary to study in more detail the role of paracrine factors of freeze-dried BMSCs in the inhibition or proliferation of residual cancer. These questions will be the focus of our future research.

Efficacy of percutaneous biliary and pancreatic duct drainage/stenting with double invaginated pancreatojejunostomy after pancreatoduodenectomy.

AIM: To evaluate the efficacy and feasibility of preoperative percutaneous pancreatic duct drainage (PPDD) and improve the safety of pancreatojejunal anastomosis, we refer to our experience from 2013 to 2017 that include the last series of 27 cases of PD for 14 pancreatic and 13 ampullary tumors. Apart from the standard "classic" Whipple procedure in 17 cases, and the "modified"pylorus-preserving variant (ppPD) in 10 cases, in 26 cases a pancreaticojejunostomy and in 1 case a pancreatico gastrostomy was performed. In last series the percutaneous biliary drainage procedure in 18 cases and dual biliary + pancreatic duct decompression in 4 casas was performed. In 21 cases the biliary drainage was used as transanastomotic stent during hepaticojejunostomy and in 3 cases the pancreatic duct drainage was also used as transanastomitic stent at our method of performing the double invaginated pancreatojejunostomy. RESULTS: Without operative mortality in our series of PD, there were however some complications requiring in two patients interventional radiologic and intensive care management, and 5 patients died at follow up period (6 months - 3 years). There was no postoperative pancreatic fistula in our last series of PD, where preoperative biliary and pancreatic duct drainage and our modified double invaginated pancreatojejunostomy was performed. CONCLUSIONS: Despite our limited experience, we can conclude that preoperative percutaneous biliary and pancreatic drainage is feasible, safe, effective and a realistic mini invasive procedure. The preliminary results obtained with the described method of double invaginated pancreatojejunostomy with transanastomotic stent and external pancreatic duct drainage are very encouraging and indicate that this technique is less complicated and time consuming, very safe, simple, easy to perform and also applicable almost to all situations. KEY WORDS: Invaginated Pancreatojejunostomy Pancreatoduodenectomy, Pancreatic Duct Drainage.

Decellularized bovine placentome for portacavally-interposed heterotopic liver transplantation in rats.

Scaffolds from healthy placentae offer advantages for tissue engineering with undamaged matrix, associated cytoprotective molecules, and embedded vessels for revascularization. As size disparities in human placenta and small recipients hamper preclinical studies, we studied alternative of bovine placentomes in smaller size ranges. Multiple cow placentomes were decellularized and anatomical integrity was analyzed. Tissue engineering used inbred donor rat livers. Placentomes were hepatized and immediately transplanted in rats with perfusion from portal vein and drainage into inferior vena cava. Cows yielded 99 ±â€¯16 placentomes each. Of these, approximately 25% had 3 to 9 cm diameter and 7 to 63 ml volume, which was suitable for transplantation. After decellularization, angiography and casts documented 100% of vessels and vascular networks were well-perfused without disruptions or leaks. The residual matrix also remained intact for transplantation of placentomes. Perfusion in transplanted placentomes was maintained over up to 30 days. Liver tissue reassembled with restoration of hepatic acinar and sinusoidal structure. Transplanted tissue was intact without apoptosis, or necrosis. Hepatic functions were maintained. Preservation of hepatic homeostasis was verified by cytofluorimetric analysis of hepatocyte ploidy. The prevalence in healthy and transplanted liver of diploid, tetraploid and higher ploidy classes was similar with 57%, 41% and 2% versus 51%, 46.5% and 2.6%, respectively, p = 0.77, ANOVA. CONCLUSIONS: Cow placentomes will allow therapeutic development with disease models in small animals. This will also advance drug or toxicology studies. Portasystemic interposition of engineered liver will be particularly suitable for treating hepatic insufficiencies (metabolic, secretory or detoxification needs), including for children or smaller adults.