{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T11:37:06Z","timestamp":1784806626137,"version":"3.55.0"},"reference-count":48,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011102","name":"European Union Seventh Framework Programme","doi-asserted-by":"crossref","award":["FP7\/2007\u20132013"],"award-info":[{"award-number":["FP7\/2007\u20132013"]}],"id":[{"id":"10.13039\/100011102","id-type":"DOI","asserted-by":"crossref"}]},{"name":"TRANSLINK","award":["603049"],"award-info":[{"award-number":["603049"]}]},{"name":"Ministerio de Econom\u00eda y Competitividad-ISCiii","award":["PI15\/00181"],"award-info":[{"award-number":["PI15\/00181"]}]},{"name":"Department of Health of Generalitat de Catalunya","award":["PERIS SLT002\/16\/00445"],"award-info":[{"award-number":["PERIS SLT002\/16\/00445"]}]},{"name":"FEDER funds"},{"name":"IDIBELL summer internship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Structural valve deterioration (SVD) remains a key limitation in bioprosthetic heart valve (BHV) usage influenced by patient age. A deeper understanding of SVD pathogenesis, particularly of the immune-mediated processes altering current BHV materials, is therefore critical. To this end, commercially available BHV tissues of bovine, porcine, and equine origin were investigated following subcutaneous implantation into \u03b11,3-galactosyltransferase-knockout (Gal KO) mice. We compared the immune responses between adult and aged animals via histological assessments of explants and measurement of serum anti-galactose \u03b11,3-galactose (Gal) and anti-non-Gal antibodies at 2 months post-implantation. In contrast to adult mice, old Gal KO mice did not show increased levels of serum anti-Gal or -non-Gal antibodies after receiving specific BHV tissue (i.e., Freedom-Solo). Instead, a significant decrease in serum anti-Gal IgM was found in old recipients of Freedom-Solo. Furthermore, the overall cellular immune response was attenuated in explants from old mice compared with adults (i.e., ATS 3f and Crown). Nevertheless, the Freedom-Solo (bovine) and the Hancock-II (porcine) tissues still elicited strong cellular immune infiltration in the old cohorts. Therefore, the Gal KO mouse model offers a valuable platform to investigate age-related differences regarding cellular and humoral immune responses to various BHV tissues, contributing to our understanding of SVD.<\/jats:p>","DOI":"10.3390\/bioengineering13010053","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T16:34:23Z","timestamp":1767198863000},"page":"53","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Antibody and Cellular Immune Responses in Old \u03b11,3-Galactosyltransferase-Knockout Mice Implanted with Bioprosthetic Heart Valve Tissues"],"prefix":"10.3390","volume":"13","author":[{"given":"Kelly","family":"Cas\u00f3s","sequence":"first","affiliation":[{"name":"Infectious Diseases and Transplantation Division, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge (IDIBELL), L\u2019Hospitalet de Llobregat, 08908 Barcelona, Spain"},{"name":"Department of Pulmonary Medicine, Servei de Pneumologia, Hospital Cl\u00ednic-Institut d\u2019Investigacions Biom\u00e8diques August Pi I Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0566-9577","authenticated-orcid":false,"given":"Roger","family":"Llatj\u00f3s","sequence":"additional","affiliation":[{"name":"Pathology Department, Bellvitge University Hospital, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2796-7428","authenticated-orcid":false,"given":"Arnau","family":"Blasco-Lucas","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Bellvitge University Hospital, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7213-6503","authenticated-orcid":false,"given":"Sebasti\u00e1n G.","family":"Kuguel","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Transplantation Division, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge (IDIBELL), L\u2019Hospitalet de Llobregat, 08908 Barcelona, Spain"},{"name":"Bioengineering Department, Institut Qu\u00edmic de Sarri\u00e0 (IQS), Universitat Ramon Llull (URL), 08017 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1249-4119","authenticated-orcid":false,"given":"Fabrizio","family":"Sbraga","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Bellvitge University Hospital, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9529-6136","authenticated-orcid":false,"given":"Cesare","family":"Galli","sequence":"additional","affiliation":[{"name":"Avantea, Laboratory of Reproductive Technologies, Via Porcellasco 7\/F, 26100 Cremona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4761-3571","authenticated-orcid":false,"given":"Vered","family":"Padler-Karavani","sequence":"additional","affiliation":[{"name":"Department of Cell Research and Immunology, The Shmunis School of Biomedicine and Cancer Research, The George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv 69978, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0110-9054","authenticated-orcid":false,"given":"Thierry","family":"Le Tourneau","sequence":"additional","affiliation":[{"name":"Institut