title: Reduction of consumptive coagulopathy using porcine cytomegalovirus-free cardiac porcine grafts in pig-to-primate xenotransplantation.
abstract: BACKGROUND
  Xenotransplantation using pigs as the source species for organs carries a potential risk for transmission and activation of porcine herpesviruses. Activation of porcine cytomegalovirus (PCMV) in pig-to-baboon xenotransplantation is associated with xenograft injury and possibly an increased incidence of consumptive coagulopathy (CC).
  
  
  METHODS
  To further investigate the role of PCMV activation in the occurrence of CC, a strategy to exclude PCMV from the donor was developed. To exclude PCMV, piglets were early-weaned and raised separated from other swine. These piglets were used as donors in an experimental protocol of pig-to-baboon heart xenotransplantation.
  
  
  RESULTS
  Early weaning of piglets was successful in excluding PCMV. Use of PCMV-free cardiac porcine xenografts in baboons resulted in prolonged graft survival and prevented consumptive coagulopathy in all recipients.
  
  
  CONCLUSIONS
  The use of PCMV-free cardiac grafts is beneficial in reducing the direct effects of PCMV activation in the graft (tissue damage) and the indirect effects of PCMV activation in the recipient (consumptive coagulopathy).
authors.affiliation: Infectious Diseases Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRJ 504, Boston, MA 02114, USA. jfisherman@partners.org
authors.forename: Nicolas J
authors.initials: NJ
authors.lastname: Mueller
authors.forename: Kenji
authors.initials: K
authors.lastname: Kuwaki
authors.forename: Frank J M F
authors.initials: FJ
authors.lastname: Dor
authors.forename: Christoph
authors.initials: C
authors.lastname: Knosalla
authors.forename: Bernd
authors.initials: B
authors.lastname: Gollackner
authors.forename: Robert A
authors.initials: RA
authors.lastname: Wilkinson
authors.forename: David H
authors.initials: DH
authors.lastname: Sachs
authors.forename: David K C
authors.initials: DK
authors.lastname: Cooper
authors.forename: Jay A
authors.initials: JA
authors.lastname: Fishman
mesh_terms: D000818:Animals; D001483:Base Sequence; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification*; D017931:DNA Primers; D004279:DNA, Viral / Q000235:genetics; D004211:Disseminated Intravascular Coagulation / Q000517:prevention & control*; D005340:Fibrinogen / Q000378:metabolism; D006085:Graft Survival / Q000502:physiology; D016027:Heart Transplantation / Q000009:adverse effects / Q000502:physiology*; D010215:Papio; D010976:Platelet Count; D016133:Polymerase Chain Reaction; D013552:Swine; D014183:Transplantation, Heterologous / Q000009:adverse effects / Q000502:physiology*
chemical_list: D017931:DNA Primers; D004279:DNA, Viral; D005340:Fibrinogen