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Is sensitization to pig antigens detrimental to subsequent allotransplantation?

Journal article
Authors Q. Li
H. Hara
Z. Q. Zhang
Michael Breimer
Y. Wang
D. K. C. Cooper
Immunology Lettersmeeting On Advances In Transplantation Immunology Sep Aberdeen Scotland V. P. Irns Tdh
Transplantation Proceedings V. P. Lne Ry
Published in Xenotransplantation
Volume 25
Issue 3
ISSN 0908-665X
Publication year 2018
Published at Institute of Clinical Sciences, Department of Surgery
Language en
Links doi.org/10.1111/xen.12393
Keywords antibodies, cross-reacting, clinical trial, immune response, human, non-human primate, pig, sensitization, xenotransplantation, swine leukocyte antigens, hla-specific antibodies, ex-vivo connection, liver-transplantation, cross-sensitization, xenotransplantation, rejection, xenografts, kidneys, porcine, Research & Experimental Medicine, Transplantation, iche l, 1990, transplantation proceedings7th scientific congress of the transplantation soc of australia and new zealand, mar 28-30, 1990, canberra, australia, v22, p2333, begona ja, 1992, transplantation proceedings1st international congress on xenotransplantation, aug 25-28, 1991, minneapolis, mn, v24, p453, ari rs, 1994, new england journal of medicine, v331, p234
Subject categories Surgery

Abstract

An important question in xenotransplantation is whether an allotransplant can safely be carried out in a patient who has become sensitized to a pig xenograft. To answer this question, we have searched the literature. We primarily limited our review to the clinically relevant pig-to-non-human primate (NHP) model and found five studies that explored this topic. No NHP that had received a pig graft developed antibodies to alloantigens, and in vitro studies indicated no increased humoral and/or cellular alloreactivity. We carried out a small in vitro study ourselves that confirmed this conclusion. There have been three experiments in which patients undergoing dialysis were exposed to wild-type pig kidneys and three clinical studies related to bridging a patient in hepatic failure to liver allotransplantation. Despite the development of anti-pig antibodies, all subsequent organ (kidney or liver) allografts were successful (except possibly in one case). In addition, pig fetal islets were transplanted into patients with kidney allografts; there was no increase in panel-reactive alloantibodies and the kidney grafts continued to function satisfactorily. In conclusion, the limited data suggest that, after sensitization to pig antigens, there is no evidence of antibody-mediated or accelerated cellular rejection of a subsequent allograft.

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