Worldwide First Successful Long-term Survival after Orthotopic Cardiac Xenotransplantation of Multitransgenic Pig Hearts into Baboons Using a CD40mAb or CD40L Costimulation Blockade

Objectives: In our orthotopic cardiac xenotransplantation (OHXTx) pig-to-baboon model with GalT-KO/hCD46/hTM transgenic donor pigs we used a non-toxic immunosuppression (IS) based on CD40mAb co-stimulation blockade in group G1 and in a group G2 a new PAsylated, nonthrombogenic CD40L-Ab. The procedure of PASylation prolongs plasma half-life to several days. Primary aims were to achieve a constant preclinical long-term survival in a life-supporting cardiac xenotransplantation model and to prevent perioperative cardiac xenograft dysfunction (PCXD).