The Effects of Exogenous Administration of Human Coagulation Factors Following Pig-to-Baboon Liver Xenotransplantation

• DOI: 10.1111/ajt.13647
• Publication Date: 2015-11-27T21:46:44Z
• Authors: N. Navarro-Alvarez; J.A. Shah; A. Zhu; J. Ligocka; H. Yeh; N. Elias; I. Rosales; R. Colvin; A.B. Cosimi; J.F. Markmann; M. Hertl; D.H. Sachs; P.A. Vagefi
• Keywords: Xenotransplantation; Bolus (digestion)

We sought to determine the effects of exogenous administration human coagulation factors following pig-to-baboon liver xenotransplantation (LXT) using GalT-KO swine donors. After LXT, baboons received no (historical control, n=1), bolus a prothrombin concentrate complex (hPCC; 2.5 mL/kg, n=2), continuous infusion hPCC (1.0 mL/h, n=1) or recombinant factor VIIa (1 µg/kg per hour, n=3). The historical control recipient demonstrated persistent thrombocytopenia despite platelet after transplant, along with widespread thrombotic microangiopathy (TMA). In contrast, levels were maintained in recipients; however, these animals quickly developed large-vessel thrombosis and TMA, leading graft failure shortened survival. Recipients experienced either stabilization an increase their circulating platelets escalating doses. Furthermore, transfusion requirements decreased, hepatic TMA was noticeably absent recipients infusions compared recipients. This effect most profound continuous, dose VIIa. Further studies are warranted because this regimen may allow for prolonged survival LXT.