Allogeneic Liver Transplantation in Nonhuman Primates: Surgical Technique With Stable Postoperative Outcomes

Area of Science:

• Transplantation research
• Primate models
• Surgical innovation

Background:

• Nonhuman primate models are crucial for preclinical transplantation research.
• Technical complexities have limited the use of nonhuman primates in liver transplantation.
• Advancing tolerance-free and ischemia-free models necessitates a standardized nonhuman primate approach.

Purpose of the Study:

• To establish a feasible and stable nonhuman primate model for orthotopic liver transplantation.
• To evaluate the efficacy and reproducibility of a baboon model for liver transplantation.

Main Methods:

• Orthotopic allogeneic liver transplantations were performed in cynomolgus macaques and baboons.
• Surgical techniques included portocaval shunts and extracorporeal bypasses in macaques, with a focus on minimizing anhepatic time in baboons.
• Outcomes were assessed through survival rates, postoperative clinical course, histopathology, and liver enzyme levels.

Main Results:

• Cynomolgus macaque models experienced surgical complications and were euthanized.
• Baboon recipients demonstrated survival exceeding 2 months post-transplantation.
• Choledochojejunostomy in baboons resulted in normalized liver function, unlike choledocholedochostomy.

Conclusions:

• Successful and stable outcomes were achieved in nonhuman primate liver transplantation using baboons.
• This baboon model offers a promising alternative to existing cynomolgus macaque models.
• The established method facilitates further clinical adaptation in translational transplantation studies.