Liver xenografts for the treatment of acute liver failure: Clinical and experimental experience and remaining immunologic barriers

Liver Transplantation

Volumn 14, Issue 4, 2008, Pages 425-434

  Hara, Hidetaka ^a   Gridelli, Bruno ^b   Lin, Yih Jyh ^a,c   Marcos, Amadeo ^a   Cooper, David K C ^a  

^a UNIVERSITY OF PITTSBURGH MEDICAL CENTER   (United States)

^b MEDITERRANEAN INSTITUTE FOR TRANSPLANTATION AND ADVANCED SPECIALIZED THERAPIES ISMETT   (Italy)

^c NATIONAL CHENG KUNG UNIVERSITY   (Taiwan)

Author keywords

[No Author keywords available]

Indexed keywords

ALPHA 1,3 GALACTOSYLTRANSFERASE; AZATHIOPRINE; CYCLOSPORIN; FRESH FROZEN PLASMA; NAFAMSTAT MESILATE; PREDNISONE;

ANTIBODY PRODUCTION; ARTIFICIAL LIVER; AUTOIMMUNE HEPATITIS; CLINICAL TRIAL; COMPLEMENT ACTIVATION; DRUG MEGADOSE; GRAFT SURVIVAL; HEPATIC ENCEPHALOPATHY; HEPATITIS B; HUMAN; IMMUNOSUPPRESSIVE TREATMENT; KNOCKOUT GENE; LIVER FAILURE; LIVER GRAFT REJECTION; LIVER SINUSOID; LIVER SUPPORT; LIVER TRANSPLANTATION; MACROPHAGE ACTIVATION; NONHUMAN; PHAGOCYTOSIS; PRIORITY JOURNAL; REVIEW; SWINE; XENOGRAFT; XENOTRANSPLANTATION;

ACUTE DISEASE; ANIMALS; HUMANS; LIVER FAILURE; LIVER TRANSPLANTATION; PAPIO; PRIMATES; SWINE; TRANSPLANTATION, HETEROLOGOUS;

EID: 42149121373     PISSN: 15276465     EISSN: 15276473     Source Type: Journal    
DOI: 10.1002/lt.21476     Document Type: Review

References (110)