du Thorax, INSERM UMR1087, Nantes University Hospital, 8 Quai Moncousu, 44007 Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9763-2383","authenticated-orcid":false,"given":"Marta","family":"Vadori","sequence":"additional","affiliation":[{"name":"Transplantation Immunology Unit, Padua University Hospital, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3928-6977","authenticated-orcid":false,"given":"Jean-Christian","family":"Roussel","sequence":"additional","affiliation":[{"name":"Institut du Thorax, INSERM UMR1087, Nantes University Hospital, 8 Quai Moncousu, 44007 Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7299-2983","authenticated-orcid":false,"given":"Tomaso","family":"Bottio","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova Medical School, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7855-5055","authenticated-orcid":false,"given":"Emanuele","family":"Cozzi","sequence":"additional","affiliation":[{"name":"Transplantation Immunology Unit, Padua University Hospital, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7468-5135","authenticated-orcid":false,"given":"Jean-Paul","family":"Soulillou","sequence":"additional","affiliation":[{"name":"Institut de Transplantation\u2013Urologie\u2013N\u00e9phrologie, INSERM Unit\u00e9 Mixte de Recherche 1064, Nantes University Hospital, 44093 Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0888-976X","authenticated-orcid":false,"given":"Manuel","family":"Gali\u00f1anes","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Reparative Therapy of the Heart, Vall d\u2019Hebron Research Institute (VHIR), University Hospital Vall d\u2019Hebron, Universitat Aut\u00f2noma de Barcelona, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0884-5564","authenticated-orcid":false,"given":"Rafael","family":"M\u00e1\u00f1ez","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Transplantation Division, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge (IDIBELL), L\u2019Hospitalet de Llobregat, 08908 Barcelona, Spain"},{"name":"Intensive Care Department, Bellvitge University Hospital, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1837-4268","authenticated-orcid":false,"given":"Cristina","family":"Costa","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Transplantation Division, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge (IDIBELL), L\u2019Hospitalet de Llobregat, 08908 Barcelona, Spain"},{"name":"Institut de Qu\u00edmica i Biotecnologia de Barcelona (IQBB), Consorci d\u2019Educaci\u00f3 de Barcelona (CEB), 08003 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1080\/14779072.2021.1924676","article-title":"Increased utilization of bioprosthetic aortic valve technology: Trends, drivers, controversies and future directions","volume":"19","author":"Qi","year":"2021","journal-title":"Expert. Rev. Cardiovasc. Ther."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.amjcard.2024.04.008","article-title":"Long-Term Outcomes of Bioprosthetic Valves in the Mitral Position: A Pooled Meta-Analysis of Reconstructed Time-to-Event Individual Patient Data","volume":"221","author":"Koulouroudias","year":"2024","journal-title":"Am. J. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.amjcard.2024.07.004","article-title":"Age-Based Outcomes After Surgical Aortic Valve Replacement with Bioprosthetic Versus Mechanicus Valves","volume":"226","author":"Ashwat","year":"2024","journal-title":"Am. J. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Williams, D.F., Bezuidenhout, D., de Villiers, J., Human, P., and Zilla, P. (2021). Long-Term Stability and Biocompatibility of Pericardial Bioprosthetic Heart Valves. Front. Cardiovasc. Med., 8.","DOI":"10.3389\/fcvm.2021.728577"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1186\/s13019-023-02464-2","article-title":"Systematic review of first-in-human and early phase clinical trials for surgically implantable biological mitral valve substitutes","volume":"18","author":"Sazzad","year":"2023","journal-title":"J. Cardiothorac. Surg."},{"key":"ref_6","first-page":"102","article-title":"Considerations for Optimal Device Selection in Transcatheter Aortic Valve Replacement: A Review","volume":"6","author":"Claessen","year":"2021","journal-title":"JAMA Cardiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1080\/17434440.2023.2288275","article-title":"Transcatheter aortic valve durability, predictors of bioprosthetic valve dysfunction, longer-term outcomes\u2014A review","volume":"21","year":"2024","journal-title":"Expert. Rev. Med. Devices"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.1016\/S0140-6736(15)60511-6","article-title":"First clinical use of a bioprosthetic total artificial heart: Report of two cases","volume":"386","author":"Carpentier","year":"2015","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1016\/j.healun.2024.01.019","article-title":"Durable left ventricular assist devices as a bridge to transplantation in The Old and The New World","volume":"43","author":"Fernandez","year":"2024","journal-title":"J. Heart Lung Transplant."