Tu179 - Comparative Analysis of Wild-type and Triple Gene-knockout Pig Red Blood Cell Transfusions in Non-human Primates: Therapeutic Efficacy and Immunological Responses

Juhye Roh – Hallym University Sacred Heart Hospital; Haneulnari Lee – Hallym University Sacred Heart Hospital; Eun Mi Park – Hallym University Sacred Heart Hospital; Hye Won Lee – Hallym University Sacred Heart Hospital; Joohyun Shim – Optipharm Inc.; Jeong Ho Hwang – Korea Institute of Toxicology; Kimyung Choi – Optipharm Inc.

Abstract Text:

Background: Blood donation shortages have led to research on pig red blood cells (pRBCs) as substitutes for human RBCs. This study evaluates the effectiveness and risks of wild-type (WT) and triple gene-knockout (TKO) pRBC transfusions in non-human primates.

Methods: O-type WT and TKO pig blood was processed and transfused into ten monkeys, with groups receiving either WT or TKO pRBCs (n=4 each) or saline (n=2). Hematologic, biochemical, and immunological responses were monitored before, after transfusion, and at intervals.

Results: Both WT and TKO pRBC transfusions effectively increased RBC count, hematocrit, and hemoglobin levels in the post-transfusion one day compared to the saline group. However, transfusions led to elevated ALT and total bilirubin levels in transfusion groups and cholesterol decrease in the WT group. Crossmatch tests showed variable aggregation; post-transfusion, profound antibody responses were observed in both transfusion groups. A second transfusion resulted in reduced hematological benefits and more adverse reactions.

Conclusion: WT and TKO pRBC transfusions initially improved hematologic parameters, but rapid pRBC clearance followed. TKO pRBCs had less impact on liver function than WT. Despite initial benefits, strong antibody responses and potential adverse reactions highlight risks in xenotransfusion. The study suggests careful consideration for clinical applications of pRBC transfusions (Grant No. 22-CM-EC-18).