Prolongation of cardiac xenograft survival by double filtration plasmapheresis and ex vivo immunoadsorption.
A double filtration plasmapheresis (DFPP) technique and ex vivo immunoadsorption were applied to remove natural antibodies and avoid hyperacute rejection in discordant xenotransplantation. A swine heart was heterotopically transplanted into a dog's neck after DFPP and ex vivo immunoadsorption using a swine spleen or liver. Mean graft survival time was prolonged to 240 +/- 141 min in the group treated by combined DFPP and splenic adsorption, and 225 +/- 62 min in the group treated by combined DFPP and hepatic adsorption, whereas it was 9 +/- 5 min in the group without any treatment (p < 0.01). Mean removal rates of IgG and IgM were 85.5% and 93.3%, respectively. Anti-swine lymphocytotoxic antibodies and hemagglutination antibodies were also effectively removed. Deposits of canine IgM and C3 on the vascular endothelium of the graft were observed on immunofluorescence, which suggested that natural antibodies in the IgM fraction played an important role in xenohyperacute rejection.
Sato
Y
Y
3rd Department of Surgery, Tokyo Women's Medical College, Japan.
Kimikawa
M
M
Suga
H
H
Hayasaka
Y
Y
Teraoka
S
S
Agishi
T
T
Ota
K
K
D000818:Animals; D000961:Antilymphocyte Serum / Q000302:isolation & purification; D004285:Dogs; D006085:Graft Survival; D016027:Heart Transplantation / Q000276:immunology*; D007074:Immunoglobulin G / Q000097:blood / Q000302:isolation & purification; D007075:Immunoglobulin M / Q000097:blood / Q000302:isolation & purification; D007163:Immunosorbent Techniques; D066298:In Vitro Techniques; D010956:Plasmapheresis / Q000379:methods*; D013552:Swine; D014183:Transplantation, Heterologous; D016042:Transplantation, Heterotopic
D000961:Antilymphocyte Serum; D007074:Immunoglobulin G; D007075:Immunoglobulin M