Xenogeneic Lung Transplant Immunosuppression

To minimize the risk of rejection, an immunosuppression regimen informed by current practices in clinical transplantation, and described for use in xeno-support of human lungs, was used (Figure 1B).^{14 ,15 (link)} At 4 hours before cross-circulation, xeno-support swine were anesthetized, intubated, and administered cobra venom factor (1 mg; Sigma-Aldrich) to deplete complement activity.^{16 (link)} Intravenous diphenhydramine (50 mg; West Ward) and methylprednisolone (1 g; Pfizer) were administered to limit the inflammatory response associated with cobra venom factor. Intravenous tacrolimus (5 mg; Astellas) and mycophenolate (500 mg; Genentech) were also administered before reperfusion and redosed every 12 hours (Supplemental Figure S1C, http://links.lww.com/HEP/F706). methylprednisolone (125 mg; Pfizer) was readministered every 8 hours after the initial dosage.