Accreditation of skin from a methanol-poisoned victim for banking and grafting.
BACKGROUND
Acute poisoning is a contraindication for organ and tissue donation. In this study the suitability of skin from a methanol-poisoned (MP) donor for future grafting and keratinocytes culturing was investigated.


METHODS
A patient was admitted with a methanol blood level of 2.7 mg/mL, which became undetectable after 4 days of treatment with 4-methylpyrazole (fomepizole). Upon declared brain death and family consent, organs and skin were harvested. For approving MP skin for grafting, the following parameters were studied: viability and plating efficiency of MP keratinocytes, integrity of MP skin after cryopreservation, and its performance as xenografts on wounds in a pig model. Nonpoisoned (NP) controls included skin of matching age, cryopreservation period, and NP keratinocytes.


RESULTS
No significant differences were observed for any parameter between NP and MP samples. Furthermore, in vitro exposure of NP keratinocytes and fibroblasts to <10 mg/mL methanol inhibited their growth by <20%, with an extrapolated LD50 of 100 mg/mL. A parallel exposure to formaldehyde, a spontaneous metabolite of methanol, yielded LD50 of 20 microg/mL and eradication of viability at 300 microg/mL.


CONCLUSIONS
These results indicate that skin from a carefully monitored MP donor is suitable for banking toward massive burns and skin losses. This methodology may be applied to approve skin harvested from other types of poisoned donors for banking and future grafting.
Department of Plastic and Reconstructive Surgery and the Burn Unit, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, 84101, Israel. alexb@bgumail.bgu.ac.il
Alexander
A
Bogdanov-Berezovsky
Ronen
R
Glesinger
Leonid
L
Kachko
Edna
E
Arbel
Lior
L
Rosenberg
Nili
N
Grossman
D000328:Adult; D000818:Animals; D015925:Cryopreservation; D006801:Humans; D008297:Male; D000432:Methanol / Q000493:pharmacokinetics / Q000506:poisoning*; D012867:Skin / Q000378:metabolism; D016038:Skin Transplantation; D013552:Swine; D014015:Tissue Banks; D014183:Transplantation, Heterologous
D000432:Methanol