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However, it had not been fully determined which immunosuppressive choice would be optimal for long-term graft survival. We aimed to compare clinical results in wild-type pig-to-rhesus corneal xenotransplantation with various immunosuppressive regimens.Methods: Medical records of 23 Chinese rhesus macaques who had received full-thickness corneal transplantation with wildtype pigs were retrospectively analyzed. They were administered various immunosuppressants including steroid, tacrolimus, anti-CD20 antibody, costimulation blockade (CoB) or their combinations. Graft survival, central corneal thickness, changes in plasma anti-\u03b1Gal and donor-specific antibodies, aqueous complement levels, and blood effector and memory T\/B cell subsets were compared between the groups with different regimens in the follow-up of 6 months.Results: Graft survival time of anti-CD20 antibody (aCD20), anti-CD40 antibody (aCD40), or anti-CD154 antibody (aCD154)-based regimen group was significantly longer than that of steroid (S) or steroid and tacrolimus (S + T) group. Interferon gamma T cell responses, both anti-\u03b1Gal immunoglobulin G (IgG) and donor-specific IgG levels, along with complement responses, were effectively managed under both the aCD20 and CoB regimens. Compared with aCD154 group, aCD40 group showed higher donor-specific IgG responses and aqueous C3a level. B and activated B cell concentrations were significantly lower in aCD20 group than in S, S + T, or CoB group.Conclusions: It suggests that an aCD20-based regimen produces clinical outcomes comparable to those of an aCD154-based regimen in wild-type pig-to-rhesus corneal xenotransplantation, whereas an aCD40-based regimen does not.<\/jats:p>","DOI":"10.3341\/kjo.2026.0004","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T05:31:31Z","timestamp":1775194291000},"page":"366-376","update-policy":"https:\/\/doi.org\/10.3341\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Comparative Analysis of Pig-to-Rhesus Corneal Xenotransplantation with Various Immunosuppressive Regimens"],"prefix":"10.3341","volume":"40","author":[{"given":"Seung Hyeun","family":"Lee","sequence":"first","affiliation":[{"name":"Laboratory of Ocular Regenerative Medicine and Immunology, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea"},{"name":"Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang Ho","family":"Yoon","sequence":"additional","affiliation":[{"name":"Laboratory of Ocular Regenerative Medicine and Immunology, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea"},{"name":"Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyuk Jin","family":"Choi","sequence":"additional","affiliation":[{"name":"Laboratory of Ocular Regenerative Medicine and Immunology, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea"},{"name":"Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun 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