Aberrations in hemostasis and coagulation in untreated discordant hepatic xenotransplantation: Studies in the dog-to-pig model

A. Joseph Tector, Jonathan A. Fridell, Nahel Elias, Taichi Watanabe, Julie Salazar, Doris Greinke, Peter Metrakos, Jean I. Tchervenkov

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18 Scopus citations

Abstract

Discordant liver xenotransplantation is a poorly explored entity. Data from the few large animal studies of hepatic xenotransplantation suggest that severe hemorrhage is encountered. The purpose of the studies described here is to characterize the nature of the hemorrhage that accompanies liver xenotransplantation. Canine livers were transplanted into porcine recipients, and lethal hemorrhage was encountered. Analysis of recipient blood showed that factors V, IX, and X were present in adequate levels until after the hemorrhage appeared, suggesting that coagulation factor loss was the result and not the cause of hemorrhage. Platelet counts decreased dramatically in recipients within minutes of graft reperfusion. There also was no evidence of clotting activity in the blood of recipients of liver xenografts within minutes of graft reperfusion. This loss of clotting activity was specific to liver xenografts, was not seen in renal xenografts with or without venovenous bypass, and also was absent in pig-to-pig liver allografts. In brief, the hemorrhage that accompanies liver xenotransplantation occurs because of a decrease in the number and function of circulating platelets in the recipient.

Original languageEnglish (US)
Pages (from-to)153-159
Number of pages7
JournalLiver Transplantation
Volume8
Issue number2
DOIs
StatePublished - Jan 1 2002

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ASJC Scopus subject areas

  • Surgery
  • Hepatology
  • Transplantation

Cite this

Tector, A. J., Fridell, J. A., Elias, N., Watanabe, T., Salazar, J., Greinke, D., Metrakos, P., & Tchervenkov, J. I. (2002). Aberrations in hemostasis and coagulation in untreated discordant hepatic xenotransplantation: Studies in the dog-to-pig model. Liver Transplantation, 8(2), 153-159. https://doi.org/10.1053/jlts.2002.30881