1. Hui T, Rozga J, Demetriou AA. Bioartificial liver support. J Hepatobiliary Pancreat Surg 2001;8:1-15.
2. Rozga J. Liver support technology - an update. Xenotransplantation 2006;13:380-389.
3. Mazaris EM, Roussos CT, Papalois VE. Hepatocyte transplantation: a review of worldwide clinical developments and experiences. Exp Clin Transplant 2005;3:306-315.
4. Strom SC, Bruzzone P, Cai H, Ellis E, Lehmann T, Mitamura K, Miki T. Hepatocyte transplantation: clinical experience and potential for future use. Cell Transplant 2006;15(suppl 1):S105-S110.
5. Fisher RA, Strom SC. Human hepatocyte transplantation: worldwide results. Transplantation 2006;82:441-449.
6. Cooper DKC, Lanza RP. Xeno - The Promise of Transplanting Animal Organs into Humans. New York, NY: Oxford University Press; 2000:1-275.
7. Calne RY. Organ transplantation between widely disparate species. Transplant Proc 1970;2:550-556.
8. Cooper DKC, Ye Y, Rolf LJ, Zudhi N. The pig as potential organ donor for man. In: Cooper DKC, Kemp E, Reemtsma K, White DJG, eds. Xenotransplantation. 1st ed. Heidelberg, Germany: Springer; 1991;481-500.
9. Cooper DK, Gollackner B, Sachs DH. Will the pig solve the transplantation backlog? Annu Rev Med 2002;53:133-147.
10. Phelps CJ, Koike C, Vaught TD, Boone J, Wells KD, Chen SH, et al. Production of alpha 1,3-galactosyltransferase-deficient pigs. Science 2003;299:411-414.
11. Kolber-Simonds D, Lai L, Watt SR, Denaro M, Am S, Augenstein ML, et al. Production of alpha-1,3-galactosyltransferase null pigs by means of nuclear transfer with fibroblasts bearing loss of heterozygosity mutations. Proc Natl Acad Sci U S A 2004;101:7335-7340.
12. Taniguchi S, Cooper DKC. Clinical xenotransplantation - a brief review of the world experience. In: Cooper DKC, Kemp E, Platt JL, White DJG, eds. Xenotransplantation. 2nd ed. Heidelberg, Germany: Springer; 1997:776-784.
13. Taniguchi S, Cooper DK. Clinical xenotransplantation: past, present and future. Ann R Coll Surg Engl 1997;79: 13-19.
14. Starzl TE, Marchioro, TL, Faris TD, McCardle RJ, Iwaski Y. Avenues of future research in homotransplantation of the liver with particular reference to hepatic supportive procedures, antilymphocyte serum, and tissue typing. Am J Surg 1966;112:391-400.
15. Makowa L, Cramer DV, Hoffman A, Breda M, Sher L, Eiras-Hreha G, et al. The use of a pig liver xenograft for temporary support of a patient with fulminant hepatic failure. Transplantation 1995;59:1654-1659.
16. Makowka L, Wu GD, Hoffman A, Podesta L, Sher L, Tuso PJ, et al. Immunohistopathologic lesions associated with the rejection of a pig-to-human liver xenograft. Transplant Proc 1994:26:1074-1075.
17. Starzi TE. Orthotopic heterotransplantation. In: Experience in Hepatic Transplantation. Philadelphia, PA: Saunders; 1969:408.
18. Giles GR, Boehmig HJ, Amemiya H, Halgrimson CG, Starzl TE. Clinical heterotransplantation of the liver. Transplant Proc 1970;2:506-512.
19. Starzl TE, Ishikawa M, Putnam CW, Porter KA, Picache R, Husberg BS, et al. Progress in and deterrents to orthotopic liver transplantation, with special reference to survival, resistance to hyperacute rejection, and biliary duct reconstruction. Transplant Proc 1974;6:129-139.
20. Starzl TE, Fung J, Tzakis A, Todo S, Demetris AJ, Marino IR, et al. Baboon-to-human liver transplantation. Lancet 1993;341-65-71.
21. Starzl TE, Fung J, Fung JJ, Todo S, Demetris AJ, Manez R, et al. Prospects of clinical xenotransplantation. Transplant Proc 1994;26:1082-1088.
22. Pascher A, Sauer IM, Hammer C, Gerlach JC, Neuhaus P. Extracorporeal liver perfusion as hepatic assist in acute liver failure: a review of world experience. Xenotransplantation 2002;9:309-324.
23. Otto JJ, Pender JC, Cleary JH, Sensenig DM, Welch CS. The use of a donor liver in experimental animals with elevated blood ammonia. Surgery 1958;43:301-309.
24. Sen PK, Bhalerao RA, Parulkar GP, Samsi AB, Shah BK, Kinare SG. Use of isolated perfused cadaveric liver in the management of hepatic failure. Surgery 1966;59:774-781.
25. Eiseman B, Liem DS, Raffucci F. Heterologous liver perfusion in treatment of hepatic failure. Ann Surg 1965; 162:329-345.
