The Journal of Thoracic and Cardiovascular Surgery, Vol 93, 809-814, Copyright © 1987 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Cardiac xenotransplantation in primates
AM Sadeghi, RC Robbins, CR Smith, PA Kurlansky, RE Michler, K Reemtsma and EA Rose
Successful cardiac xenotransplantation would alleviate the severe shortage
of donor organs that presently limits the availability of cardiac
transplantation. Early attempts at human xenotransplantation achieved
minimal success. However, the effectiveness of cyclosporine in nonhuman
xenotransplant models has received little experimental investigation. We
have therefore studied the effect of cyclosporine- based immunosuppression
in primate cardiac xenograft models using cynomolgus monkey donors and
baboon recipients. Donor hearts were transplanted heterotopically into the
necks of recipients or in the orthotopic position. Recipients were treated
with no immunosuppression (controls), cyclosporine and steroids, or
cyclosporine, steroids, azathioprine, and antithymocyte globulin.
Statistically significant prolongation of graft survival compared to the
control group was observed in the heterotopic groups. Mean survival time of
the cyclosporine-treated and steroid-treated heterotopic grafts was 61 days
compared to 6 days for grafts in the control group (p = 0.01); the addition
of azathioprine and antithymocyte globulin yielded a mean survival of 84
days (p less than 0.01). No significant increase in graft survival was
noted in the orthotopic groups treated with either immunosuppressive
regimen. Although long-term use of human xenografts as an alternative for
heart replacement is not supported by these data, further investigation of
the orthotopic model is clearly justified.
