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Clinical xenotransplantation
Thomas E Starzl1, Noriko Murase, Andreas Tzakis
1Pittsburgh Transplant Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
Xenotransplantation
|December 15, 2010
Summary
Baboon liver xenografts in patients with B virus hepatitis showed limited function. Complement activation, not overt rejection, likely caused the poor outcomes, suggesting new strategies are needed.
Area of Science:
- Transplantation immunology
- Hepatology
- Xenotransplantation
Background:
- B virus hepatitis poses a significant challenge in liver transplantation.
- Baboon liver xenografts are a potential solution for organ shortage.
- Optimizing xenograft function requires understanding rejection mechanisms.
Purpose of the Study:
- To evaluate the function and survival of baboon liver xenografts in patients with B virus hepatitis.
- To investigate the underlying causes of suboptimal xenograft performance.
- To identify strategies for improving xenograft outcomes.
Main Methods:
- Two patients with B virus hepatitis received baboon liver xenografts.
- Serial biopsies were performed to assess histopathologic findings.
- Evidence of humoral and cellular rejection was evaluated.
- Complement activation was assessed in post-transplant biopsies.
Main Results:
- Xenografts supported life for 70 and 26 days.
- Minimal or no overt humoral or cellular rejection was observed.
- Significant evidence of complement activation was detected in both cases.
- Suboptimal xenograft function correlated with complement activation.
Conclusions:
- Complement activation appears to be a critical factor in the failure of baboon liver xenografts.
- Overt immune rejection may not be the primary barrier in this xenotransplantation model.
- Strategies targeting complement pathways are crucial for successful liver xenotransplantation.