26. Abouna GM. Pig liver perfusion with human blood. The effect of preparing and flushing the liver with various balanced solutions on its subsequent viability and function. Br J Surg 1968;55:761-768.
27. Abouna GM. Extracorporeal xenogeneic liver perfusion for the treatment of hepatic failure. In: Cooper DKC, Kemp E, Platt JL, White DJG, eds. Xenotransplantation. 2nd ed. Heidelberg, Germany: Springer; 1997:785-792.
28. Cramer DV, Sher L, Makowka L. Liver xenotransplantation: clinical experience and future considerations. In: Cooper DKC, Kemp E, Reemstsma K, White DJG, eds. Xenotransplantation. 1st ed. Heidelberg, Germany: Springer; 1991: 559-573.
29. Tuso PJ, Cramer DV, Yasunaga C, Cosenza CA, Wu GD, Makowka L. Removal of natural human xenoantibodies to pig vascular endothelium by perfusion of blood through pig kidneys and livers. Transplantation 1993; 55:1375-1378.
30. Collins BH, Chari RS, Magee JC, Harland RC, Lindman BJ, Logan JS, et al. Mechanisms of injury in porcine livers perfused with blood of patients with fulminant hepatic failure. Transplantation 1994;58:1162-1171.
31. Collins BH, Char! RS, Magee JC, Harland RC, Lindman RJ, Logan JS, et al. Immunopathology of porcine livers perfused with blood of humans with fulminant hepatic failure. Transplant Proc 1995;27:280-281.
32. Horslen SP, Hammel JM, Fristoe LW, Kangas JA, Collier DS, Sudan DL, et al. Extracorporeal liver perfusion using human and pig livers for acute liver failure. Transplantation 2000;70:1472-1478.
33. Tector AJ, Elias N, Rosenberg L, Soderland C, Naimi J, Duguid WP, Tchervenkov JI. Mechanisms of resistance to injury in pig livers perfused with blood from patients in liver failure. Transplant Proc 1997;29:966-969.
34. Tector AJ, Berho M, Fridell JA, DiCarlo A, Liu S, Soderland C, et al. Rejection of pig liver xenografts in patients with liver failure: implications for xenotransplantation. Liver Transpl 2001;7:82-89.
35. Ellison RT III, Horsburgh CR Jr, Curd J. Complement levels in patients with hepatic dysfunction. Dig Dis Sci 1990;35:231-235.
36. Morgan BP, Gasque P. Extrahepatic complement biosynthesis: where, when and why? Clin Exp Immunol 1997; 107:1-7.
37. Levy MF, Crippin J, Sutton S, Netto G, McCormack J, Curiel T, et al. Liver allotransplantation after extracorporeal hepatic support with transgenic (hCD55/hCD59) porcine livers: clinical results and lack of pig-to-human transmission of the porcine endogenous retrovirus. Transplantation 2000;69:272-280.
38. Chari RS, Collins BH, Magee JC, DiMaio JM, Kirk AD, Harland RC, et al. Brief report: treatment of hepatic failure with ex vivo pig-liver perfusion followed by liver transplantation. N Engl J Med 1994;331:234-237.
39. Byrne GW, McCurry KR, Martin MJ, McClellan SM, Platt JL, Logan JS. Transgenic pigs expressing human CD59 and decay-accelerating factor produce an intrinsic barrier to complement-mediated damage. Transplantation 1997;63:149-155.
40. Cozzi E, Tucker AW, Langford GA, Pino-Chavez G, Wright L, O'Connell MJ, et al. Characterization of pigs transgenic for human decay-accelerating factor. Transplantation 1997;64:1383-1392.
41. Calne RY, Davis DR, Pena JR, Balner H, de Vries M, Herbertson BM, et al. Hepatic allografts and xenografts in primates. Lancet 1970;1:103-106.
42. Gridelli B, Gatti S, Piazzini A, Reggiani P, Langer M, DeK-lerk W, et al. Xenogeneic orthotopic liver transplantation in nonhuman primates. Transplant Proc 1993;25:457-461.
43. Donato MF, Arosio E, Berti E, Gatti S, Piazzini A, Colledan M, et al. Immunopathology of liver allografts and xenografts in nonhuman primates. Transplant Proc 1993;25:850-855.
44. Gridelli B, Gatti S, Donato MF, Andreani P, Fassati LR, Galmarini D. Experimental concordant liver xenotransplantation in nonhuman primates. In: Cooper DKC, Kemp E, Platt JL, White DJG, eds. Xenotransplantation. 2nd ed. Heidelberg, Germany: Springer; 1997:323-327.
45. Zhong R, Tucker J, Grant D, Wall W, Garcia B, Asfar S, et al. Long-term survival and functional tolerance of baboon to monkey kidney and liver transplantation: a preliminary report. Transplant Proc 1996;28:762.
