Universitat Internacional de Catalunya
Cellular Therapy and Regenerative Medicine. Bone Marrow, Organ and Tissue Transplant
Teaching staff
Students may ask lecturers questions at the end of each class. For enquiries outside of class time, students must make an appointment by email:
Ramon Salinas Argente: rsalinas@bst.cat
Dra Maria Del Mar Pujol Balaguer:
Dr Enric Contreras Barbeta:
Dr Joaquim Vives: jvivesa@uic.es
Introduction
Regenerative medicine is the medical discipline that studies the use of stemcells and other types of transplants or for regeneration of damaged tissues impersonation. Regenerative Medicine has made exponential growthin recent years thanks to molecular and cellular biology,and currently represents one of the areas with higher growth expectations and therapeutic usein the near future
Pre-course requirements
Basic knowledge of pathophysiology and molecular and cell biology.
Objectives
Stem Cells and therapeutic applications in regenerative medicine
- Know the natural methods of endogenous regeneration of our fabrics
- Types of stem cells.
- Use of the stem cells in regeneration of bone, cartilage, and adipose tissue
- Stem cells derived from umbilical cord and its therapeutic uses
- Induced pluripotent stem cells (IPSC)
Solid organ transplantation. Results and current problems
- Learning the different types of transplantation with its specific characteristics, prognosis and survival. Knowledge of aspects that affect the long-term (Hepatitis C virus, immunosuppressive therapy itself, etc ...)
Liquid transplant organs.
• Understand the biological basis that condition compatibilidd progenitor
• Know the signs of bone marrow transplantation
• Know the types of TPH and collection systems of bone marrow progenitor cells
• Understand the technology of cell preservation and implantation techniques
Competences/Learning outcomes of the degree programme
- 12 - Understanding the foundations for action, the indications and efficacy of therapeutic interventions, based on available scientific evidence.
- 27 - Recognize role in multidisciplinary teams, assuming leadership when appropriate, for the delivery of health care, such as interventions for health promotion.
- 31 - Understand, critically evaluate and know how to use sources of clinical and biomedical information to obtain, organize, interpret and communicate scientific and health care information.
- 35 - Understand the importance and limitations of scientific thinking in the study, prevention and treatment of disease.
- 37 - Acquire basic training for research.
- CB-5 - To transmit in a clear and unambiguous way to a specialised or non-specialised audience, the results of scientific and technological research projects and innovation from the field of the most advanced innovation, as well as the most important concepts which they are based on.
Learning outcomes of the subject
Stem Cells and therapeutic applications in regenerative medicine
- Students will learn the different types of adult stem cells and tissues where they are, potential, biological niche, etc.
- Students will learn about the uses and disadvantages of mesenchymal stem cells in the regeneration of hard tissue such as bone or cartilage. Also known most commonly used biomaterials to give the necessary three-dimensional structure.
- Students will learn the operation of a bank of umbilical cord and their therapeutic applications
- Students will learn the process of obtaining iPSC cells as well as their advantages and disadvantages compared to other types of stem cells.
Solid organ transplantation. Results and current problems
- The student will know the indications and methodology used in transplants more common solid organs: liver, lung, heart and kidney.
- Students will be able to identify and prevent those common problems and can be relatively easily resolved if they are diagnosed early (bacterial and viral infection, rejection, etc ...)
- Students will be able to recognize the current site of transplantation in treatment of various diseases and the problems that are still unresolved (donation, organ quality, metabolic syndrome, etc..)
Liquid transplant organs.
- Students will learn the basics of the HLA system and its role in the rejection of TPH
- Students will learn the various sources of obtaining parents and mobilization methods to obtain them.
- The student will know the indications and methodology used in transplants of hematopoietic progenitors.
- Students will be able to identify and prevent those common problems and can be relatively easily resolved if they are diagnosed early (bacterial and viral infection, rejection, etc ...)
- Students will be able to know the basic principles of management of the transplanted patient, focusing on all aspects loas support, prevention and treatment of the most common acute complications.
- Students will learn about the different stages of TPH
- The student will know the basic principles of cryobiology that allow the preservation and storage of stem cells
Syllabus
Stem Cells and therapeutic applications in regenerative medicine
- Natural regeneration of tissues
- Types of stem cells. Current and future uses
- Mesenchymal stem cells and their use in the regeneration of bone, cartilage, and adipose tissue
- Tissue bank of umbilical cord. Therapeutic uses.
- Development of the IPSC cells. Advantages and disadvantages compared to other stem cells.
Solid organ transplantation. Results and current problems
- The problem of the Grant. organizational systems
- The heart and lung transplant
- Renal and Liver Transplantation
- From living donor transplantation. Renal and Hepatic
- Transplantation from heart-beating donor
- Immunosuppression Guidelines. induction
- Side Effects of Immunosuppression
- The quality of life beyond 10 years
Liquid transplant organs.
- Fundamentals, Types and indications of stem cell transplantation (HSCT)
- Sources of obtaining parental
- TPH concept unit
- Accreditation of centers
- Cost Analysis
- Indications and results
- Assessment of patient
- Selection of the donor and donor assessment. Concepts of unrelated donor
- Conditioning treatments
- Getting parents: bone marrow, peripheral blood.
