title: Human ABO blood group is important in survival and function of porcine working hearts.
abstract: Pig organs express alphaGal antigen and thus are hyperacutely rejected if perfused by human blood. Human B/A antigens are similar to pig alphaGal antigen, suggesting that the corresponding antibodies may cross-react. Our purpose was to determine if there is a human ABO blood-group difference in porcine-human xenotransplantation. Plasma from six A, five B, seven AB, and six O individuals pooled by blood group were tested in an ex-vivo porcine working heart model. Blood-group A plasma-perfused hearts survived 20 +/- 14 min (n = 5), B 241 +/- 9 min (n = 3), AB 151 +/- 37 min (n = 5), and O 9 +/- 1 min (n = 8). A and O were different (p < 0.001) from B and AB. Function was significantly better in group B. Edema accumulation and creatine kinase change was highest in A and O. All groups had comparable levels of anti-alphaGal antibody, as well as comparable perfusion and operative conditions. Multivariate linear regression analysis showed the anti-B antibody levels to be predictive of survival (p < 0.001). At higher plasma concentrations, hearts perfused with B plasma survived longer (p = 0.01) than AB (218 +/- 45 min, n = 4 vs. 6 +/- 0 min, n = 3). These results suggest a human ABO blood-group difference in porcine-to-human xenotransplantation, which may be mediated by the anti-A and anti-B antibodies.
authors.affiliation: The Division of Cardiac Surgery, Department of Surgery, and The Surgical Medical Research Institute, University of Alberta, Edmonton, Alberta, Canada. manji@ualberta.ca
authors.forename: Rizwan A
authors.initials: RA
authors.lastname: Manji
authors.forename: Jacqueline S
authors.initials: JS
authors.lastname: Manji
authors.forename: Arvind
authors.initials: A
authors.lastname: Koshal
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Korbutt
authors.forename: Ray V
authors.initials: RV
authors.lastname: Rajotte
mesh_terms: D000017:ABO Blood-Group System; D000818:Animals; D001835:Body Weight; D003402:Creatine Kinase / Q000378:metabolism; D004487:Edema; D004797:Enzyme-Linked Immunosorbent Assay; D005700:Galactosyltransferases / Q000096:biosynthesis*; D006321:Heart / Q000502:physiology*; D016027:Heart Transplantation / Q000401:mortality*; D006801:Humans; D016014:Linear Models; D015999:Multivariate Analysis; D009206:Myocardium / Q000378:metabolism; D010477:Perfusion; D010641:Phenotype; D013552:Swine; D013997:Time Factors; D014183:Transplantation, Heterologous / Q000401:mortality*
chemical_list: D000017:ABO Blood-Group System; D005700:Galactosyltransferases; C047006:N-acetyllactosaminide alpha-1,3-galactosyltransferase; D003402:Creatine Kinase