Multi-omics analysis of a pig-to-human decedent kidney xenotransplant.

Abstract

Organ shortage remains a major challenge in transplantation, and gene-edited pig organs offer a promising solution<sup>1-3</sup>. Despite gene editing, the immune reactions following xenotransplantation can still cause transplant failure<sup>4</sup>. To understand the immunological response of a pig-to-human kidney xenotransplantation, we conducted large-scale multi-omics profiling of the xenograft and the host's blood over a 61-day procedure in a brain-dead human (decedent) recipient. Blood plasmablasts, natural killer cells and dendritic cells increased between postoperative day (POD) 10 and 28, concordant with an expansion of IgG and IgA B cell clonotypes and subsequent biopsy-confirmed antibody-mediated rejection (AMR) at POD33. Human T cell frequencies increased from POD14 and peaked between POD33 and POD49 in the blood and xenograft, which coincided with T cell receptor diversification, expansion of a restricted TRBV2 and TRBJ1 clonotype and histological evidence of combined AMR and cell-mediated rejection at POD49. At POD33, the most abundant human immune population in the graft was CXCL9<sup>+</sup> macrophages, which aligned with interferon-γ-driven inflammation and a T helper 1-type immune response. There was also evidence of interactions between activated pig-resident macrophages and infiltrating human immune cells. Xenograft tissue showed pro-fibrotic tubular and interstitial injury marked by S100A6 (ref. <sup>5</sup>), SPP1 (also known as osteopontin)<sup>6</sup> and COLEC11 (ref. <sup>7</sup>) expression at POD21-POD33. Proteomic profiling revealed activation of human and pig complement, with a decreased human component after AMR therapy, in which complement was inhibited. Collectively, these data delineate the molecular orchestration of human immune responses to a porcine kidney and reveal potential immunomodulatory targets for improving xenograft survival.

EDRN PI Authors
  • (None specified)
Medline Author List
  • Al-Ali RA
  • Albay J
  • Aljabban I
  • Andrijevic D
  • Argibay D
  • Ayares D
  • Bartlett AQ
  • Batzoglou S
  • Bhatt R
  • Boeke JD
  • Bombardi R
  • Camellato BR
  • Chang A
  • Chen HM
  • Chong AS
  • Crawford A
  • Dowdell AK
  • Eitan T
  • Fairchild RL
  • Ferdosi S
  • Gandla D
  • Gao H
  • Gao S
  • Gragert L
  • Griesemer A
  • Guo Q
  • Habara AH
  • Hamilton L
  • Heguy A
  • Herati RS
  • Holmes MV
  • Jaffe I
  • Kagermazova L
  • Kaikkonen MU
  • Keating BJ
  • Kellis M
  • Khalil K
  • Kim J
  • Lau B
  • Linna-Kuosmanen S
  • Lorber M
  • Loupy A
  • Maden B
  • Mangiola M
  • Mattoo A
  • Mauduit V
  • Mohebnasab M
  • Moi K
  • Montgomery RA
  • Motter JD
  • Nellore A
  • O'Brien DP
  • Piening BD
  • Robinson FL
  • Rophina M
  • Saxena D
  • Schmauch E
  • Siddiqui A
  • Skolnik EY
  • Snyder MP
  • Stern J
  • Stukalov A
  • Taft R
  • Tatapudi VS
  • Thomas SC
  • Vikman S
  • Wang C
  • Weldon E
  • Williams SH
  • Wu L
  • Zanoni F
  • Zayas Z
  • Zhang W
PubMed ID
Appears In
Nature, 2025 Nov (issue None)