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Baboon-to-human liver transplantation

Starzl, TE and Fung, J and Tzakis, A and Todo, S and Demetris, AJ and Marino, IR and Doyle, H and Zeevi, A and Warty, V and Kusne, S and Demetris, AJ and Rudert, WA and Trucco, M and Michaels, M (1993) Baboon-to-human liver transplantation. The Lancet, 341 (8837). 65 - 71. ISSN 0140-6736

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Abstract

Our ability to control both the cellular and humoral components of xenograft rejection in laboratory experiments, together with an organ shortage that has placed limits on clinical transplantation services, prompted us to undertake a liver transplantation from a baboon to a 35-year-old man with B virus-associated chronic active hepatitis and human immunodeficiency virus infection. Liver replacement was performed according to conventional surgical techniques. Immunosuppression was with the FK 506-prednisone-prostaglandin regimen used routinely for hepatic allotransplantation, to which a daily non-myelotoxic dose of cyclophosphamide was added. During 70 days of survival, there was little evidence of hepatic rejection by biochemical monitoring or histopathological examination. Products of hepatic synthesis, including clotting factors, became those of the baboon liver with no obvious adverse effects. Death followed a cerebral and subarachnoid haemorrhage that was caused by an angioinvasive aspergillus infection. However, the underlying cause of death was widespread biliary sludge that formed in the biliary tree despite a seemingly satisfactory choledochojejunostomy. During life and in necropsy samples, there was evidence of the chimerism that we believe is integral to the acceptance of both xenografts and allografts. Our experience has shown the feasibility of controlling the rejection of the baboon liver xenograft in a human recipient. The biliary stasis that was the beginning of lethal infectious complications may be correctable by modifications of surgical technique. In further trials, the error of over-immunosuppression should be avoidable. © 1993.

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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Starzl, TEtes11@pitt.eduTES11
Fung, J
Tzakis, A
Todo, S
Demetris, AJ
Marino, IR
Doyle, H
Zeevi, A
Warty, V
Kusne, S
Demetris, AJ
Rudert, WA
Trucco, M
Michaels, M
Centers: Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute
Date: 9 January 1993
Date Type: Publication
Journal or Publication Title: The Lancet
Volume: 341
Number: 8837
Page Range: 65 - 71
DOI or Unique Handle: 10.1016/0140-6736(93)92553-6
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0140-6736
Other ID: uls-drl:31735062112853, Starzl CV No. 1498
Date Deposited: 08 Apr 2010 17:25
Last Modified: 03 Feb 2020 15:55
URI: http://d-scholarship.pitt.edu/id/eprint/4884

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