Donor contraindications

There are, however, several limitations and contraindications with MSC therapy. One of the limitations is in the establishment of MSC cultures from donors, parents or siblings. Although MSC can be readily isolated and expanded in vitro, establishing the MSC cultures can be a limiting factor. Failure to establish such cell cultures in a timely manner, and in sufficient qualities and quantities, may have profound consequences on the therapy. Since MHC compatibility is not necessary for MSC immunosuppression, and because MSC immunomodulatory activity can also be observed in third-party donor cells [656550], MSCs derived from unrelated, -unmatched, healthy, third-party donors would represent a universal donor MSC product with the advantage of being a readily-available product that may provide an opportunity for multiple and higher MSC doses, potentially at a reduced cost [659019 ]. 

Cross-match Cross-matching is the process of testing the cells of a prospective organ donor with the serum of a prospective organ recipient for compatibility. The flow cytometric cross-match determines whether serum from the recipient contains antibodies that bind to the donor cells. Such binding constitutes a positive cross-match and is a contraindication to transplantation in that particular donor/recipient combination. 

Film dressings are used in the treatment of a wide range of conditions, including pressure ulcers, burns, abrasions, and donor sites. In a dermabrasion, hemostasis must first be obtained and the margin of the wound dried before the film is applied. In its application for the treatment of burns, careful disinfection must precede the positioning of the film and it is only recommended for application to superficial and clinically clean burns. The use of films is contraindicated for deep burns as they retard the separation of necrotic tissue. 

Now as ever there are lots of discussions focused on a patient s age in transplantation. Should younger patients be transplanted before older patients In the recent past, chronologic age was a contraindication both for organ donation and transplantation. However, similar to trends in the overall general population, there has been an increasing, yet disproportionate, shift towards increasing numbers of older donors and recipients in for example kidney transplantation (Stratta et al. 2005). 

The use of moderate inotropes to maintain a stable output in donors is not a contraindication, but high doses of catecholamines over a longer period can jeopardize the donor myocardium leading to impaired post-transplant function. 

Absolute contraindications for using a potential donor include previous myocardial infarction, severe echocardiographic ventricular dysfunction, severe coronary artery disease (detected by coronary angiogram), intractable ventricular arrhythmia and positive HIV status. Relative contraindications include, among others, positive hepatitis B or C serology, sepsis, history of metastatic cancer, evidence of cardiac contusion, prolonged hypotension, non-critical coronary artery disease, and a history of intravenous drug abuse (Miniati and Robbin 2002). 

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