The Problem Of Hyperacute Rejection

Before porcine xenografting can become a reality, the first hurdle to overcome is HAR. Evidence now strongly suggests that this immunological barrier to xenotransplantation between disparate species combinations derives from one or more of three factors: (1) the specific interaction of recipient xenoreactive antibodies with antigens present on the endothelium of the donor organ, followed by activation of the complement cascade, (2) the direct activation of the recipient complement system by donor endothelial cells, (3) the relative failure of complement inhibitory proteins in the donor organ to impede activation of the recipient complement system. This improved understanding of the pathogenesis of HAR has provided a scientific foundation on which to devise and evaluate therapeutic approaches to extend porcine xenograft survival.

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