Application of double filtration plasmapheresis to cynomolgus monkeys: surgical techniques and a pilot study of pig fetal kidney transplantation

Abstract

ABSTRACT Purpose: To detail a technique to implant a double-lumen catheter to remove anti-pig antibodies. We transplanted fetal pig kidneys into cynomolgus monkeys using a double filtration plasma exchange (DFPP) protocol. Methods: Two approaches for double-lumen catheter insertion in monkeys (3–9.2 kg) were developed. DFPP was performed using hydroxyethyl starch (6%) as a replacement fluid. We transplanted fetal porcine kidneys, administered immunosuppressive agents, and evaluated the grafts. Results: The catheter insertion site was large, with postoperative hemostasis similar to blind subcutaneous puncture. Monkeys tolerated DFPP well, maintaining stable blood pressure. The technique reduced anti-pig antibodies by 67%, though acute rejection was not fully suppressed. Conclusion: A safe technique for double-lumen catheter placement in cynomolgus monkeys was developed, along with a DFPP protocol for reducing anti-pig antibodies.

Keywords

• Transplantation, Heterologous
• Plasmapheresis
• Macaca fascicularis