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Organ transplantation is the sole treatment to improve or save the life of patients with final-stage organ failure. The shortage of available organs for transplantation constitutes a universal problem, estimating that 10% of patients on waiting lists die. Brain death is an undesirable result; nevertheless, it has beneficial side-effects since it is the most frequent source of organs for transplantation. However, this phenomenon is relatively uncommon and has a limited potential. One of the options that focuses on increasing organ donation is to admit patients with catastrophic brain injuries (with a high probability of brain death and nontreatable) to the Intensive Care Unit, with the only purpose of donation. To perform elective nontherapeutic ventilation (ENTV), a patient’s anticipated willingness to donate organs and/or explicit acceptance by his/her relatives is required. This process should focus exclusively on those patients with catastrophic brain injuries and imminent risk of death which, due to its acute damage, are not considered treatable. This article defends ENTV as an effective strategy to improve donation rate, analyzing its ethical and legal basis.

Normal wound healing is a dynamic and complex process involving coordinated interactions between diverse immunological and biological systems. If a wound does not heal in an orderly and timely sequence, or if the healing process does not result in structural integrity, then the wound is considered chronic. It is easy to define a chronic wound, but finding a solution is a complicated matter. Conventional treatment of chronic wounds does not seem to work in several cases, so it is necessary to develop different strategies. Cell therapy constitutes a new alternative to classic methods of wound healing. In this bibliographic review, we present some of the data published up to date on the use of adipose tissue- and bone-marrow-derived Mesenchymal stem cells in patients with chronic wounds caused by several pathologies. Even though cell therapy is a relatively new tool, several studies prove these types of cells may be used safely, and they have demonstrated their efficacy in healing wounds in several cases.

Bone marrow has been considered the main source for isolation of multipotent mesenchymal stem cells for therapeutic approaches. However, alternative sources of mesenchymal stem cells have been sought because their frequency and differentiating capacity decrease with age and because they are not easy to obtain from healthy donors. These cells have been also described both in umbilical cord blood and in Wharton’s jelly. To date, several studies have shown that CD271 is the most specific marker expressed of bone marrow mesenchymal stem cells before being cultured. The aim of this study was to determine whether it is possible to identify not cultured mesenchymal stem cells umbilical cord blood and Wharton’s Jelly using this marker, as well as to compare the results found to those obtained in bone marrow. Bone marrow, umbilical cord blood and Wharton’s Jelly cells suspension were analyzed by flow cytometry in order to identify the CD271+/CD45- population. Furthermore, we evaluated the potential to obtain mesenchymal stem cells from each source. Our results showed CD271+/CD45- cells in bone marrow samples, although this population did not appeared in umbilical cord blood nor from Wharton’s Jelly. However, the absence of this phenotype before culture samples had no relation with the ability to culture mesenchymal stem cells, specially taking into account that is was possible to obtain them from Wharton’s Jelly but not from umbilical cord blood. Our findings suggest that CD271 is not an adequate marker to identify mesenchymal stem cells from human umbilical cord before culture.