46. Zhong R, Tucker J, Zhang Z, Wall W, Grant D, Quan D, et al. The long-term survival of baboon-to-monkey kidney and liver xenografts. Xenotransplantation 2003;10:398-409.
47. Mieles L, Ye Y, Luo Y, Kobayashi T, Li SF, Nielkrasz M, et al. Auxiliary liver allografting and xenografting in the nonhuman primate. Transplantation 1995;59:1670-1676.
48. Luo Y, Kosanke S, Mieles L, Kobayashi T, Li SF, Niekrasz M, et al. Comparative histopathology of hepatic allografts and xenografts in the nonhuman primate. Xenotransplantation 1998;5:197-206.
49. Calne RY, White HJ, Herbertson BM, Millard PR, Davis DR, Salaman JR, Samuel JR. Pig-to-baboon liver xenografts. Lancet 1968;1:1176-1178.
50. Powelson J, Cosimi AB, Austen W Jr, Bailen M, Colvin R, Gianello P, et al. Porcine-to-primate orthotopic liver transplantation. Transplant Proc 1994;26:1353-1354.
51. Ramirez P, Chavez R, Majado M, Munitiz V, Munoz A, Hernandez Q, et al. Life-supporting human complement regulator decay accelerating factor transgenic pig liver xenograft maintains the metabolic function and coagulation in the nonhuman primate for up to 8 days. Transplantation 2000;70:989-998.
52. Ramirez P, Yelamos J, Parrilla P, Chavez R. Hepatic xenotransplantation will benefit from strategies aimed to reduce complement activation. Liver Transpl 2001;7:562-563.
53. Valdivia LA, Lewis JH, Celli S, Bontempo FA, Fung JJ, Demetris AJ, Starzl TE. Hamster coagulation and serum proteins in rat recipients of hamster xenografts. Transplantation 1993;56:489-490.
54. Valdivia LA, Fung JJ, Demetris AJ, Celli S, Pan F, Tsugita M, Starzl TE. Donor species complement after liver xenotransplantation. The mechanism of protection from hyperacute rejection. Transplantation 1994;57:918-922.
55. Celli S, Baldivia LA, Fung JJ, Kelly RH. Early recipient-donor switch of the complement type after liver xenotransplantation. Immunol Invest 1997;26:589-600.
56. Ramirez P, Montoya MJ, Rios A, Garcia Palenciano C, Majado M, Chavez R, et al. Prevention of hyperacute rejection in a model of orthotopic liver xenotransplantation from pig to baboon using polytransgenic pig livers (CD55, CD59, and H-transferase). Transplant Proc 2005; 37:4103-4106.
57. Jerusalem C, Heyde MN, Jap P, Reinking JW, Schmidt WJ, Bilski R, Tjebbes FA. Rejection phenomena in heterotopic liver homo- and heterografts. Transplant Proc 1971;3:554-557.
58. Gridelli B, Gatti S, Piazzini A, Colledan M, Maggi U, Reggiani P, et al. Xenogeneic orthotopic liver transplantation from sheep to pig. Transplant Proc 1992;24:614-616.
59. Gridelli B, Gatti S, Andreani P, Donato MF, Bergamaschini L, Berti E, et al. Xenogeneic orthotopic liver transplantation from sheep to pig: delay of rejection by FUT 175 infusion. Transplant Proc 1996;28:784-787.
60. Tector AJ, Fridell JA, Watanabe T, Forbes RD, Salazar J, Grienke D, et al. Pulmonary injury in recipients of discordant hepatic and renal xenografts in the dog-to-pig model. Xenotransplantation 1998;5:44-49.
61. Tector AJ, Fridell JA, Elias N, Watanabe T, Salazar J, Greinke D, et al. Aberrations in hemostasis and coagulation in untreated discordant hepatic xenotransplantation: studies in the dog-to-pig model. Liver Transpl 2002; 8:153-159.
62. Tector AJ, Fridell JA, Ruiz P, Khurana RJ, Jensen G, Mak A, et al. Experimental discordant hepatic xenotransplantation in the recipient with liver failure: implications for clinical bridging trials. J Am Coll Surg 2000;191:54-64.
63. Platt JL. The humoral barrier to transplantation of the liver: is it more real than apparent? Liver Transpl 2001; 7:90-92.
64. Harland RC, Platt JL. Prospects for xenotransplantation of the liver. J Hepatol 1996:25:248-258.
65. Gordon RD, Iwatsuki S, Esquivel CO, Tzakis A, Todo S, Starzl TE. Liver transplantation across ABO blood groups. Surgery 1986;100:342-348.
66. Gordon RD, Fung JJ, Markus B, Fox I, Iwatsuki S, Esquivel CO, et al. The antibody crossmatch in liver transplantation. Surgery 1986;100:705-715.
67. Colten HR. Biosynthesis of complement. Adv Immunol 1976;22:67-118.
68. Platt JL. Xenotransplantation of the liver: is more complement control needed? Liver Transpl 2001;7:933-934.
