[World's first pig heart transplant dies, Lancet releases case report]

On June 29, 2023, The Lancet published a case report on the world's first porcine heart transplant entitled Graft dysfunction in compassionate use of genetically engineered pig-to-human cardiac xenotransplantation: a case report. A case report of the world's first porcine heart transplantation.TPE SexpuppenOn January 7, 2022, a patient in Maryland, USA, was successfully transplanted with a pig heart, which functioned well after surgery.On post-operative day 47, the patient developed diastolic heart failure.On postoperative day 50, an endomyocardial biopsy showed capillary damage with interstitial edema and extravasation of red blood cells.Finally, on postoperative day 60, life support was withdrawn with the consent of the family. The world's first pig heart transplant patient died.After a year of research, The Lancet published a case report on this surgery. Lebensechte Sexpuppe In the report, the latest conclusions of the analysis of the causes of failure can be found.I. Extensive endothelial damage in the graft suggests the presence of antibody-mediated rejectionThe report shows that although the immunosuppressive doses used by the investigators were lower than the standard regimen, they were still sufficient to deplete peripheral B and T lymphocytes. However, lymph nodes taken on postoperative day 2 showed that B and T cells were still present.Neue SexpuppeAccording to peripheral blood mononuclear cytometry analysis:Peripheral B lymphocytes remained low from the beginning and reappeared after day 50 postoperatively.T lymphocytes were effectively depleted in the first 10 days but then repopulated.Endomyocardial myocardial biopsy revealed thatAt day 34 postoperatively, the myocardium had mild interstitial edema and slight endothelial damage with features suggestive of apoptosis.On postoperative day 50, there was significant interstitial edema with a pile of disorganized endothelium and mononuclear cells.On postoperative day 59, there was a large amount of cellular debris in the interstitium and extravasation of red blood cells in some areas.II. IVIG binds strongly to the donor endothelium and may lead to immune activation.Anime SexpuppenThe report showed that the patient received two high doses of IVIG (intravenous immunoglobulin), and the second dose on day 47 correlated with a significant deterioration of the patient's condition.Previously, IVIG was shown to not bind to triple knockout porcine aortic endothelial cells in vitro. However, such binding had never been tested in ten knockout cells. Now, the researchers observed strong binding of three different lots of IVIG from the same brand and manufacturer to donor porcine aortic endothelial cells.III. Latent PCMV/PRV in xenografts may trigger inflammatory responsesA progressive increase in the cfDNA of PCMV/PRV (PCMV, porcine cytomegalovirus; PRV, porcine rosacea virus) was observed during testing of microbial cfDNA of various pathogens in the recipients.After autopsy, a comprehensive assessment of PCMV/PRV was performed by PCR on different parts of the recipient and xenograft. PCMV/PRV DNA was detected in all recipient organs.Previously, on June 22, 2022, the NEJM published the results of the first study of the world's first pig heart transplant patient, concluding that the patient's cardiac autopsy findings were not consistent with typical xenograft rejection. The MIT Technology Review reported on May 4, 2022, that the cause of death may have been the presence of the virus in the transplanted pig heart.Elf Sexpuppe