SiM | Der Simulierte Mensch
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„Der Simulierte Mensch“ ("The Simulated Human", Si-M) is a new research building which is currently under construction and is expected to be finished in 2023. The building site is directly adjacent to the Charité Campus Virchow-Klinikum of the Charité - Universitätsmedizin in Berlin-Wedding and is also the birthplace of biotechnology at the TU Berlin.

The initiators of Si-M are Roland Lauster (Head of the Department of Medical Biotechnology at TU Berlin) and Andreas Thiel (Head of the research group Regenerative Immunology and Aging at Charité – Universitätsmedizin Berlin). They applied for the research building in 2018 (GG §91b) and successfully defended it before the German Science Council.

In the building, scientists from both institutions will work together to simulate the functions of human cells and tissues with new technologies of 3D cultivation, multi-organ chips or 3D bioprinting. In contrast to already existing collaborative projects, the building will be used to practice the joint development of models "side by side" in the same laboratory environment. In this way, both the development of organ models and technological developments can be adapted and optimized at the same time.

More information via https://www.si-m.org .

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Dual versus single vessel normothermic ex vivo perfusion of rat liver grafts using metamizole for vasodilatation
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F. Claussen, J.M.G.V. Gassner, S. Moosburner, D. Wyrwal, M. Nösser, P. Tang, L. Wegener, J. Pohl, A. Reutzel-Selke, R. Arsenic, J. Pratschke, I.M. Sauer, and N. Raschzok published their trecent work on "Dual versus single vessel normothermic ex vivo perfusion of rat liver grafts using metamizole for vasodilatation" in PLoS One 2020;15(7): e0235635.

Normothermic ex vivo liver perfusion (NEVLP) is a promising strategy to increase the donor pool in liver transplantation. Small animal models are essential to further investigate questions regarding organ preservation and reconditioning by NEVLP. A dual vessel small animal NEVLP (dNEVLP) model was developed using metamizole as a vasodilator and compared to conventional portovenous single vessel NEVLP (sNEVLP).

Livers of male Wistar rats were perfused with erythrocyte-supplemented culture medium for six hours by either dNEVLP via hepatic artery and portal vein or portovenous sNEVLP. dNEVLP was performed either with or without metamizole treatment. Perfusion pressure and flow rates were constantly monitored. Transaminase levels were determined in the perfusate at the start and after three and six hours of perfusion. Bile secretion was monitored and bile LDH and GGT levels were measured hourly. Histopathological analysis was performed using liver and bile duct tissue samples after perfusion.

Hepatic artery pressure was significantly lower in dNEVLP with metamizole administration. Compared to sNEVLP, dNEVLP with metamizole treatment showed higher bile production, lower levels of transaminases during and after perfusion as well as significantly lower necrosis in liver and bile duct tissue. Biochemical markers of bile duct injury showed the same trend.

Our miniaturized dNEVLP system enables normothermic dual vessel rat liver perfusion. The administration of metamizole effectively ameliorates arterial vasospasm allowing for six hours of dNEVLP, with superior outcome compared to sNEVLP.

Magnetic resonance elastography quantification of decellularized liver tissue
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"Magnetic resonance elastography quantification of the solid-to-fluid transition of liver tissue due to decellularization" was published in the latest issue of the Journal of the Mechanical Behavior of Biomedical Materials.

Maintenance of tissue extracellular matrix (ECM) and its biomechanical properties for tissue engineering is one of the substantial challenges in the field of decellularization and recellularization. Preservation of the organ-specific biomatrix is crucial for successful recellularization to support cell survival, proliferation, and functionality. However, understanding ECM properties with and without its inhabiting cells as well as the transition between the two states lacks appropriate test methods capable of quantifying bulk viscoelastic parameters in soft tissues.
We used compact magnetic resonance elastography (MRE) with 400, 500, and 600 Hz driving frequency to investigate rat liver specimens for quantification of viscoelastic property changes resulting from decellularization. Tissue structures in native and decellularized livers were characterized by collagen and elastin quantification, histological analysis, and scanning electron microscopy.
Decellularization did not affect the integrity of microanatomy and structural composition of liver ECM but was found to be associated with increases in the relative amounts of collagen by 83-fold (37.4 ± 17.5 vs. 0.5 ± 0.01 μg/mg, p = 0.0002) and elastin by approx. 3-fold (404.1 ± 139.6 vs. 151.0 ± 132.3 μg/mg, p = 0.0046). Decellularization reduced storage modulus by approx. 9-fold (from 4.9 ± 0.8 kPa to 0.5 ± 0.5 kPa, p < 0.0001) and loss modulus by approx. 7-fold (3.6 kPa to 0.5 kPa, p < 0.0001), indicating a marked loss of global tissue rigidity as well as a property shift from solid towards more fluid tissue behavior (p = 0.0097).
Our results suggest that the rigidity of liver tissue is largely determined by cellular components, which are replaced by fluid-filled spaces when cells are removed. This leads to an overall increase in tissue fluidity and a viscous drag within the relatively sparse remaining ECM. Compact MRE is an excellent tool for quantifying the mechanical properties of decellularized biological tissue and a promising candidate for useful applications in tissue engineering.

