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. Author manuscript; available in PMC: 2016 Jun 2.
Published in final edited form as: Xenotransplantation. 2014 Jan 21;21(1):1–10. doi: 10.1111/xen.12080

Figure 2. Immunological response to GBHV and potential ways a genetically-modified BHV may lessen or eliminate the immunological response.

Figure 2

Figure 2 depicts various immunological, coagulative/thrombogenic, and fixative (glutaraldehyde)-related injuries that can affect a porcine GBHV, leading to calcification and failure of the graft. Genetic engineering of pigs may reduce or prevent the above-mentioned injuries. Several groups have reported multiple genetic modifications of the pig, such as GTKO.hCD46.hCD55.hTBM, GTKO.hCD46.CIITA-DN, GTKO.NeuGC-KO, or GTKO.hCD55.hCD39.

A20 = tumor necrosis factor-alpha-induced protein 3; CIITA-DN = MHC class II transactivator-knockdown; CRP = complement regulatory proteins; EC = endothelial cell; ELAM-1 = endothelial-leukocyte adhesion molecule-1; GBHV = glutaraldehyde-fixed bioprosthetic heart valve; GTKO = α1,3-galactosyltransferase gene-knockout; h = human; HO-1 = hemeoxygenease-1; ICAM = intercellular adhesion molecule; NeuGc-KO = N-glycolylneuraminic acid gene-knockout; p = porcine TBM = thrombomodulin’; TFPI = tissue factor pathway inhibitor; vWF = von Willebrand factor.