Survival of non-human primates (NHPs) with life-supporting kidneys 1-4 or hearts 5 extends for many months. Attention has now turned towards phase transition to the first clinical trials. Ideally, the genetically engineered pig used as the source of the organs in the pre-clinical studies should be the same as that planned for the first clinical trials. Unfortunately, this will be difficult, and maybe impossible, because of differences in antibody binding to pig cells between humans and Old World NHPs. 6,7
In conclusion, the present study indicates that, apart from GTKO and DKO, removal of the three major known carbohydrate xenoglycans from pigs does not reduce the human proliferative response to pig cells. The evidence revealed a role of the sialic acid Neu5Gc expression in pig cells for T-cell immune response via glycan-mediated pathways. 8,9 We suggest, therefore, that, although the human antibody-mediated response to a TKO pig organ graft will be reduced, cell-mediated rejection may be just as vigorous as to a WT pig organ, and greater than to a GTKO or DKO pig organ.
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