Background. The lack of human organ donors has prompted a renewed inte
rest in xenotransplantation. Xenoantibody is believed to be an initiat
or of a complex cascade of events ultimately ending in rapid xenograft
destruction. Methods. Cell-free plasma was obtained via plasmapheresi
s of the recipient canine. This plasma was then perfused in an ex vivo
fashion through either the donor (pig) spleen or liver, allowing for
specific antidonor antibody deposition in the ''screening'' organ, and
is then returned to the animal. A porcine kidney is then transplanted
to the dog, and the outcome is observed. Results. We have used specif
ic antibody depletion to prolong xenotransplant survival. In the untre
ated pig-to-dog combination, the transplanted pig kidney is destroyed
by the dog in 13 minutes (mean). Adsorption using either the donor spl
een or liver resulted in an increase of 3.4 hours and 7.8 hours of gra
ft survival, respectively. The histologic picture of rejected kidneys
after adsorption shows a modified form of rejection. Conclusions. In t
his pig-to-dog xenograft combination, xenoantibody adsorption allows f
or prolonged graft survival compared with control animals. Subsequent
xenograft destruction occurs but in a modified manner.