Acute Vascular Xenograft Rejection Avxr

These complement inhibitory strategies have not entirely solved the xenograft rejection problem, as they have unmasked an acute and irreversible vascular rejection, which causes graft loss days to weeks posttransplant despite effective complement inhibition. This process, known as AVXR or delayed xenograft rejection (DXR), is currently the most significant immunological barrier to successful xenotransplantation. AVXR is typically associated with: endothelial antibody deposition; infiltration of macrophages and natural killer (NK) cells; evidence of endothelial activation and localized hypercoagulability; loss of endothelial integrity, and microvascular thrombosis. While AVXR is not the result of complement mediated lysis (CML), anti-porcine xenoantibodies still appear to play a central role.

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