Transplantation Research Center, Samsung Medical Center, Seoul, Republic of Korea; Department of Health Sciences & Technology, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul 06355, Republic of Korea.
Department of Surgery, Dongguk University Ilsan Hospital, Dongguk University School of Medicine, Goyang, Republic of Korea.
Transplant Proc. 2024 Apr;56(3):686-691. doi: 10.1016/j.transproceed.2024.01.028. Epub 2024 Feb 19.
Xenotransplantation, particularly when involving pig donors, presents challenges related to the transmission of porcine cytomegalovirus (pCMV) and its potential impact on recipient outcomes. This study aimed to investigate the relationship between pCMV positivity in both donors and recipients and the survival time of cynomolgus monkey recipients after xenogeneic kidney transplantation.
We conducted 20 cynomolgus xenotransplants using 18 transgenic pigs. On the surgery day, donor pig blood was sampled, and DNA was extracted from serum and peripheral blood mononuclear cells. Recipient DNA extraction followed the same protocol from pre-transplantation to post-transplantation. Porcine cytomegalovirus detection used real-time polymerase chain reaction (real-time PCR) with the ViroReal kit, achieving a sensitivity of 50 copies/reaction. A Ct value of 37.0 was the pCMV positivity threshold.
Of 20 cynomolgus recipients, when donors tested negative for pCMV, recipients also showed negative results in 9 cases. In 4 cases where donors were negative, recipients tested positive. All 5 cases with pCMV-positive donors resulted in positive assessments for recipients. Detection of donor pCMV correlated with shorter recipient survival. Continuous recipient positivity during observation correlated with shorter survival, whereas transient detection showed no significant change in survival rates. However, donor pig phenotypes and transplantation protocols did not significantly impact survival.
The detection of pCMV in both donors and recipients plays a crucial role in xenotransplantation outcomes. These findings suggest the importance of monitoring and managing pCMV in xenotransplantation to enhance long-term outcomes.
异种移植，特别是涉及猪供体时，存在与猪巨细胞病毒（pCMV）传播相关的挑战，及其对受者结局的潜在影响。本研究旨在探讨供体和受者 pCMV 阳性与食蟹猴异种肾移植后受者存活时间之间的关系。
我们进行了 20 例食蟹猴异种移植，使用了 18 只转基因猪。在手术当天，采集供体猪的血液，并从血清和外周血单核细胞中提取 DNA。受者 DNA 提取遵循从移植前到移植后的相同方案。使用 ViroReal 试剂盒的实时聚合酶链反应（real-time PCR）检测猪巨细胞病毒，灵敏度为 50 拷贝/反应。pCMV 阳性的阈值为 Ct 值 37.0。
在 20 例食蟹猴受者中，当供体 pCMV 检测为阴性时，9 例受者也呈阴性结果。在 4 例供体为阴性的情况下，受者检测为阳性。所有 5 例 pCMV 阳性供体的受者均呈阳性评估。供体 pCMV 的检测与受者存活时间较短相关。观察期间受者持续阳性与存活时间较短相关，而短暂检测则未显示存活时间的显著变化。然而，供体猪表型和移植方案并未显著影响存活。
供体和受者 pCMV 的检测在异种移植结局中起着关键作用。这些发现表明，在异种移植中监测和管理 pCMV 对于提高长期结局至关重要。
