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Merl S, Chen B, Gunes ME, Atta H, Yang K, Ekanayake-Alper D, Hajosi D, Huang F, Bhola B, Patwardhan S, Jordache P, Nowak G, Martinez M, Kato T, Sykes M, Yamada K, Weiner J. Development of a large animal orthotopic intestinal transplantation model with long-term survival for study of immunologic outcomes. FRONTIERS IN TRANSPLANTATION 2024; 3:1367486. [PMID: 38993771 PMCID: PMC11235311 DOI: 10.3389/frtra.2024.1367486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 04/15/2024] [Indexed: 07/13/2024]
Abstract
Introduction Intestinal transplantation (ITx) is the last remaining therapy for patients with intestinal failure once parenteral nutrition is no longer an option, however its use is limited by immunological complications, including high rates of rejection and morbidity associated with immunosuppression, such as infection and malignancy. We aimed to develop a large animal model of ITx with which to study the immune response to ITx and to design and test tolerance induction regimens. Methods Learning from prior complications, we developed and progressively improved both surgical methods for the donor and recipient as well as postoperative management strategies. Methods of stoma generation, bowel positioning, vessel preparation, and fluid management were optimized. The immunosuppression strategy mirrored our clinical regimen. Results As a result of our modifications, results improved from survival less than 1 month to consistent long-term survival with good graft function. We review several techniques that were developed to avoid pitfalls that were encountered, which can be used to optimize outcomes in this model. Discussion Achieving long-term survival after swine orthotopic ITx permits immunological analysis and pre-clinical trials in a large animal model of ITx.
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Affiliation(s)
- Sarah Merl
- Columbia Center for Translational Immunology, Columbia University, New York, NY, United States
- Department of Pathology and Cell Biology, Columbia University, New York, NY, United States
| | - Bryan Chen
- Columbia Center for Translational Immunology, Columbia University, New York, NY, United States
| | - M. Esad Gunes
- Columbia Center for Translational Immunology, Columbia University, New York, NY, United States
| | - Hussein Atta
- Columbia Center for Translational Immunology, Columbia University, New York, NY, United States
| | - Kryscilla Yang
- Columbia Center for Translational Immunology, Columbia University, New York, NY, United States
| | - Dilrukshi Ekanayake-Alper
- Columbia Center for Translational Immunology, Columbia University, New York, NY, United States
- Department of Comparative Medicine, Yale School of Medicine, Yale University, New Haven, CT, United States
| | - Dominik Hajosi
- Columbia Center for Translational Immunology, Columbia University, New York, NY, United States
| | - Fei Huang
- Columbia Center for Translational Immunology, Columbia University, New York, NY, United States
| | - Brittany Bhola
- Columbia Center for Translational Immunology, Columbia University, New York, NY, United States
| | - Satyajit Patwardhan
- Columbia Center for Translational Immunology, Columbia University, New York, NY, United States
| | - Philip Jordache
- Columbia Center for Translational Immunology, Columbia University, New York, NY, United States
| | - Greg Nowak
- Columbia Center for Translational Immunology, Columbia University, New York, NY, United States
- Department of Surgery, Karolinska Institute, Solna, Sweden
| | - Mercedes Martinez
- Columbia Center for Translational Immunology, Columbia University, New York, NY, United States
- Department of Pediatrics, New York-Presbyterian Hospital, Columbia University, New York, NY, United States
| | - Tomoaki Kato
- Columbia Center for Translational Immunology, Columbia University, New York, NY, United States
- Department of Surgery, New York-Presbyterian Hospital, Columbia University, New York, NY, United States
| | - Megan Sykes
- Columbia Center for Translational Immunology, Columbia University, New York, NY, United States
- Department of Surgery, New York-Presbyterian Hospital, Columbia University, New York, NY, United States
- Department of Medicine, New York-Presbyterian Hospital, Columbia University, New York, NY, United States
- Department of Microbiology & Immunology, Columbia University, New York, NY, United States
| | - Kazuhiko Yamada
- Columbia Center for Translational Immunology, Columbia University, New York, NY, United States
- Department of Surgery, Johns Hopkins University, Baltimore, MD, United States
| | - Joshua Weiner
- Columbia Center for Translational Immunology, Columbia University, New York, NY, United States
- Department of Surgery, New York-Presbyterian Hospital, Columbia University, New York, NY, United States
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Duran-Struuck R, Matar A, Crepeau R, Gusha A, Schenk M, Hanekamp I, Pathiraja V, Spitzer TR, Sachs DH, Huang CA. Lack of antidonor alloantibody does not indicate lack of immune sensitization: studies of graft loss in a haploidentical hematopoietic cell transplantation swine model. Biol Blood Marrow Transplant 2012; 18:1629-37. [PMID: 22892552 PMCID: PMC3575102 DOI: 10.1016/j.bbmt.2012.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 08/02/2012] [Indexed: 11/23/2022]
Abstract
Loss of chimerism is an undesirable outcome of allogeneic hematopoietic cell transplantation (HCT) after reduced-intensity conditioning. Understanding the nature of cellular and humoral immune responses to HCT after graft loss could lead to improved retransplantation strategies. We investigated the immunologic responses after graft loss in miniature swine recipients of haploidentical HCT that received reduced-intensity conditioning. After the loss of peripheral blood chimerism, antidonor cellular responses were present without detectable antidonor antibody. Reexposure to donor hematopoietic cells after graft loss induced a sensitized antidonor cellular response. No induced antidonor antibody response could be detected despite evidence of cellular sensitization to donor cells. In contrast, unconditioned animals exposed repeatedly to similar doses of haploidentical donor cells developed antidonor antibody responses. These results could have important implications for the design of treatment strategies to overcome antidonor responses in HCT and improve the outcome of retransplantation after graft loss.
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Affiliation(s)
- Raimon Duran-Struuck
- Department of Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts 02129, USA.
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