title: Efficacy of double filtration plasmapheresis in removing xenoantibodies and prolonging xenograft survival in an ex vivo swine perfusion model.
abstract: BACKGROUND
  In xenotransplantation, antibodies mediate humoral rejection, resulting in organ dysfunction. Removal of xenoantibodies is likely a first step for successful transplantation. Double filtration plasmapheresis (DFPP) selectively removes large molecular weight pathogenic substances, such as immunoglobulins (Ig), without other plasma proteins. The antibodies fractions removed and the changes in blood biochemistry are unanswered questions after DFPP in addressed this ex vivo swine heart perfusion model.
  
  
  METHODS
  Twelve swine hearts were perfused with human blood in a modified Langendorff's apparatus. The perfusate containing human blood was divided into 2 groups: controls (N = 6) and DFPP-treated group (N = 4). Blood counts, biochemistry data, and immunological profiles were compared at 3 time points: before and after DFPP and after heart perfusion.
  
  
  RESULTS
  Perfusion times of control and DFPP groups were 5.43 ± 1.81 vs 9.25 ± 3.00 hours, respectively. Only the values of albumin and total protein showed difference. The immunologic profile revealved complete removal of IgM and most IgG, IgA, C3, and C4, namely, 79.95%, 88.58%, 83.15%, and 87.97%, respectively.
  
  
  CONCLUSIONS
  DFPP showed excellent efficacy to remove xenoantiboidies and prolong xenograft survival in an ex vivo perfusion model.
authors.affiliation: Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan.
authors.forename: Y-T
authors.initials: YT
authors.lastname: Lee
authors.forename: C-H
authors.initials: CH
authors.lastname: Chu
authors.forename: S-H
authors.initials: SH
authors.lastname: Sue
authors.forename: I-C
authors.initials: IC
authors.lastname: Chen
authors.forename: J
authors.initials: J
authors.lastname: Wei
mesh_terms: D000818:Animals; D000910:Antibodies, Heterophile / Q000097:blood*; D001803:Blood Transfusion; D006085:Graft Survival; D006321:Heart; D006801:Humans; D056724:Immunity, Humoral; D007074:Immunoglobulin G / Q000097:blood*; D023421:Models, Animal; D010477:Perfusion; D010956:Plasmapheresis / Q000379:methods*; D012709:Serum Albumin / Q000378:metabolism; D013552:Swine; D013997:Time Factors; D014183:Transplantation, Heterologous / Q000276:immunology
chemical_list: D000910:Antibodies, Heterophile; D007074:Immunoglobulin G; D012709:Serum Albumin