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Le BBS, Tillou X, Branchereau J, Dilek N, Poirier N, Châtelais M, Charreau B, Minault D, Hervouet J, Renaudin K, Crossan C, Scobie L, Takeuchi Y, Diswall M, Breimer M, Klar N, Daha M, Simioni P, Robson S, Nottle M, Salvaris E, Cowan P, d’Apice A, Sachs D, Yamada K, Lagutina I, Duchi R, Perota A, Lazzari G, Galli C, Cozzi E, Soulillou JP, B. V, Blancho G. Bortezomib, C1-inhibitor and plasma exchange do not prolong the survival of multi-transgenic GalT-KO pig kidney xenografts in baboons. Am J Transplant 2015; 15:358-70. [PMID: 25612490 PMCID: PMC4306235 DOI: 10.1111/ajt.12988] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 07/23/2014] [Accepted: 08/12/2014] [Indexed: 01/25/2023]
Abstract
Galactosyl-transferase KO (GalT-KO) pigs represent a potential solution to xenograft rejection, particularly in the context of additional genetic modifications. We have performed life supporting kidney xenotransplantation into baboons utilizing GalT-KO pigs transgenic for human CD55/CD59/CD39/HT. Baboons received tacrolimus, mycophenolate mofetil, corticosteroids and recombinant human C1 inhibitor combined with cyclophosphamide or bortezomib with or without 2-3 plasma exchanges. One baboon received a control GalT-KO xenograft with the latter immunosuppression. All immunosuppressed baboons rejected the xenografts between days 9 and 15 with signs of acute humoral rejection, in contrast to untreated controls (n = 2) that lost their grafts on days 3 and 4. Immunofluorescence analyses showed deposition of IgM, C3, C5b-9 in rejected grafts, without C4d staining, indicating classical complement pathway blockade but alternate pathway activation. Moreover, rejected organs exhibited predominantly monocyte/macrophage infiltration with minimal lymphocyte representation. None of the recipients showed any signs of porcine endogenous retrovirus transmission but some showed evidence of porcine cytomegalovirus (PCMV) replication within the xenografts. Our work indicates that the addition of bortezomib and plasma exchange to the immunosuppressive regimen did not significantly prolong the survival of multi-transgenic GalT-KO renal xenografts. Non-Gal antibodies, the alternative complement pathway, innate mechanisms with monocyte activation and PCMV replication may have contributed to rejection.
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Affiliation(s)
- Bas-Bernardet S. Le
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France,Transplant Immunology Unit, Padua General Hospital, Padua, Italy and Consortium for Research in Organ Transplantation (CORIT), Padua, Italy
| | - X. Tillou
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France
| | - J. Branchereau
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France
| | - N. Dilek
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France,Effimune, Nantes, France
| | - N. Poirier
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France,Effimune, Nantes, France
| | - M. Châtelais
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France,Transplant Immunology Unit, Padua General Hospital, Padua, Italy and Consortium for Research in Organ Transplantation (CORIT), Padua, Italy
| | - B. Charreau
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France,Transplant Immunology Unit, Padua General Hospital, Padua, Italy and Consortium for Research in Organ Transplantation (CORIT), Padua, Italy
| | - D. Minault
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France
| | - J. Hervouet
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France
| | - K. Renaudin
- Pathology Laboratory, CHU- Hôtel Dieu, Nantes, France
| | - C. Crossan
- Department of Biological and Biomedical Sciences, Glasgow Caledonian University, Glasgow, United Kingdom,Transplant Immunology Unit, Padua General Hospital, Padua, Italy and Consortium for Research in Organ Transplantation (CORIT), Padua, Italy
| | - L. Scobie
- Department of Biological and Biomedical Sciences, Glasgow Caledonian University, Glasgow, United Kingdom,Transplant Immunology Unit, Padua General Hospital, Padua, Italy and Consortium for Research in Organ Transplantation (CORIT), Padua, Italy
| | - Y. Takeuchi
- University College London, London, United Kingdom,Transplant Immunology Unit, Padua General Hospital, Padua, Italy and Consortium for Research in Organ Transplantation (CORIT), Padua, Italy
| | - M. Diswall
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - M.E. Breimer
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - N. Klar
- Department of Nephrology, University Medical Center, Leiden, The Netherlands,Transplant Immunology Unit, Padua General Hospital, Padua, Italy and Consortium for Research in Organ Transplantation (CORIT), Padua, Italy
| | - M.R. Daha
- Department of Nephrology, University Medical Center, Leiden, The Netherlands,Transplant Immunology Unit, Padua General Hospital, Padua, Italy and Consortium for Research in Organ Transplantation (CORIT), Padua, Italy
| | - P. Simioni
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padua, Padua, Italy,European Xenotransplantation Network Xenome (LSHB- CT- 2006- 037377)
| | - S.C. Robson
- Gastroenterology and Transplant Institute, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - M.B. Nottle
- Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia
| | - E.J. Salvaris
- Immunology Research Centre, St Vincent’s Hospital Melbourne, Victoria, Australia
| | - P.J. Cowan
- Immunology Research Centre, St Vincent’s Hospital Melbourne, Victoria, Australia
| | - A.J.F. d’Apice
- Immunology Research Centre, St Vincent’s Hospital Melbourne, Victoria, Australia
| | - D.H. Sachs
- Transplantation Biology Research Center (TBRC), Massachusetts General Hospital, and Harvard Medical School, Boston, MA, USA
| | - K. Yamada
- Transplantation Biology Research Center (TBRC), Massachusetts General Hospital, and Harvard Medical School, Boston, MA, USA
| | - I. Lagutina
- Avantea, Cremona, Italy,European Xenotransplantation Network Xenome (LSHB- CT- 2006- 037377)
| | - R. Duchi
- Avantea, Cremona, Italy,European Xenotransplantation Network Xenome (LSHB- CT- 2006- 037377)
| | - A. Perota
- Avantea, Cremona, Italy,European Xenotransplantation Network Xenome (LSHB- CT- 2006- 037377)
| | - G. Lazzari
- Avantea, Cremona, Italy,European Xenotransplantation Network Xenome (LSHB- CT- 2006- 037377)
| | - C. Galli
- Avantea, Cremona, Italy,Dept. of Veterinary Medical Science, University of Bologna, Ozzano Emilia, Italy,European Xenotransplantation Network Xenome (LSHB- CT- 2006- 037377)
| | - E. Cozzi
- Transplant Immunology Unit, Padua General Hospital, Padua, Italy and Consortium for Research in Organ Transplantation (CORIT), Padua, Italy,European Xenotransplantation Network Xenome (LSHB- CT- 2006- 037377)
| | - J.-P. Soulillou
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France,European Xenotransplantation Network Xenome (LSHB- CT- 2006- 037377)
| | - Vanhove B.
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France,Effimune, Nantes, France
| | - G. Blancho
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France,European Xenotransplantation Network Xenome (LSHB- CT- 2006- 037377)
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