Non‐Classical Swine Leukocyte Antigens SLA‐6, ‐7, and ‐8, Are Xenoantigens for Some Waitlisted Patients

ABSTRACT Attack of donor tissues by pre‐formed anti‐pig antibodies is well known to cause graft failure in xenotransplantation. Genetic engineering of porcine donors to eliminate targets of these pre‐formed antibodies coupled with advances in immunosuppressive medicines have now made it possible to achieve extended survival in the pre‐clinical pig‐to‐non‐human primate model. Despite these improvements, antibodies remain a risk over the lifetime of the transplant, and many patients continue to have pre‐formed donor‐specific antibodies even to highly engineered pigs. While therapeutics exist that can help mitigate the detrimental effects of antibodies, they act broadly potentially dampening beneficial immunity. Identifying additional xenoantigens may enable more targeted approaches, such as gene editing, to overcome these challenges by further eliminating antibody targets on donor tissue. Because we have found that classical class I swine leukocyte antigens are targets of human antibodies, we now examine whether related pig proteins may also be targeted by human antibodies. We show here that non‐classical class I swine leukocyte proteins (SLA‐6, ‐7, ‐8) can be expressed at the surface of mammalian cells and act as antibody targets.