Abstract
PURPOSE: To detail a technique to implant a double-lumen catheter to remove anti-pig antibodies. We transplanted fetal pig kidneys into cynomolgus monkeys using a double filtration plasma exchange (DFPP) protocol. METHODS: Two approaches for double-lumen catheter insertion in monkeys (3-9.2 kg) were developed. DFPP was performed using hydroxyethyl starch (6%) as a replacement fluid. We transplanted fetal porcine kidneys, administered immunosuppressive agents, and evaluated the grafts. RESULTS: The catheter insertion site was large, with postoperative hemostasis similar to blind subcutaneous puncture. Monkeys tolerated DFPP well, maintaining stable blood pressure. The technique reduced anti-pig antibodies by 67%, though acute rejection was not fully suppressed. CONCLUSION: A safe technique for double-lumen catheter placement in cynomolgus monkeys was developed, along with a DFPP protocol for reducing anti-pig antibodies.