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Cited by 471Xenotransplantation and immune responseOrgan Transplantation Techniques and OutcomesTransplantation: Methods and Outcomes

Baboon-to-human liver transplantation

Open access
Starzl, T.E, Fung, J, Tzakis, A, Todo, S, Demetris, A.J, Marino, I.R, Doyle, H, Zeevi, A +11 more·1993·The Lancet
DOI 10.1016/0140-6736(93)92553-6PMC PMC2962592
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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.

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  • Orthotropic transplantation of a liver from a small-size donor to a larger-size recipient causes an increase in the transplant's size.

    “It has been demonstrated, that orthotropic transplantation of liver from small size donor to larger size recipient causes the increase in transplant’s size[35].”

    From Liver regeneration after partial hepatectomy: Triggers and mechanisms (2025) · cites this paper as [35]

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Research works printed but not linked: 31

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Authors
Starzl, T. E., Fung, J., Tzakis, A., Todo, S., Demetris, A. J., Marino, I. R., Doyle, H., Zeevi, A., Warty, V, Kusne, S., Demetris, A. J., Zeevi, A., Warty, V, Rudert, W. A., Trucco, M., Michaels, M., Kusne, S., Rudert, W. A., & Trucco, M.
Affiliations
University of Pittsburgh (US)
Corresponding author
Starzl, T.E
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
1993-01
Volume
341
Issue
8837
Pages
65-71
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/0140-6736(93)92553-6
PMC
PMC2962592
OpenAlex
W2146821092
Cited by
471
References
0
Citations by year
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FWCI
46.55
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • D-Scholarship@Pitt (University of Pittsburgh) (acceptedVersion)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Funders
National Institute of Diabetes and Digestive and Kidney Diseases (DK 29961, R01DK029961)
Topics
  • Health Sciences › Medicine › Surgery › Xenotransplantation and immune response
  • Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
  • Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
Keywords
xenotransplantation, xenograft rejection, chronic active hepatitis B, HIV infection, cyclophosphamide, immunosuppression, chimerism, biliary stasis, choledochojejunostomy, aspergillosis, cerebral hemorrhage
MeSH terms
Adult, Animals, Hepatitis B, Hepatitis, Chronic, Humans, Immunologic Techniques, Liver, Liver Cirrhosis, Liver Function Tests, Male, Papio, Postoperative Care, Postoperative Period, Transplantation, Heterologous, HIV Infections, Liver Transplantation, AIDS-Related Opportunistic Infections

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