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急性中毒自杀后的皮肤捐赠。

Skin donations after suicide by acute poisoning.

作者信息

Amoroso L, Fratini A, Baronti R, Ierardi F, Migliaccio M L, Di Schiena M, Rubegni P, Pianigiani E

机构信息

Tuscany Region Skin Bank, Department of Dermatology, Santa Maria alle Scotte Hospital, Policlinico Santa Maria Alle Scotte, Viale Bracci, 53100, Siena, Italy.

Clinical Toxicology and Antidoping Centre, ASL Toscana Centro, Florence, Italy.

出版信息

Cell Tissue Bank. 2023 Mar;24(1):265-272. doi: 10.1007/s10561-022-10033-5. Epub 2022 Aug 30.

DOI:10.1007/s10561-022-10033-5
PMID:36042071
Abstract

The demand for skin tissue allografts to treat burns and other types of injuries increases each year to the extent that categories of donors formerly deemed "unsuitable", such as victims of suicide by polytrauma or poisoning, are now considered. Patients who died by ingestion of/exposure to toxic substances can be accepted as tissue donors after assessment of graft safety to rule out any risks of transferring toxic substances to the recipient. A cadaveric skin donation was obtained from a 57-year-old woman who died from intoxication after ingesting colchicine tablets (0.2 mg/kg). To determine the safety of cadaveric skin allografts, high-performance liquid chromatography-mass spectrometry (LC-MS/MS) was used to identify and quantify colchicine in procured skin. Results revealed that colchicine concentrations were lower than the instrument limit of detection (LOD) of 0.5 ng/mg both in epidermis and dermis. Cell viability assessed through the MTT ([3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide]) test was within standard limits. Thanks to accurate tests performed, which are routinely applied also in clinical diagnostics and forensic toxicology, it was possible to ascertain the safety and suitability of skin tissue for donation.

摘要

用于治疗烧伤和其他类型损伤的同种异体皮肤移植的需求逐年增加,以至于现在开始考虑以前被认为“不合适”的供体类别,比如多发伤或中毒自杀的受害者。因摄入/接触有毒物质而死亡的患者,在评估移植物安全性以排除将有毒物质转移给接受者的任何风险后,可被接受为组织供体。从一名因服用秋水仙碱片(0.2毫克/千克)中毒死亡的57岁女性身上获取了尸体皮肤捐赠。为了确定尸体皮肤移植的安全性,采用高效液相色谱-质谱联用仪(LC-MS/MS)来识别和定量所获取皮肤中的秋水仙碱。结果显示,表皮和真皮中的秋水仙碱浓度均低于仪器检测限(LOD)0.5纳克/毫克。通过MTT([3-(4,5-二甲基噻唑-2-基)-2,5-二苯基四氮唑溴盐])试验评估的细胞活力在标准范围内。由于进行了准确的检测,这些检测在临床诊断和法医毒理学中也常规应用,所以能够确定皮肤组织捐赠的安全性和适用性。

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本文引用的文献

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Successful Liver Transplantation from a Deceased Donor After Ethylene Glycol Ingestion: A Case Report and Review of the Literature of Organ Donation from Poisoned Donors.乙二醇摄入后成功进行尸体供肝移植:病例报告和文献复习中毒供者器官捐献。
Transplant Proc. 2022 Jan-Feb;54(1):128-134. doi: 10.1016/j.transproceed.2021.11.015. Epub 2021 Dec 28.
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After another decade: LC-MS/MS became routine in clinical diagnostics.又过了十年:LC-MS/MS 在临床诊断中变得常规化。
Clin Biochem. 2020 Aug;82:2-11. doi: 10.1016/j.clinbiochem.2020.03.004. Epub 2020 Mar 15.
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Clinical outcomes after colchicine overdose: A case report.
秋水仙碱过量后的临床结果:一例病例报告。
Medicine (Baltimore). 2019 Jul;98(30):e16580. doi: 10.1097/MD.0000000000016580.
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Liver Procurement from Poisoned Donors: A Survival Study.从中毒供体中获取肝脏:一项生存研究。
Exp Clin Transplant. 2020 Jun;18(3):334-338. doi: 10.6002/ect.2018.0339. Epub 2019 May 17.
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A rare case report of heavy dose colchicine induced acute kidney injury.一例大剂量秋水仙碱致急性肾损伤的罕见病例报告
BMC Pharmacol Toxicol. 2018 Oct 30;19(1):69. doi: 10.1186/s40360-018-0260-z.
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Pesticide-Poisoned Patients: Can They Be Used as Potential Organ Donors?农药中毒患者:他们能否作为潜在的器官捐献者?
J Med Toxicol. 2018 Dec;14(4):278-282. doi: 10.1007/s13181-018-0673-5. Epub 2018 Jul 9.
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The effects of donor age on organ transplants: A review and implications for aging research.供体年龄对器官移植的影响:综述及对衰老研究的启示。
Exp Gerontol. 2018 Sep;110:230-240. doi: 10.1016/j.exger.2018.06.019. Epub 2018 Jun 20.
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Assessment of cryopreserved donor skin viability: the experience of the regional tissue bank of Siena.冷冻保存供体皮肤活力的评估:锡耶纳地区组织库的经验
Cell Tissue Bank. 2016 Jun;17(2):241-53. doi: 10.1007/s10561-016-9550-0. Epub 2016 Mar 3.
10
[ACCIDENTAL POISONING WITH A PLANT COLCHICUM AUTUMNALE: REPORT OF TWO CASES].[秋水仙(秋水仙属植物)意外中毒:两例报告]
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