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Nat Commun. 2016 Apr 5;7:11138. doi: 10.1038/ncomms11138.

Chimeric 2C10R4 anti-CD40 antibody therapy is critical for long-term survival of GTKO.hCD46.hTBM pig-to-primate cardiac xenograft.

Author information

1
Cardiothoracic Surgery Research Program, NHLBI, NIH, Bethesda, Maryland 20892, USA.
2
Division of Veterinary Resources, ORS, NIH, Bethesda, Maryland 20892, USA.
3
NICHD/NIH, Bethesda, Maryland 20892, USA.
4
Leidos Biomedical Research, Inc., Bethesda, Maryland 20892, USA.
5
University of Maryland Medical Center, Baltimore, Maryland 20201, USA.
6
MassBiologics, University of Massachusetts Medical School, Boston, Massachusetts 02126, USA.
7
Ludwig Maximilian University, Munich 81377, Germany.
8
Revivicor Inc., Blacksburg, Virginia 24060, USA.

Abstract

Preventing xenograft rejection is one of the greatest challenges of transplantation medicine. Here, we describe a reproducible, long-term survival of cardiac xenografts from alpha 1-3 galactosyltransferase gene knockout pigs, which express human complement regulatory protein CD46 and human thrombomodulin (GTKO.hCD46.hTBM), that were transplanted into baboons. Our immunomodulatory drug regimen includes induction with anti-thymocyte globulin and αCD20 antibody, followed by maintenance with mycophenolate mofetil and an intensively dosed αCD40 (2C10R4) antibody. Median (298 days) and longest (945 days) graft survival in five consecutive recipients using this regimen is significantly prolonged over our recently established survival benchmarks (180 and 500 days, respectively). Remarkably, the reduction of αCD40 antibody dose on day 100 or after 1 year resulted in recrudescence of anti-pig antibody and graft failure. In conclusion, genetic modifications (GTKO.hCD46.hTBM) combined with the treatment regimen tested here consistently prevent humoral rejection and systemic coagulation pathway dysregulation, sustaining long-term cardiac xenograft survival beyond 900 days.

PMID:
27045379
PMCID:
PMC4822024
DOI:
10.1038/ncomms11138
[Indexed for MEDLINE]
Free PMC Article

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