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Analysis of potential porcine endogenous retrovirus (PERV) transmission in a whole-organ xenotransplantation model without interfering microchimerism
Authors:Martin Loss  Heiko Arends  M. Winkler  Michael Przemeck  Gustav Steinhoff  Susanne Rensing  Franz-Josef Kaup  Hans J. Hedrich  Monica E. Winkler  Ulrich Martin
Affiliation:Klinik für Viszeral- und Transplantationschirurgie, Medizinische Hochschule Hannover, Germany.
Abstract:The question whether porcine xenografts can lead to porcine endogenous retrovirus (PERV) infection of recipients is critical for the evaluation of the safety of pig-to-man xenotransplantation. Unfortunately, polymerase chain reaction (PCR)-based analysis of potential PERV infections in nonhuman-primate whole-organ xenotransplantation models is hampered by false positive results due to chimeric porcine cells. To avoid the inherent analytical problem of xenomicrochimerism, we developed a non-life-supporting pig-to-primate kidney xenotransplantation model: porcine kidneys were transplanted, whereas the functioning recipient kidneys remained in situ. Subsequent to rejection (after 2 hours to 15 days), xenografts were removed, and recipients remained alive for up to 287 days. Immunosuppressive therapy based on cyclophosphamide, cyclosporine, and steroids was maintained for 28 days after transplantation. Using appropriate PCR assays, xenochimerism was found in tissue samples and partly even in peripheral blood leukocytes (PBLs) while the porcine kidneys were in situ. After graft removal, xenochimerism was no longer detectable, thus allowing analysis for possible PERV transmission.
Keywords:Xenotransplantation    Porcine endogenous retrovirus    Chimerism    Pig-to-primate    Kidney transplantation
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