Authors are Hannah Everwien, Angela Ariza de Schellenberger, Nils Haep, Heiko Tzschätzsch, Johann Pratschke, Igor M. Sauer, Jürgen Braun, Karl H. Hillebrandt and Ingolf Sack.

J Mech Behav Biomed Mater. 2020 Apr;104:103640. doi: 10.1016/j.jmbbm.2020.103640. Epub 2020 Jan 14.
Hepatocyte transplantation to the liver via the splenic artery
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Hepatocyte transplantation (HcTx) is a promising approach for the treatment of metabolic diseases in newborns and children. The most common application route is the portal vein, which is difficult to access in the newborn. Transfemoral access to the splenic artery for HcTx has been evaluated in adults, with trials suggesting hepatocyte translocation from the spleen to the liver with a reduced risk for thromboembolic complications. Using juvenile Göttingen minipigs, we aimed to evaluate feasibility of hepatocyte transplantation by transfemoral splenic artery catheterization, while providing insight on engraftment, translocation, viability, and thromboembolic complications. Four Göttingen Minipigs weighing 5.6 kg to 12.6 kg were infused with human hepatocytes (two infusions per cycle, 1.00E08 cells per kg body weight). Immunosuppression consisted of tacrolimus and prednisolone. The animals were sacrificed directly after cell infusion (n=2), 2 days (n=1), or 14 days after infusion (n=1). The splenic and portal venous blood flow was controlled via color-coded Doppler sonography. Computed tomography was performed on days 6 and 18 after the first infusion. Tissue samples were stained in search of human hepatocytes. Catheter placement was feasible in all cases without procedure-associated complications. Repetitive cell transplantations were possible without serious adverse effects associated with hepatocyte transplantation. Immunohistochemical staining has proven cell relocation to the portal venous system and liver parenchyma. However, cells were neither present in the liver nor the spleen 18 days after HcTx. Immunological analyses showed a response of the adaptive immune system to the human cells. We show that interventional cell application via the femoral artery is feasible in a juvenile large animal model of HcTx. Moreover, cells are able to pass through the spleen to relocate in the liver after splenic artery infusion. Further studies are necessary to compare this approach with umbilical or transhepatic hepatocyte administration.

"Hepatocyte Transplantation to the Liver via the Splenic Artery in a Juvenile Large Animal Model" was published in Cell Transplantation.
Authors are J. Siefert, K.H. Hillebrandt, S. Moosburner, P. Podrabsky, D. Geisel, T. Denecke, J.K. Unger, B. Sawitzki, S. Gül-Klein, S. Lippert, P. Tang, A. Reutzel-Selke, M.H. Morgul, A.W. Reske, S. Kafert-Kasting, W. Rüdinger, J. Oetvoes, J. Pratschke, I.M. Sauer, and N. Raschzok.
New book: Decellularized Extracellular Matrix: Characterization, Fabrication and Applications
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The extracellular matrix (ECM) supports cells and regulates various cellular functions in our body. The native ECM promises to provide an excellent scaffold for regenerative medicine. In order to use the ECM as a scaffold in medicine, its cellular fractions need to be removed while retaining its structural and compositional properties. This process is called decellularization, and the resulting product is known as the decellularized extracellular matrix (dECM).
The book Decellularized Extracellular Matrix: Characterization, Fabrication and Applications (Editors: Tetsuji Yamaoka, Takashi Hoshiba) focuses on the sources of dECM and its preparation, characterization techniques, fabrication, and applications in regenerative medicine and biological studies. Using this book, the reader will gain a good foundation in the field of ECM decellularization complemented with a broad overview of dECM characterization, ranging from structural observation and compositional assessment to immune responses against dECM and applications, ranging from microfabrication and 3D-printing to the application of tissue-derived dECM in vascular grafts and corneal tissue engineering etc. The book closes with a section dedicated to cultured cell dECM, a complementary technique of tissue-derived dECM preparation, for application in tissue engineering and regenerative medicine, addressing its use in stem cell differentiation and how it can help in the study of the tumor microenvironment as well as in clinical trials of peripheral nerve regeneration.