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1016\/j.hlc.2019.09.013","article-title":"Patient Risk Factors for Bioprosthetic Aortic Valve Degeneration: A Systematic Review and Meta-Analysis","volume":"29","author":"Ochi","year":"2020","journal-title":"Heart Lung Circ."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e018506","DOI":"10.1161\/JAHA.120.018506","article-title":"Degeneration of Bioprosthetic Heart Valves: Update 2020","volume":"9","author":"Kostyunin","year":"2020","journal-title":"J. Am. Heart Assoc."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e018921","DOI":"10.1161\/JAHA.120.018921","article-title":"Noncalcific Mechanisms of Bioprosthetic Structural Valve Degeneration","volume":"10","author":"Marro","year":"2021","journal-title":"J. Am. Heart Assoc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1038\/s41591-022-01682-w","article-title":"The role of antibody responses against glycans in bioprosthetic heart valve calcification and deterioration","volume":"28","author":"Senage","year":"2022","journal-title":"Nat. Med."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Gali\u00f1anes, M., Cas\u00f3s, K., Blasco-Lucas, A., Permanyer, E., M\u00e1\u00f1ez, R., Le Tourneau, T., Barquinero, J., Schwartz, S., Roussel, J.C., and Fellah-Hebia, I. (2022). Oxidative Stress in Structural Valve Deterioration: A Longitudinal Clinical Study. Biomolecules, 12.","DOI":"10.3390\/biom12111606"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e2219054120","DOI":"10.1073\/pnas.2219054120","article-title":"Bioprosthetic heart valve structural degeneration associated with metabolic syndrome: Mitigation with polyoxazoline modification","volume":"120","author":"Abramov","year":"2023","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1111\/xen.12044","article-title":"First quantification of alpha-Gal epitope in current glutaraldehyde-fixed heart valve bioprostheses","volume":"20","author":"Naso","year":"2013","journal-title":"Xenotransplantation"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1111\/xen.12260","article-title":"Characterization of immunogenic Neu5Gc in bioprosthetic heart valves","volume":"23","author":"Reuven","year":"2016","journal-title":"Xenotransplantation"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1111\/xen.12254","article-title":"Human antibody recognition of xenogeneic antigens (NeuGc and Gal) on porcine heart valves: Could genetically modified pig heart valves reduce structural valve deterioration?","volume":"23","author":"Lee","year":"2016","journal-title":"Xenotransplantation"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1111\/xen.12187","article-title":"Characterization of the cellular infiltrate in bioprosthetic heart valves explanted from patients with structural valve deterioration","volume":"22","author":"Manji","year":"2015","journal-title":"Xenotransplantation"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Li, L., Duan, X., Wang, H., Sun, Y., Zhao, W., Lu, Y., Xu, H., You, Y., and Wang, Q. (2022). Is cell regeneration and infiltration a double edged sword for porcine aortic valve deterioration? A large cohort of histopathological analysis. BMC Cardiovasc. Disord., 22.","DOI":"10.1186\/s12872-022-02776-6"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Cas\u00f3s, K., Llatj\u00f3s, R., Blasco-Lucas, A., Kuguel, S.G., Sbraga, F., Galli, C., Padler-Karavani, V., Le Tourneau, T., Vadori, M., and Perota, A. (2023). Differential Immune Response to Bioprosthetic Heart Valve Tissues in the \u03b11,3Galactosyltransferase-Knockout Mouse Model. Bioengineering, 10.","DOI":"10.3390\/bioengineering10070833"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Galili, U. (2023). Antibody production and tolerance to the alpha-gal epitope as models for understanding and preventing the immune response to incompatible ABO carbohydrate antigens and for alpha-gal therapies. Front. Mol. Biosci., 10.","DOI":"10.3389\/fmolb.2023.1209974"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1096\/fj.02-0630fje","article-title":"Delayed rejection of porcine cartilage is averted by transgenic expression of alpha1,2-fucosyltransferase","volume":"17","author":"Costa","year":"2003","journal-title":"FASEB J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1056\/NEJMoa1613792","article-title":"Mechanical or Biologic Prostheses for Aortic-Valve and Mitral-Valve Replacement","volume":"377","author":"Goldstone","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/xen.12080","article-title":"Bioprosthetic heart valves of the future","volume":"21","author":"Manji","year":"2014","journal-title":"Xenotransplantation"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1869","DOI":"10.1172\/JCI16526","article-title":"Removal of anti-Galalpha1,3Gal xenoantibodies with an injectable polymer","volume":"110","author":"Katopodis","year":"2020","journal-title":"J. Clin. Invest."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"258","DOI":"10.22203\/eCM.v030a18","article-title":"Genetic engineering strategies to prevent the effects of antibody and complement on xenogeneic chondrocytes","volume":"30","author":"Sommaggio","year":"2015","journal-title":"Eur. Cell. Mater."