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  3. Consistent success in life-supporting porcine cardiac xenotransplantation.

Consistent success in life-supporting porcine cardiac xenotransplantation.

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DOI
10.7892/boris.124854
Publisher DOI
10.1038/s41586-018-0765-z
PubMed ID
30518863
Abstract
Heart transplantation is the only cure for patients with terminal cardiac failure, but the supply of allogeneic donor organs falls far short of the clinical need. Xenotransplantation of genetically modified pig hearts has been discussed as a potential alternative. Genetically multi-modified pig hearts that lack galactose-α1,3-galactose epitopes (α1,3-galactosyltransferase knockout) and express a human membrane cofactor protein (CD46) and human thrombomodulin have survived for up to 945 days after heterotopic abdominal transplantation in baboons. This model demonstrated long-term acceptance of discordant xenografts with safe immunosuppression but did not predict their life-supporting function. Despite 25 years of extensive research, the maximum survival of a baboon after heart replacement with a porcine xenograft was only 57 days and this was achieved, to our knowledge, only once. Here we show that α1,3-galactosyltransferase-knockout pig hearts that express human CD46 and thrombomodulin require non-ischaemic preservation with continuous perfusion and control of post-transplantation growth to ensure long-term orthotopic function of the xenograft in baboons, the most stringent preclinical xenotransplantation model. Consistent life-supporting function of xenografted hearts for up to 195 days is a milestone on the way to clinical cardiac xenotransplantation.
Date Issued
2018-12
Publication Type
Article
Subject(s)
600 Technology > 610 Medicine & health
Language(s)
en
Author(s)
Längin, Matthias
Mayr, Tanja
Reichart, Bruno
Michel, Sebastian
Buchholz, Stefan
Guethoff, Sonja
Dashkevich, Alexey
Baehr, Andrea
Egerer, Stefanie
Bauer, Andreas
Mihalj, Maks  
Universitätsklinik für Herz- und Gefässchirurgie  
Panelli, Alessandro
Issl, Lara
Ying, Jiawei
Fresch, Ann Kathrin
Buttgereit, Ines
Mokelke, Maren
Radan, Julia
Werner, Fabian
Lutzmann, Isabelle
Steen, Stig
Sjöberg, Trygve
Paskevicius, Audrius
Qiuming, Liao
Sfriso, Riccardo  
Department for BioMedical Research, Forschungsbereich Murtenstrasse 50  
Department for BioMedical Research, Forschungsgruppe Herz und Gefässe  
Rieben, Robert  
Department for BioMedical Research (DBMR)  
Department for BioMedical Research, Forschungsgruppe Herz und Gefässe  
Dahlhoff, Maik
Kessler, Barbara
Kemter, Elisabeth
Klett, Katharina
Hinkel, Rabea
Kupatt, Christian
Falkenau, Almuth
Reu, Simone
Ellgass, Reinhard
Herzog, Rudolf
Binder, Uli
Wich, Günter
Skerra, Arne
Ayares, David
Kind, Alexander
Schönmann, Uwe
Kaup, Franz-Josef
Hagl, Christian
Wolf, Eckhard
Klymiuk, Nikolai
Brenner, Paolo
Abicht, Jan-Michael
Additional Credits
Universitätsklinik für Herz- und Gefässchirurgie  
Department for BioMedical Research, Forschungsbereich Murtenstrasse 50  
Department for BioMedical Research, Forschungsgruppe Herz und Gefässe  
Department for BioMedical Research (DBMR)  
Journal
Nature
Publisher
Macmillan Journals Ltd.
ISSN
0028-0836
Related URL(s)
https://boris.unibe.ch/id/eprint/136247
Access(Rights)
restricted
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