E. Keshi, I.M. Sauer and K.H. Hillebrandt contributed the chapter "Engineering an endocrine Neo-Pancreas".

The print version of this book (Royal Society of Chemistry, ISBN 978-1-78801-467-0) is planned for release on 11 December 2019.
Simon Moosburner defended thesis summa cum laude
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Today, Simon Moosburner successfully defended his doctoral thesis entitled "Erweiterung der Spenderpopulation bei Lebertransplantation: Klinischer Bedarf und Entwicklung eines Kleintier-Lebermaschinenperfusionssystems (Expanding the donor pool for liver transplantation: clinical need and development of small animal liver perfusion system)" summa cum laude !

Congratulations!
Einstein BIH Visiting Fellow project, funded by Stiftung Charité
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The Stiftung Charité will fund our project “Vascular Composite Tissue Allotransplantation (VCA): An integrated, multidisciplinary basic and clinical research program for hand and uterus transplantation” (Einstein BIH Visiting Fellowship) within the framework of the Private Excellence Initiative Johanna Quandt for two more years!

The Charité has a long tradition as an international leader in transplantation. Prior to starting our Einstein BIH funded project in February 2017, Vascular Composite Tissue Allotransplantation (VCA) was neither object of scientific investigations, nor offered to patients. As an Einstein BIH Visiting Fellow Prof. Stefan G. Tullius, Harvard Medical School, ignited both: a basic research group in this field and a clinical research transplant program. During the first three years of our multidisciplinary basic and clinical research program, we have been able to implement complex small animal models (mouse hindlimb, heart, skin transplant models); a rat uterus transplant model is currently established. Those models offer unique opportunities to address basic research questions of translational relevance including: organ-specific alloimmune responses, immunogenicity, and the maternal-fetal interface in uterus transplantation.
An enthusiast clinical, multi-disciplinary has been established, led and mentored by Prof. Tullius that has brought preparatory surgical exercises and clinical algorithms for VCA at the Charité on the way.

Stiftung Charité is an independent charitable foundation. It was endowed in 2005 by entrepreneur Johanna Quandt, who entrusted it with the mission of supporting the innovative potential and excellence of Berlin’s university medicine, which can look back on a rich tradition in medical research and patient care. Thereby, the foundation is active in two focal areas: promoting technology transfer between the laboratory and the clinic as well as improving the framework conditions for innovation and entrepreneurship in medicine. Since 2014, Stiftung Charité is also funding the life sciences in Berlin by its Private Excellence Initiative Johanna Quandt.
Development of a rat liver machine perfusion system for normothermic and subnormothermic conditions
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Tissue Engineering Part A accepted our paper on the "Development of a rat liver machine perfusion system for normothermic and subnormothermic conditions" (Tissue Eng Part A. 2019 Jul 31. doi: 10.1089/ten.TEA.2019.0152. [Epub ahead of print[) !
Ex vivo liver machine perfusion is a promising alternative for preservation of liver grafts from extended criteria donors. Small animal models can be used to evaluate different perfusion conditions. We here describe the development of a miniaturized ex vivo machine perfusion system for rat liver grafts, evaluating cell-free and erythrocyte-based perfusion solutions, subnormothermic and normothermic temperatures and dialysis. A perfusion chamber was designed after a suitable liver position was identified. Normothermic ex vivo liver perfusion (NEVLP) required supplementation of erythrocytes to reduce cell damage. Perfusion with erythrocytes led to rising potassium levels after 12 hours (NEVLP, 16.2mmol/l, interquartile range (IQR) 5.7 and subnormothermic ex vivo liver perfusion (SNEVLP), 12.8 mmol/l, IQR 3.5), which were normalized by dialysis using a laboratory dialysis membrane (NEVLP, 6.2 mmol/l, IQR 0.5 and SNEVLP, 5.3 mmol/l, IQR 0.1; p=0.004). Livers treated with NEVLP conditions showed higher bile production (18.52mg/h/g, IQR 8.2) compared to livers perfused under SNEVLP conditions (0.4 mg/h/g, IQR 1.2, p=0.01). Reducing the perfusion volume from 100ml to 50ml allowed for higher erythrocytes concentrations, leading to significantly lower transaminases (15.75 U/l/ml, IQR 2.29 vs. 5.97 U/l/ml, IQR 18.07, p=0.002). In conclusion, a well-designed perfusion system, appropriate oxygen carriers, dialysis, and miniaturization of the perfusion volume are critical features for successful miniaturized ex vivo liver machine perfusion.

