What question did this study set out to answer?

The study aims to evaluate how human thrombomodulin affects early complications in pig-to-primate liver xenotransplantation.

March 25, 2026Open Access

Expression of Human Thrombomodulin Prevents Early Thrombocytopenia and Thrombotic Microangiopathy in Pig‐to‐Nonhuman Primate Orthotopic Liver Xenotransplantation

Key Points

The study aims to evaluate how human thrombomodulin affects early complications in pig-to-primate liver xenotransplantation.
Used GTKO/CMAHKO/β4GalNT2KO/hCD55/hTBM donor livers for transplantation.
Monitored for early thrombocytopenia, transfusion needs, and thrombotic microangiopathy (TMA).
Investigated the impact of genetic modifications on transplantation outcomes.
No severe thrombocytopenia or transfusion requirements were observed early on.
Thrombotic microangiopathy (TMA) was absent at the early stage.
Long-term survival remains limited due to immune rejection and coagulation issues.

Abstract

GTKO/CMAHKO/β4GalNT2KO/hCD55/hTBM donor liver transplantation was associated with an absence of early severe thrombocytopenia, transfusion requirement, and TMA, but long-term survival was limited by immune-mediated rejection and cross-species incompatibilities in coagulation factor synthesis. Optimizing (i) donor genetic modifications and (ii) immunosuppressive therapy, with (iii) replacement of targeted coagulation factors will be crucial for achieving durable survival in pig liver xenotransplantation.

Expression of Human Thrombomodulin Prevents Early Thrombocytopenia and Thrombotic Microangiopathy in Pig‐to‐Nonhuman Primate Orthotopic Liver Xenotransplantation

Key Points

Abstract

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