- Mobilisation of peripheral blood progenitors
- Product obtained: handling, processing control, purging, removal of inoculum linfocits T, implementation and chimerism
- Patient management: central venous catheter, transfusion support, nutritional support, prevention of disease Graft versus host disease (GVHD) prophylaxis infections
- Complications: implant failure, action to take in the febrile neutropenic patient infections: bacterial, fungal, viral,
- Hepatic veno-occlusive disease
- Disease GVH
- Late Complications
- Second neoplasms
- Relapse post HSCT
Teaching and learning activities
Online
Clases magistrales combinadas con actividades en grupo como discusión sobre un artículo, desarrollo de una guía terapéutica, resolución de casos, asistencia a la realización de un trasplante, etc.
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Conceptos básicos de medicina regenerativa. Clasificacion de las células según su capacidad de diferenciación: totipotente, pluripotente,multipotente progenitora. Clasificacion según su origen: embrionarias, específicas de tejidos |
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Aproximaciones biotecnológicas a la medicina regenerativa1: Terapia celular (células mesenquimales, inmunoterapia celular). Terapia genica |
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Aproximaciones biotecnológicas a la medicina regenerativa 2: Terapia génica. Ingenieria tisular |
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Traslacion a la clínica de la medicina regenerativa. Terapias avanzadas. Ensayos clínicos de terapias avanzadas |
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Banco de Cordón umbilical. Condiciones para la donación. Procesamiento:Purging y Expansion ex vivo. Almacenamiento. Distribución. Indicaciones del trasplante de cordón Umbilical. |
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El sistema HLA. Conceptos básicos. Els sistema HLA y el trasplante de medula ósea. Compatibilidad HLA en trasplante de cordón umbilical. Compatibilidad HLA en trasplante alogénico |
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Soporte transfusional del paciente en el programa de trasplante. |
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El Banco de leche materna: conceptos básicos, selección de donantes. Procesamiento del producto. Almacenamiento. Distribución. Indicaciones de la lactancia materna de Banco |
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Organizaciones implicadas en el trasplante de órganos y tejidos: ONT, OCATT, REDMO. Trasplante de órganos y tejidos. Conceptos y tipos |
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El donante de órganos y tejidos. Conceptos básicos de muerte encefálica y muerte en asistolia. Legislación |
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El papel del coordinador de trasplantes. El abordaje de la familia. Atención psicológica a la familia del donante. Logística de la extracción. Listas de espera |
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Banco de Tejidos. Concepto de Banco de tejidos. Tejidos de donante vivo para uso autólogo. |
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Tejidos de donante vivo para uso alogénico. Tejidos de donante Cadáver |
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Generalidades sobre el Trasplante de progenitores hematopoyéticos. Indicaciones del TPH. Visión panorámica del proceso: Indicación. Movilización. Recolección. Acondicionamiento. Procesamiento. Infusion. Modalidades de TPH TPH: Modelos de acreditación en trasplante de CPH. Conceptos básicos sobre la organizacion de la Unidad de TPH. El receptor del TPH: soporte nutricional, soporte familiar, soporte psicologico |
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TPH: Selección del donante y fuente de progenitores: sangre periférica, cordón umbilical, medula ósea. LA célula CD34 +. Métodos de Identificación de la celula CD34+ |
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TPH: Conceptos básicos de movilización. Nuevas pautas de movilización. Fracaso en la Movilización. Aplicación de la citometria de flujo como control de la movilización e identificación de células progenitoras
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TPH. Modalidades de obtención de progenitores hematopoyéticos: Medula ósea. Sangre periférica. Sangre de cordón. Recoleccion de sangre periférica. La importancia del catéter. Técnica de recolección con COBE-ESPECTRA. Cantidad necesaria de células para la adecuada infusión, en TPH autologo y alogénico
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TPH: Procesamiento (manipulación y técnica de selección celular) y crio preservación de los progenitores hematopoyéticos: Técnicas de selección celular. Soluciones crio protectoras Teoría y técnicas de la crio preservación. TPH: Tratamiento de acondicionamiento pre trasplante. Infusion Efectos adversos en el proceso de obtención e infusión de progenitores hematopoyéticos. Rol de los profesionales de enfermería en el proceso de infusión
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Biologia de la inmunosupresión del trasplante de órganos. Tipos de rechazo en trasplante de órganos |
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Complicaciones del TPH 1: infecciones. Toxicidades no hematológicas. Síndrome de obstrucción del sinusoide hepático |
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Complicaciones del TPH 2: enfermedad del injerto contra el huésped. |
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El trasplante de órganos. Evolución Histórica. Trasplantes que han marcado época: el primer trasplante de corazón, el trasplante de cara. Consideraciones especiales en el trasplante de órganos: Riñon, Corazón, Pulmon, páncreas, intestino. |
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Consideraciones especiales en el trasplante de órganos: Riñon, Corazón, Pulmon, páncreas, intestino |
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Presentación trabajo alumnos Visita edificio Frederic Duran i Jorda |
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Evaluation systems and criteria
Online
• Presentation of a teamwork. The first day the teams will be defined. The second day will be distributed topics to develop. The teams develop a presentation point p submit in class. Other teams will make questions about this presentation. the synthesis CAPACITY be evaluated. The presentation and the questions other teams (90%)
• Comments class short. Some days the teacher will ask students their opinion, valuation or comments about some of the subjects developed during class time. The written response to the comment should never exceed half a page, all the questions should be answered in a maximum of six total (10%)
The final result of the course will be the sum of the presentation and the short class comments.
Bibliography and resources
- Manual de trasplante hemopoyético. Tercera edición. Enric Carreras, Salut Brunet, JJ Ortega, Jorge Sierra, Alvaro Urbano. Editorila Antares 2004