Authors are M. Nösser, J.M.G.V. Gassner, S. Moosburner, D. Wyrwal, F. Claussen, K.H. Hillebrandt, R. Horner, P. Tang, A. Reutzel-Selke, D. Polenz, R. Arsenic, J. Pratschke, I.M. Sauer, and N. Raschzok.
TEBURU – our latest bioreactor system
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Three‐dimensional tissue cultures are important models for the study of cell‐cell and cell‐matrix interactions, as well as, to investigate tissue repair and reconstruction pathways. Therefore, we designed a reproducible and easy to handle printable bioreactor system (Teburu), that is applicable for different approaches of pathway investigation and targeted tissue repair using human tissue slices as a three‐dimensional cell culture model. Here, we definitively describe Teburu as a controlled environment to reseed a 500‐µm thick decellularized human liver slice using human mesenchymal stroma cells. During a cultivation period of eight days, Teburu, as a semi‐open and low consumption system, was capable to maintain steady pH and oxygenation levels. Its combination with additional modules delivers an applicability for a wide range of tissue engineering approaches under optimal culture conditions.

"Teburu—Open source 3D printable bioreactor for tissue slices as dynamic three‐dimensional cell culture models" was published in Artif Organs. 2019 Jun 18. doi: 10.1111/aor.13518. [Epub ahead of print]. Authors are A. Daneshgar, P. Tang, C. Remde, M. Lommel, S. Moosburner, U. Kertzscher, O. Klein, M. Weinhart, J. Pratschke, I.M. Sauer, and K.H. Hillebrandt.
EUROSTARS project
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Within the Eurostars project „Comprehensive qualitative/quantitative multi-pathogen IVD workflow for immunocompromised patients (Im-compr-IVD)“ an IVD workflow covering sample preparation up to clinical relevant diagnosis of infection in immunocompromised patients will be developed. Deliverables are:
  • Design, development and preclinical validation of QIC-Finder assay with novel primers and probes for qualitative and quantitative screening of 23 pathogens (bacterial, viral, fungal and parasitic);
  • Detection instrumentation and interpretation software optimized for assay performance;
  • Instructions for high quality DNA/RNA extraction from plasma.
Partners are Pathofinder (Netherlands, Coordinator), Ella Biotech (Germany), IT-IS International Ltd. (United Kingdom) and Charité - Universitätsmedizin Berlin.

Eurostars projects are co-funded by EUREKA member countries and the European Union Horizon 2020 Framework program.
Priv.-Doz. Dr. Felix Krenzien & Priv.-Doz. Dr. Christian Benzing
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Today Dr. Felix Krenzien and Dr. Christian Benzing received they post-doctoral lecturing qualification (Habilitation) at Charité – Universitätsmedizin Berlin.
The title of Felix Krenzien's Habilitationsschrift is "Der differenzierte Einfluss der Seneszenz auf die Organtransplantation und Leberteilresektion", Christian Benzing focussed on the "Untersuchung der gesundheitsbezogenen Lebensqualität und der psychischen Gesundheit nach Lebertransplantation".

