Objective: Ex vivo perfusion model of pig-to-human kidney xenotransplantation to evaluate human antiporcine xenograft rejection once hyperacute rejection (HAR) is avoided.
Methods: Pig kidneys were perfused for 3 hours with pig blood (group 1; n = 5), human blood (group 2; n = 5), complement heat inactivated human blood (group 3; n = 5), platelet-depleted human blood (group 4; n = 5); and xenoreactive natural antibodies (XNA)-depleted human blood (group 5; n = 5). Tissue samples were studied with immunoperoxidase techniques.
Results: Pig kidneys perfused with human blood, group 2, showed HAR with interstitial haemorrhage, vascular thrombi and glomerular injury. Pig kidneys perfused with manipulated human blood (groups 3 to 5) had no histologic evidence of HAR, but showed signs of acute cellular rejection with different degrees of interstitial infiltrate of mononuclear cells, specially in the XNA-depleted group.
Conclusions: The model may be valuable in the isolated evaluation of the elements involved in the pig-to-human xenorejection. The depletion of complement, platelets and XNA protected porcine kidneys form HAR in our study and allowed the development of an acute cellular rejection, a very unusual fact in this short time, 3 hours.
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