Table 3. Clinical course of the first porcine-to-human cardiac xenotransplantation.
| Postoperative day | Event | |
|---|---|---|
| 2 | Extubation | |
| 4 | Decannulation of extracorporeal membrane oxygenation | |
| 10 | Exploratory laparotomy due to sudden abdominal pain | |
| • Small bowel thickening without acute ischemia/perforation | ||
| • Bacterial peritonitis | ||
| 20 | pCMV first detected in mcfDNA | |
| 34 | 1st endomyocardial biopsy | |
| • Normal histologic characteristics | ||
| • No evidence of rejection | ||
| 43 | Intubation; diffuse ulceration on airways with no histopathologic evidence of viral infection | |
| 47 | Extubation; improved airway ulceration | |
| 49 | Intubation and vasopressors due to hypotension → ECMO | |
| • Echocardiography: increased LV wall thickness and reduced LV chamber size | ||
| 50 | 2nd endomyocardial biopsy | |
| • Focal capillary damage but no C4d staining | ||
| • No cellular infiltrate | ||
| Rising titers of xenograft-specific IgM and IgG | ||
| 56 | 3rd endomyocardial biopsy | |
| • C4d staining and antibody-mediated rejection grade 1 | ||
| • Capillary damage and myocyte necrosis | ||
| 60 | Withdrawal of life sustaining modalities | |
ECMO = extracorporeal membrane oxygenation; Ig = immunoglobulin; LV = left ventricle; mcfDNA = microbial cell-free DNA; pCMV = porcine cytomegalovirus.