Congratulations !
Strategies based on organ decellularization and recellularization
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Transplantation is the only curative treatment option available for patients suffering from end-stage organ failure, improving their quality of life and long-term survival. However, because of organ scarcity, only a small number of these patients actually benefit from transplantation. Alternative treatment options are needed to address this problem. The technique of whole-organ decellularization and recellularization has attracted increasing attention in the last decade. Decellularization includes the removal of all cellular components from an organ, while simultaneously preserving the micro and macro anatomy of the extracellular matrix. These bioscaffolds are subsequently repopulated with patient-derived cells, thus constructing a personalized neo-organ and ideally eliminating the need for immunosuppression. However, crucial problems have not yet been satisfyingly addressed and remain to be resolved, such as organ and cell sources.

In this paper "Strategies based on organ decellularization and recellularization" (Transpl Int. 2019; 32(6):571-585), we focus on the actual state of organ de- and recellularization, as well as the problems and future challenges. Authors are K.H. Hillebrandt, H. Everwien, N. Haep, E. Keshi, J. Pratschke, and I.M. Sauer.
Impact of Percoll purification on isolation of primary human hepatocytes
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Scientific Reports published our paper "Impact of Percoll purification on isolation of primary human hepatocytes" (Sci Rep. 2019 Apr 25;9(1):6542). Authors are R. Horner, J.G.M.V. Gassner, M. Kluge, P. Tang, S. Lippert, K.H. Hillebrandt, S. Moosburner, A. Reutzel-Selke, J. Pratschke, I.M. Sauer, and N. Raschzok.

Research and therapeutic applications create a high demand for primary human hepatocytes. The limiting factor for their utilization is the availability of metabolically active hepatocytes in large quantities. Centrifugation through Percoll, which is commonly performed during hepatocyte isolation, has so far not been systematically evaluated in the scientific literature. 27 hepatocyte isolations were performed using a two-step perfusion technique on tissue obtained from partial liver resections. Cells were seeded with or without having undergone the centrifugation step through 25% Percoll. Cell yield, function, purity, viability and rate of bacterial contamination were assessed over a period of 6 days. Viable yield without Percoll purification was 42.4 × 106 (SEM ± 4.6 × 106) cells/g tissue. An average of 59% of cells were recovered after Percoll treatment. There were neither significant differences in the functional performance of cells, nor regarding presence of non-parenchymal liver cells. In five cases with initial viability of <80%, viability was significantly increased by Percoll purification (71.6 to 87.7%, p = 0.03). Considering our data and the massive cell loss due to Percoll purification, we suggest that this step can be omitted if the initial viability is high, whereas low viabilities can be improved by Percoll centrifugation.
Dr. med. Martin Kluge
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Martin Kluge is wearing excellent suits and successfully defended his doctoral thesis magna cum laude! He examined the effects of the magnetic field of magnetic resonance imaging (MRI) systems on cells labeled with micrometer-sized iron oxide particles.

Congratulations!

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Cytokine production of human CD4+ memory T cells
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Nature Communication accepted the manuscript "Progressive expression of killer-like receptors and GPR56 defines the cytokine production of human CD4+ memory T cells" for publication. Authors are Kim-Long Truong, Stephan Schlickeiser, Katrin Vogt, David Boës, Katarina Stanko, Christine Appelt, Mathias Streitz, Gerald Grütz, Nadja Stobutzki, Christian Meisel, Christina Iwert, Stefan Tomiuk, Julia Polansky, Andreas Pascher, Nina Babel, Ulrik Stervbo, Igor Sauer, Undine Gerlach, and Birgit Sawitzki.