69. Luo Y, Levy G, Ding J, Qi J, Chakbrati S, Garcia BM, et al. HDAF transgenic pig livers are protected from hyperacute rejection during ex vivo perfusion with human blood. Xenotransplantation 2002;9:36-44.
70. Rees MA, Butler AJ, Chavez-Cartaya G, Wight DG, Casey ND, Alexander G, et al. Prolonged function of extracorporeal hDAF transgenic pig livers perfused with human blood. Transplantation 2002;73:1194-1202.
71. Cascalho M, Platt JL. The immunological barrier to xenotransplantation. Immunity 2001;14:437-446.
72. Rees MA, Butler AJ, Negus MC, Davies HF, Friend PJ. Classical pathway complement destruction is not responsible for the loss of human erythrocytes during porcine liver perfusion. Transplantation 2004;77:1416-1423.
73. Tai HC, Zhu X, Hara H, Lin YJ, Ezzelarab M, Long C, et al. The pig-to-primate immune response: relevance for xenotransplantation. Xenotransplantation 2007;14:227-235.
74. Merion RM, Colletti LM. Hyperacute rejection in porcine liver transplantation. I. Clinical characteristics, histopathology, and disappearance of donor-specific lymphocytotoxic antibody from serum. Transplantation 1990;49: 861-868.
75. Nakamura K, Murase N, Becich MJ, Furuya T, Todo S, Fung JJ, et al. Liver allograft rejection in sensitized recipients. Observations in a clinically relevant small animal model. Am J Pathol 1993;142:1383-1391.
76. Manez R, Kelly RH, Kobayashi M, Takaya S, Bronsther O, Kramer D, et al. Immunoglobulin G lymphocytotoxic antibodies in clinical liver transplantation: studies toward further defining their significance. Hepatology 1995;21: 1345-1352.
77. Tector AJ, Chen X, Soderland C, Tchervenkov JI. Complement activation in discordant hepatic xenotransplantation. Xenotransplantation 1998;5:257-261.
78. Cattan P, Zhang B, Braet F, Atia N, Conti F, Conjeaud H, et al. Comparison between aortic and sinusoidal liver endothelial cells as targets of hyperacute xenogeneic rejection in the pig to human combination. Transplantation 1996;62:803-810.
79. Good AH, Cooper DK, Malcolm AJ, Ippolito RM, Koren E, Neethling FA, et al. Identification of carbohydrate structures that bind human antiporcine antibodies: implications for discordant xenografting in humans. Transplant Proc 1992;24:559-562.
80. Cooper DK, Good AH, Koren E, Oriol R, Malcolm AJ, Ippolito RM, et al. Identification of alpha-galactosyl and other carbohydrate epitopes that are bound by human anti-pig antibodies: relevance to discordant xenografting in man. Transpl Immunol 1993;1:198-205.
81. Kuwaki K, Tseng YL, Dor FJ, Shimizu A, Houser SL, Sanderson TM, et al. Heart transplantation in baboons using alpha1,3-galactosyltransferase gene-knockout pigs as donors: initial experience. Nat Med 2005;11:29-31.
82. Tseng YL, Kuwaki K, Dor FJ, Shimizu A, Houser S, Hisashi Y, et al. Alpha1,3-galactosyltransferase gene-knockout pig heart transplantation in baboons with survival approaching 6 months. Transplantation 2005;80:1493-1500.
83. Yamada K, Yazawa K, Shimizu A, Iwanaga T, Hisashi Y, Nuhn M, et al. Marked prolongation of porcine renal xenograft survival in baboons through the use of alpha1, 3-galactosyltransferase gene-knockout donors and the cotransplantation of vascularized thymic tissue. Nat Med 2005:11:32-34.
84. Kanai N, Platt JL. Xenotransplantation of the liver. Clin Liver Dis 2000;4:731-746, x-xi.
85. Holzknecht ZE, Coombes S, Blocher BA, Plummer TB, Bustos M, Lau CL, et al. Immune complex formation after xenotransplantation: evidence of type III as well as type II immune reactions provide clues to pathophysiology. Am J Pathol 2001;158:627-637.
86. Van Rooijen N, Sanders A. Liposome mediated depletion of macrophages: mechanism of action, preparation of liposomes and applications. J Immunol Methods 1994; 174:83-93.
87. Basker M, Alwayn IP, Buhler L, Harper D, Abraham S, Kruger Gray H, et al. Clearance of mobilized porcine peripheral blood progenitor cells is delayed by depletion of the phagocytic reticuloendothelial system in baboons. Transplantation 2001;72:1278-1285.
88. Ide K, Ohdan H, Kobayashi T, Hara H, Ishiyama K, Asahara T. Antibody- and complement-independent phagocytotic and cytolytic activities of human macrophages toward porcine cells. Xenotransplantation 2005;12:181-188.
