title: Efficacy of pig-to-rhesus lamellar corneal xenotransplantation.
abstract: PURPOSE. To solve the shortage of donor corneas, a decellularizing method based on hypertonic saline treatment was introduced, and a favorable outcome was observed in pig-to-rabbit lamellar corneal transplantation. This study was an investigation of the efficacy of pig-to-nonhuman primate lamellar corneal transplantation, using both decellularized and fresh porcine corneas to assess feasibility as a substitute for human corneas. METHODS. Nine Chinese rhesus macaques underwent lamellar corneal transplantation using both decellularized (n = 5) and fresh (n = 4) porcine corneas. Clinically acceptable graft size (7.5 mm in diameter) and minimal immunosuppression based on topical and systemic corticosteroids were applied. Rejection signs, histology of porcine grafts, and serial changes in recipients' blood profile, including memory T-cell subset, anti-α-Gal and donor pig-specific antibodies, and complement were evaluated. Changes in aqueous complement concentration were also assessed at 4 weeks after transplantation. RESULTS. Of the decellularized porcine lamellar grafts, 80% remained transparent for more than 6 months, whereas half of the fresh porcine lamellar grafts developed chronic rejection. Rejected grafts showed extensive cellular infiltration, predominantly CD8(+) T lymphocytes and macrophages. Immunologic profiles of the recipients with rejected grafts showed a significant increase in the concentration of aqueous complement, an enhancement of memory T cells, and an abrupt increase in donor pig-specific antibodies. CONCLUSIONS. The findings suggested that decellularized porcine cornea could be a promising substitute for human corneal allograft. Fresh porcine cornea may be a feasible option for a substitute if combined with more potent immunosuppression or if obtained from transgenic pigs with complement-regulatory proteins.
authors: Department of Ophthalmology, Healthcare System Gangnam Center, Seoul, Korea.
authors: Hyuk Jin
authors: HJ
authors: Choi
authors: Mee Kum
authors: MK
authors: Kim
authors: Hyun Ju
authors: HJ
authors: Lee
authors: Jung Hwa
authors: JH
authors: Ko
authors: So Hee
authors: SH
authors: Jeong
authors: Jae-Il
authors: JI
authors: Lee
authors: Byoung-Chol
authors: BC
authors: Oh
authors: Hee Jung
authors: HJ
authors: Kang
authors: Won Ryang
authors: WR
authors: Wee
mesh_terms: D000818:Animals; D001082:Aqueous Humor / Q000276:immunology; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D003165:Complement System Proteins / Q000276:immunology; D003315:Cornea / Q000276:immunology* / Q000473:pathology; D016039:Corneal Transplantation; D004797:Enzyme-Linked Immunosorbent Assay; D005434:Flow Cytometry; D019084:Fluorescent Antibody Technique, Indirect; D006084:Graft Rejection / Q000276:immunology; D006085:Graft Survival / Q000502:physiology; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008253:Macaca mulatta; D008264:Macrophages / Q000276:immunology; D013552:Swine; D013556:Swine, Miniature; D014183:Transplantation, Heterologous; D000519:alpha-Galactosidase / Q000276:immunology
chemical_list: D007074:Immunoglobulin G; D007075:Immunoglobulin M; D003165:Complement System Proteins; D000519:alpha-Galactosidase