All memory T cells mount an accelerated response on antigen reencouter, but significant functional heterogeneity is present within the respective memory T cell subsets as defined by CCR7 and CD45RA expression, thereby warranting further stratification. Here we show that several surface markers, KLRB1, KLRG1, GPR56 and KLRF1, help define “low”, “high” or “exhausted” cytokine producers within human peripheral and intra-hepatic CD4+ memory T cells. Highest simultaneous production of TNF and IFN-γ is observed in KLRB1+KLRG1+GPR56+ CD4 T cells. By contrast, KLRF1 expression is associated with reduced TNF/IFN-γ production and T cell exhaustion. Lastly, TCRbeta repertoire analysis and in vitro differentiation support a regulated, successive expression for these markers during CD4+ memory T cell differentiation. Our results thus help refine the classification of human memory T cells to provide insights on inflammatory disease progression and immunotherapy development.
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Critical Care for Potential Liver Transplant Candidates
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The book Critical Care for Potential Liver Transplant Candidates
(D. Bezinover and F. Saner [Eds.]) focuses on patients with end-stage-liver disease (ESLD) who could possibly qualify for liver transplant. This patient cohort raises many problems: who should be treated and also, when is it too late for transplant? The authors are all dedicated experts in the field of ESLD/liver transplantation, but from different disciplines with different views of the problem.
In the past 15 years many things have changed in the treatment for these patients: cardiac assessment, treatment of porto-pulmonary hypertension, hemodynamics, coagulation assessment and management, diagnosis of kidney failure, and the timing of dialysis. These issues are comprehensively discussed in this book, in order to provide physicians starting in the field of transplantation an overview of different areas of concern.
This book is aimed at specialists and trainees in critical care, hepatology, anesthesia, surgery, and nephrology.

N. Raschzok, K.H. Hillebrandt and I.M. Sauer contributed with the chapter "Liver Assist Systems for Bridging to Transplantation: Devices and Concepts".

More information via this link.
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Dr. med. Antje Butter
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Today, Antje Butter successfully defended her doctoral thesis magna cum laude!
Congratulations!

Antje was involved in basic research with respect to liver decellularization and recellularization. A proprietary, customized bioreactor was established to repopulate decellularized rat livers with primary rat hepatocytes via the hepatic artery and to subsequently evaluate graft morphology and function during 7 days of ex vivo perfusion. More information via this link.
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Percoll purification after isolation of Primary Human Hepatocytes
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The manuscript "Isolation of Primary Human Hepatocytes: Is Percoll Purification Really Necessary?" was accepted for publication in Scientific Reports.
Authors are Rosa Horner, Jospeh G.M.V. Gassner, Martin Kluge M, Peter Tang, Steffen Lippert, Karl H. Hillebrandt, Simon Moosburner, Anja Reutzel-Selke, Johann Pratschke, Igor M. Sauer and Nathanael Raschzok.

Research and therapeutic applications create a high demand for primary human hepatocytes. The limiting factor for their utilization is the availability of metabolically active hepatocytes in large quantities. Centrifugation through Percoll, which is commonly performed during hepatocyte isolation, has so far not been systematically evaluated in the scientific literature. 27 hepatocyte isolations were performed using a two-step perfusion technique on tissue obtained from partial liver resections. Cells were seeded with or without having undergone the centrifugation step through 25% Percoll. Cell yield, function, purity, viability and rate of bacterial contamination were assessed over a period of 6 days. Viable yield without Percoll purification was 42.4 x 106 (SEM ± 4.6 x 106) cells/g tissue. An average of 59% of cells were recovered after Percoll treatment. There were neither significant differences in the functional performance of cells, nor regarding presence of non-parenchymal liver cells. In five cases with initial viability of <80%, viability was significantly increased by Percoll purification (71.6 to 87.7%, p=0.03). Considering our data and the massive cell loss due to Percoll purification, we suggest that this step can be omitted if the initial viability is high, whereas low viabilities can be improved by Percoll centrifugation.
Read More
Critical Care for Potential Liver Transplant Candidates
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The book Critical Care for Potential Liver Transplant Candidates
(D. Bezinover and F. Saner [Eds.]) focuses on patients with end-stage-liver disease (ESLD) who could possibly qualify for liver transplant. This patient cohort raises many problems: who should be treated and also, when is it too late for transplant? The authors are all dedicated experts in the field of ESLD/liver transplantation, but from different disciplines with different views of the problem.
In the past 15 years many things have changed in the treatment for these patients: cardiac assessment, treatment of porto-pulmonary hypertension, hemodynamics, coagulation assessment and management, diagnosis of kidney failure, and the timing of dialysis. These issues are comprehensively discussed in this book, in order to provide physicians starting in the field of transplantation an overview of different areas of concern.
This book is aimed at specialists and trainees in critical care, hepatology, anesthesia, surgery, and nephrology.

N. Raschzok, K.H. Hillebrandt and I.M. Sauer contributed with the chapter "Liver Assist Systems for Bridging to Transplantation: Devices and Concepts".