89. Oldenborg PA, Zheleznyak A, Fang YF, Lagenaur CF, Gresham HD, Lindberg FP. Role of CD47 as a marker of self on red blood cells. Science 2000;288:2051-2054.
90. Oldenborg PA, Gresham HD, Lindberg FP. CD47-signal regulatory protein alpha (SIRPalpha) regulates Fcgamma and complement receptor-mediated phagocytosis. J Exp Med 2001;193:855-862.
91. Shahein YE, de Andres DF, Perez de la Lastra JM. Molecular cloning and functional characterization of the pig homologue of integrin-associated protein (IAP/CD47). Immunology 2002;106:564-576.
92. Ide K, Wang H, Tahara H, Liu J, Wang X, Asahara T, et al. Role for CD47-SIRPalpha signaling in xenograft rejection by macrophages. Proc Natl Acad Sci U S A 2007;104: 5062-5066.
93. Cooper DK, Tseng YL, Saidman SL. Alloantibody and xenoantibody cross-reactivity in transplantation. Transplantation 2004;77:1-5.
94. Baertschiger RM, Dor FJ, Prabharasuth D, Kuwaki K, Cooper DK. Absence of humoral and cellular alloreactivity in baboons sensitized to pig antigens. Xenotransplantation 2004;11:27-32.
95. Ye Y, Luo Y, Kobayashi T, Taniguchi S, Li S, Niekrasz M, et al. Secondary organ allografting after a primary "bridging" xenotransplant. Transplantation 1995;60:19-22.
96. Michler RE, Shah AS, Itescu S, O'Hair DP, Tugulea S, Kwiatkowski PA, et al. The influence of concordant xenografts on the humoral and cell-mediated immune responses to subsequent allografts in primates. J Thorac Cardiovase Surg 1996;112:1002-1009.
97. Key T, Schuurman HJ, Taylor CJ. Does exposure to swine leukocyte antigens after pig-to-nonhuman primate xenotransplantation provoke antibodies that cross-react with human leukocyte antigens? Xenotransplantation 2004;11:452-456.
98. Baquerizo A, Mhoyan A, Kearns-Jonker M, Arnaout WS, Shackleton C, Busuttil RW, et al. Characterization of human xenoreactive antibodies in liver failure patients exposed to pig hepatocytes after bioartificial liver treatment: an ex vivo model of pig to human xenotransplantation. Transplantation 1999;67:5-18.
99. Paradis K, Langford G, Long Z, Heneine W, Sandstrom P, Switzer WM, et al., for the XEN 111 Study Group. Search for cross-species transmission of porcine endogenous retrovirus in patients treated with living pig tissue. Science 1999;285:1236-1241.
100. Onions D, Cooper DK, Alexander TJ, Brown C, Claassen E, Foweraker JE, et al. An approach to the control of disease transmission in pig-to-human xenotransplantation. Xenotransplantation 2000;7:143-155.
101. Fishman JA. Screening of source animals and clinical monitoring for xenotransplantation. Xenotransplantation 2007;14:349-352.
102. Mueller NJ, Livingston C, Knosalla C, Barth RN, Yamamoto S, Gollackner B, et al. Activation of porcine cytomegalovirus, but not porcine lymphotropic herpesvirus, in pig-to-baboon xenotransplantation. J Infect Dis 2004;189:1628-1633.
103. Mueller NJ, Kuwaki K, Dor FJ, Knosalla C, Gollackner B, Wilkinson RA, et al. Reduction of consumptive coagulopathy using porcine cytomegalovirus-free cardiac porcine grafts in pig-to-primate xenotransplantation. Transplantation 2004;78:1449-1453.
104. Ildstad ST. Xenotransplantation for AIDS. Lancet 1996; 347:761.
105. Exner BG, Neipp M, Ildstad ST. Baboon bone marrow transplantation in humans: application of cross-species disease resistance. World J Surg 1997;21:962-967.
106. Kanazawa A, Platt JL. Prospects for xenotransplantation of the liver. Semin Liver Dis 2000;20:511-522.
107. Hammer C. Physiological obstacles after xenotransplantation. Ann N Y Acad Sci 1998;862:19-27.
108. Hammer C. Evolutionary obstacles to xenotransplantation. In: Cooper DKC, Kemp E, Platt JL, White DJG, eds. Xenotransplantation. 2nd ed. Heidelberg, Germany: Springer; 1997:716-735.
109. Ibrahim Z, Busch J, Awwad M, Wagner R, Wells K, Cooper DK. Selected physiologic compatibilities and incompatibilities between human and porcine organ systems. Xenotransplantation 2006;13:488-499.
110. Horton PJ, Chaudhury P, Rochon C, Metrakos P, Tchervenkov J. Should trials of liver xenotransplantation proceed in toxic fulminant hepatic failure? Xenotransplantation 2006;13:483.