{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:02:11Z","timestamp":1791810131169,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,9,22]],"date-time":"2021-09-22T00:00:00Z","timestamp":1632268800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006492","name":"Division of Intramural Research, National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["AI090959"],"award-info":[{"award-number":["AI090959"]}],"id":[{"id":"10.13039\/100006492","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011120","name":"Office of Postdoctoral Education, University of Alabama at Birmingham","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100011120","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Blood transfusion remains important in the treatment of patients with sickle cell disease (SCD). However, alloimmunization after blood transfusion is associated with patient morbidity and mortality. Triple\u2010knockout (TKO) pigs (i.e., pigs in which the three known xenoantigens to which humans have anti\u2010pig antibodies have been deleted) may be an alternative source of RBCs for these patients because many humans have no preformed antibodies to TKO pig RBCs (pRBCs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and materials<\/jats:title><jats:p>In an in vitro study, plasma from alloimmunized (<jats:italic>n<\/jats:italic>\u00a0=\u00a012) or non\u2010alloimmunized (<jats:italic>n<\/jats:italic>\u00a0=\u00a012) SCD patients was used to determine IgM\/IgG binding to, and CDC of, TKO pRBCs. In an in vivo study, after an estimated 25% of blood volume was withdrawn from two capuchin monkeys, CFSE\u2010labeled TKO pRBCs were transfused. Loss of TKO pRBCs was monitored by flow cytometry, and 7\u2009weeks later, 25% of blood was withdrawn, and CFSE\u2010labeled monkey RBCs were transfused.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The in vitro study demonstrated that plasma from neither alloimmunized nor non\u2010alloimmunized SCD patients bound IgM\/IgG to, or induced CDC of, TKO pRBCs. In the in vivo study, survival of TKO pRBCs in the two capuchin monkeys was of 5 and 7\u2009days, respectively, whereas after allotransfusion, survival was &gt;28\u2009days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In conclusion, (1) in the present limited study, no antibodies were detected that cross\u2010reacted with TKO pRBCs, and (2) TKO pigs may possibly be an alternate source of RBCs in an emergency if no human RBCs are available.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.16667","type":"journal-article","created":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T05:39:22Z","timestamp":1632375562000},"page":"3104-3118","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Initial experimental experience of triple\u2010knockout pig red blood cells as potential sources for transfusion in alloimmunized patients with sickle cell disease"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8216-0750","authenticated-orcid":false,"given":"Takayuki","family":"Yamamoto","sequence":"first","affiliation":[{"name":"Xenotransplantation Program, Department of Surgery University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"Division of Transplantation, Department of Surgery Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3100-0041","authenticated-orcid":false,"given":"Mohamed H.","family":"Bikhet","sequence":"additional","affiliation":[{"name":"Xenotransplantation Program, Department of Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa B.","family":"Marques","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huy Q.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Xenotransplantation Program, Department of Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yehua","family":"Cui","sequence":"additional","affiliation":[{"name":"Xenotransplantation Program, Department of Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariyam","family":"Javed","sequence":"additional","affiliation":[{"name":"Xenotransplantation Program, Department of Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3864-8198","authenticated-orcid":false,"given":"Syed Sikandar","family":"Raza","sequence":"additional","affiliation":[{"name":"Xenotransplantation Program, Department of Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Ayares","sequence":"additional","affiliation":[{"name":"Revivicor  Blacksburg Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayato","family":"Iwase","sequence":"additional","affiliation":[{"name":"Xenotransplantation Program, Department of Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David K. 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