More information via this link.
Read More
Composite tissue allotransplantation: opportunities and challenges
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"Composite tissue allotransplantation: opportunities and challenges" is available in Cellular & Molecular Immunology (Cell Mol Immunol. 2019 Mar 6. doi: 10.1038/s41423-019-0215-3. [Epub ahead of print]). Authors are J. Iske, Y. Nian, R. Maenosono, M. Maurer, I.M. Sauer & S.G. Tullius.

Vascularized composite allotransplants (VCAs) have unique properties because of diverse tissue components transplanted en mass as a single unit. In addition to surgery, this type of transplant also faces enormous immunological challenges that demand a detailed analysis of all aspects of alloimmune responses, organ preservation, and injury, as well as the immunogenicity of various tissues within the VCA grafts to further improve graft and patient outcomes. Moreover, the side effects of long-term immunosuppression for VCA patients need to be carefully balanced with the potential benefit of a non-life-saving procedure. In this review article, we provide a comprehensive update on limb and face transplantation, with a specific emphasis on the alloimmune responses to VCA, established and novel immunosuppressive treatments, and patient outcomes.
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Charité Digital Clinician Scientist Pilot Program (D-CSP)
The Deutsche Forschungsgemeinschaft (DFG) will fund the Charité Digital Clinician Scientist Pilot Program (D-CSP). The ideas is to improve and safeguard the current BIH Charité Clinician Scientist Program by building an additional structure for a novel “digital science” driven career track to prepare academic clinicians for the challenges of the emerging technological transformation of medicine.
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Designated Spokesperson is Prof. Dr. Duska Dragun. Co-applicants are the NeuroCure Cluster of Excellence, Department of Experimental Neurology, Department of Pediatric Oncology and Hematology, Department of Radiology and Pediatric Radiology, Department of Surgery, Berlin Institute for Medical Systems Biology (BIMSB), Institute of Medical Biometrics and Clinical Epidemiology, Department of Neurology and Experimental Neurology, and the Department of Anesthesiology and Intensive Care Medicine.

With the changing dynamics in biomedical research having fully entered into the digital era, it is becoming increasingly clear after seven years of experience that we need more dedicated efforts to create opportunities by establishing stronger interfaces with physics, mathematics, systems biology, and computational sciences for future generations of Clinician Scientists. The newly proposed research and educational structure for integrating these new areas of expertise into the established CSP should act as a “central processing unit” to facilitate biomedical knowledge derived from a variety of clinical disciplines supported by leading technology experts to address the specific challenges of data-driven medicine in the future.

  • Precision medicine in cancer and beyond,
  • Systems biology,
  • Big data science and decision support systems,
  • Quantitative imaging,
  • Computational neuroscience and brain simulation, and
  • Augmented, mixed and virtual reality in surgery
are exemplary research topics highlight how applicants will interact with Digital Clinician Scientists to develop their skills in giving prognoses, optimizing delivery of care, and personalizing patient management and therapeutic choices.
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DFG Research Grant
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Priv.-Doz. Dr. Nathanael Raschzok receives a research grant from the Deutsche Forschungsgemeinschaft (DFG) for his project "Defatting of steatotic liver grafts by normothermic ex vivo machine perfusion with DNP" in collaboration with Prof. Dr. med. Andreas Birkenfeld, Universitätsklinikum Carl Gustav Carus, Dresden.

Transplantation of steatotic marginal liver grafts is associated with a certain risk of graft dysfunction, primary non-function, and biliary complications, which results in a worse outcome compared to transplantation of unimpaired livers.
We hypothesize, that normothermic machine perfusion combined with adequate pharmacological intervention can prevent the deleterious effect of ischemia-reperfusion injury on macrovesicular grafts by a) minimizing the negative effect of cold storage, and by b) actively decreasing the intracellular fat content of the graft.
Mild mitochondrial uncoupling by DNP decreases the intrahepatic fat content of steatotic liver grafts during normothermic ex vivo machine perfusion. Efficient defatting can be safely achieved ex vivo with DNP concentrations that would be toxic in vivo. Systemic side effects of DNP are prevented by exclusive hepatic exposure through machine perfusion, and by washing DNP out of the liver graft at the end of the perfusion period. The synergetic effects of normothermic perfusion and defatting with DNP will prevent ischemia-reperfusion injury and make severely steatotic liver grafts acceptable for transplantation.
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