Hyperacute rejection of hDAF-transgenic pig organ xenografts in cynomolgus monkeys: Influence of pre-existing anti-pig antibodies and prevention by the αGal glycoconjugate GAS914

Tuan T. Lam, Bernard Hausen, Katrin Boeke-Purkis, Ricardo Paniagua, Macy Lau, Laurie Hook, Gerry Berry, John Higgins, Rudolf O. Duthaler, Andreas G. Katopodis, Robert Robbins, Bruce Reitz, Dominique Borie, Henk Jan Schuurman, Randall E. Morris

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Background: Our introductory pig-to-cynomolgus monkey heart or kidney transplantation using organs from pigs transgenic for human decay-accelerating factor (hDAF), showed a high incidence of hyperacute rejection (HAR), which was ascribed to extraordinary high levels of anti-pig antibodies. We evaluated the efficacy of GAS914, a Galα1-3Gal trisaccharide linked to a poly-L-lysine backbone, in inhibition of HAR. Methods: hDAF transgenic heterotopic heart (n = 15) or life-supporting kidney (n = 8) transplantation included induction with cyclophosphamide or anti-thymocyte globulin, and maintenance with cyclosporine or tacrolimus, steroids and mycophenolate sodium/mofetil. Four doses of GAS914 were given before transplantation. Rejection was confirmed by graft histology, and anti-pig antibody levels were determined in various assays. Results: Four of six heart transplants without GAS914 treatment showed HAR. Nine subsequent transplants with GAS914 pre-treatment, did not show HAR (chi-square, P < 0.05). Two of four kidney transplants without GAS914 treatment ended with HAR. Four subsequent transplants with GAS914 did not show HAR. Animals with HAR showed extremely high antibody levels. Samples just before transplantation showed significantly higher antibody levels in recipients presenting with HAR. In all assays antibody levels were significantly lowered by GAS914 pre-treatment. Conclusions: HAR of hDAF solid organs could be ascribed to high levels of anti-pig antibodies. It is hypothesized that the hDAF transgene shows a threshold in efficacy, above which an overwhelming attack by antibodies and complement activation cannot be modulated to prevent HAR. HAR does not occur when animals with lower levels are used, or when antibodies are effectively depleted from the circulation by GAS914 treatment.

Original languageEnglish (US)
Pages (from-to)517-524
Number of pages8
JournalXenotransplantation
Volume11
Issue number6
DOIs
StatePublished - Nov 2004

Keywords

  • GAS914
  • Hyperacute rejection
  • Pig-to-nonhuman primate transplantation
  • Soluble Gal glycoconjugate
  • hDAF-transgenic organs

ASJC Scopus subject areas

  • Immunology
  • Transplantation

Fingerprint Dive into the research topics of 'Hyperacute rejection of hDAF-transgenic pig organ xenografts in cynomolgus monkeys: Influence of pre-existing anti-pig antibodies and prevention by the αGal glycoconjugate GAS914'. Together they form a unique fingerprint.

Cite this