Anesthesia, kidney harvesting in pigs, and renal Tx in baboons have been described previously (26 (link)-27 (link)). Both native baboon kidneys were excised. All recipient baboons received prophylactic intravenous (i.v.) antibiotics for the first 3 post-Tx days, and famotidine and ganciclovir throughout the post-operative period. Conventional heparin was begun on day 0 (day of Tx) and gradually increased in an effort to maintain the activated partial thromboplastin time (APTT) at approximately 150sec from day 3, as described previously(26 (link)), but was discontinued when the recipient developed features of CC, particularly if spontaneous bleeding occurred. Human albumin was administered i.v. from day 0 to prevent hypoalbuminemia that resulted from persistent proteinuria. Washed baboon red blood cells were administered when necessary to maintain the hematocrit >20%.
Blood cell counts, chemistry, and coagulation parameters (prothrombin time, APTT, fibrinogen, D-dimer) were measured in the Central Laboratory of the University of Pittsburgh Medical Center. Kidney graft status was monitored by serum creatinine. CC was defined by the development of the following features:- (i) unexplained and persistent thrombocytopenia (>30% fall in platelet count) and (ii) significant and persistent decrease in serum fibrinogen (and increase in serum D-dimer), followed by (iii) clinical lethargy, requiring euthanasia, and/or (iv) overt bleeding, requiring euthanasia.