title: Prevention of hyperacute rejection by human decay accelerating factor in xenogeneic perfused working hearts.
abstract: As a potential source of organs for xenotransplantation, pigs that are transgenic for human decay accelerating factor (DAF) have been bred in order to overcome hyperacute rejection. We investigated the protective effect of human DAF in a porcine working heart model perfused by human blood. Hearts of normal landrace pits served as controls. The following parameters were measured: stroke work index, coronary flow and arteriovenous oxygen consumption, 6-keto prostaglandin F1alpha and prostaglandin E2 as markers of endothelial cell activation; creatine phosphokinase and lactate dehydrogenase for evaluation of the extent of myocardial damage; TNFalpha and IL-6 as markers of mononuclear cell activation. Histological and ultrastructural investigations from myocardial tissue sections were done at the end of perfusion. Human (h) DAF appeared to inhibit complement-mediated endothelial cell activation of transgenic pig hearts successfully. This was in contrast to landrace pig hearts, which had a sixfold increase of prostaglandin levels during perfusion with human blood. The cardiac weight increase during perfusion time due to interstitial edema tended to be less in the hDAF group. Myocardial damage was minimal in transgenic hearts, whereas normal pig hearts produced a threefold increase of creatine phosphokinase and lactate dehydrogenase levels. In these hearts, electron microscopy revealed single cell necrosis of myocytes and vacuolization of mitochondria with cristae rupture. According to the results obtained in the working heart model, the breeding of pigs that are transgenic for hDAF represents a promising step to making heart xenotransplantation a clinical reality in the future.
authors.affiliation: Department of Cardiac Surgery, Klinikum Grosshadern, University of Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Schmoeckel
authors.forename: G
authors.initials: G
authors.lastname: Nollert
authors.forename: M
authors.initials: M
authors.lastname: Shahmohammadi
authors.forename: V K
authors.initials: VK
authors.lastname: Young
authors.forename: G
authors.initials: G
authors.lastname: Chavez
authors.forename: W
authors.initials: W
authors.lastname: Kasper-König
authors.forename: D J
authors.initials: DJ
authors.lastname: White
authors.forename: J
authors.initials: J
authors.lastname: Müller-Höcker
authors.forename: R M
authors.initials: RM
authors.lastname: Arendt
authors.forename: U
authors.initials: U
authors.lastname: Wilbert-Lampen
authors.forename: C
authors.initials: C
authors.lastname: Hammer
authors.forename: B
authors.initials: B
authors.lastname: Reichart
mesh_terms: D000208:Acute Disease; D000818:Animals; D030801:Animals, Genetically Modified; D001769:Blood / Q000276:immunology*; D018958:CD55 Antigens / Q000235:genetics / Q000502:physiology*; D003167:Complement Activation; D003180:Complement C3b Inactivator Proteins / Q000235:genetics / Q000502:physiology*; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control*; D006321:Heart / Q000502:physiology*; D006334:Heart Function Tests; D016027:Heart Transplantation / Q000276:immunology*; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism; D008297:Male; D009206:Myocardium / Q000276:immunology*; D010477:Perfusion; D013045:Species Specificity; D013552:Swine / Q000235:genetics / Q000276:immunology*; D014183:Transplantation, Heterologous / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D018958:CD55 Antigens; D003180:Complement C3b Inactivator Proteins; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha