In the hamster to rat liver transplant model, we determined the efficacy of tacrolimus in attenuating natural xenospecific humoral immunity and in abrogating the hyperacute liver rejection that is produced by presensitizing the Lewis rat recipient. Hamster livers, transplanted orthotopically into naive rats (controls), were rejected with animal death after 6.4±0.5 (SD) days. The infusion on (day -6) of 1.5 x 10 7 hamster hepatocytes, or of 1.5 x 10 8 nonparenchymal cells (NPC), resulted in hyperacute rejection and death in s1.9 days. However, when the rats were pretreated with 1 mglkg/day tacrolimus from days -6 to -1, survival of non-presensitized animals was prolonged to 25±20 days and that of recipients presensitized with hamster hepatocytes to 36±16 days or with NPC to 32±1.7 days. The tacrolimus pretreatment significantly reduced the hamster-specific complement-dependent cytotoxic antibodies response directed to liver NPC but not to lymph node cell targets. These observations suggest that the prolongation of survival by appropriately timed treatment with this T cell directed drug model is caused by the inhibition of humoral as well as cellular xenograft rejection.The consequences of humoral immunity in xenotransplant models are dictated by the species combination (1, 2), the kind of organ that is engrafted (3), and the direction of organ transfer between the species (4, 5). With the appropriate selection of these variables, xenograft survival in an unaltered recipient may range from a few minutes (hyperacute rejection [HAR*]) to several days. In the longer survival models, species-specific xenosensitization of the recipient produces HAR (6)(7)(8)(9)(10). For example, the humoral rejection in 3 days of abdominally placed hamster hearts is converted in presensitized rats to HAR that is complete in < 10 min (6,. In contrast, when the antibody resistant hamster liver is transplanted under the same circumstances of presensitization, the reduction in survival is from 7 to <2.0 days (11).Untreated nude (T-cell deficient) rats reject hamster heart grafts at the same 3 days as in normal rats (12)(13)(14), ostensi- bly in accord with a T-cell independent mechanism of humoral xenograft rejection. However, the pre sensitization procedure that caused HAR within 10 min in normal rats resulted in prolonged xenograft survival in all nude rat recipients, and, in 4 of 10 experiments, survival exceeded 100 days (15). This observation, coupled with the demonstration of a remarkably obtunded antibody response in the presensitized nude recipients, prompted the experiments in normal Lewis rats reported here in which the nude rat environment was mimicked with a 6-day pretransplant course of the T-cell directed immunosuppressant tacrolimus. Tacrolimus pretreatment alone did not reduce the titer of preformed xenospecific antibodies. However, it abrogated HAR of hamster hepatic xenografts by presensitized rats, and it prolonged the survival of the transplanted livers several times beyond that in untreated recipients, whether or not t...