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1093\/ejcts\/ezr260","article-title":"Immune response to bovine pericardium implanted into \u03b11,3-galactosyltransferase knockout mice: Feasibility as an animal model for testing efficacy of anticalcification treatments of xenografts","volume":"42","author":"Lee","year":"2012","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Naso, F., Gandaglia, A., Sturaro, G., Galli, C., and Melder, R.J. (2024). The \u03b1-Gal KO Mouse Animal Model is a Reliable and Predictive Tool for the Immune-Mediated Calcification Assessment of Heart Valve Bioprostheses. Front. Biosci., 29.","DOI":"10.31083\/j.fbl2905181"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/j.imlet.2014.06.017","article-title":"Immunosenescence in monocytes, macrophages, and dendritic cells: Lessons learned from the lung and heart","volume":"162","author":"Linton","year":"2014","journal-title":"Immunol. Lett."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.imlet.2020.12.003","article-title":"The impact of ageing on monocytes and macrophages","volume":"230","author":"Chambers","year":"2021","journal-title":"Immunol. Lett."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1023\/A:1007094614047","article-title":"Modulation of adherence and chemotaxis of macrophages by norepinephrine. Influence of ageing","volume":"203","author":"Ortega","year":"2000","journal-title":"Mol. Cell. Biochem."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1146\/annurev-cellbio-011620-034148","article-title":"B Cell Immunosenescence","volume":"36","author":"Frasca","year":"2020","journal-title":"Annu. Rev. Cell. Dev. Biol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.imlet.2014.06.016","article-title":"The aging bone marrow and its impact on immune responses in old age","volume":"162","author":"Pritz","year":"2014","journal-title":"Immunol. Lett."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/j.coi.2009.05.009","article-title":"Effects of aging on T cell function","volume":"21","author":"Haynes","year":"2009","journal-title":"Curr. Opin. Immunol."},{"key":"ref_36","first-page":"222","article-title":"Anti-alpha-Gal antibody response following xenogeneic heart valve implantation in adults","volume":"22","author":"Park","year":"2013","journal-title":"J. Heart Valve Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1111\/j.1399-3089.2004.00152.x","article-title":"Failure to deplete anti-Galalpha1-3Gal antibodies after pig-to-baboon organ xenotransplantation by immunoaffinity columns containing multiple Gal alpha1-3Gal oligosaccharides","volume":"11","author":"Domenech","year":"2004","journal-title":"Xenotransplantation"},{"key":"ref_38","unstructured":"Abbas, A.K., Lichtman, A.H.H., and Pillai, S. (2017). Cellular and Molecular Immunology, Elsevier. [9th ed.]."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.imlet.2019.03.014","article-title":"Differential effects of anaphylatoxin C5a on antigen presenting cells, roles for C5aR1 and C5aR2","volume":"209","author":"Zaal","year":"2019","journal-title":"Immunol. Lett."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1517\/13543784.9.5.975","article-title":"Therapeutic potential of complement inhibitors in myocardial ischaemia","volume":"9","author":"Lucchesi","year":"2000","journal-title":"Expert Opin. Investig. Drugs."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1038\/nri2206","article-title":"Fc gamma receptors as regulators of immune responses","volume":"8","author":"Nimmerjahn","year":"2008","journal-title":"Nat. Rev. Immunol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.xjon.2021.02.012","article-title":"Inflammatory immune response in recipients of transcatheter aortic valves","volume":"6","author":"Veraar","year":"2021","journal-title":"JTCVS Open"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1016\/j.jtcvs.2012.08.060","article-title":"Durability of pericardial versus porcine bioprosthetic heart valves","volume":"144","author":"Grunkemeier","year":"2012","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1093\/ejcts\/ezu473","article-title":"Pitfalls and premature failure of the Freedom SOLO stentless valve","volume":"48","author":"Stanger","year":"2015","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Chiariello, G.A., Di Mauro, M., Villa, E., Koulouroudias, M., Bruno, P., Mazza, A., Pasquini, A., D\u2019Avino, S., De Angelis, G., and Corigliano, K. (2024). Sutureless Bioprostheses for Aortic Valve Replacement: An Updated Systematic Review with Long-Term Results. J. Clin. Med., 13.","DOI":"10.3390\/jcm13226829"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e12394","DOI":"10.1111\/xen.12394","article-title":"B4GALNT2 and xenotransplantation: A newly appreciated xenogeneic antigen","volume":"25","author":"Byrne","year":"2018","journal-title":"Xenotransplantation"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Breimer, M.E., and Holgersson, J. (2019). The Structural Complexity and Animal Tissue Distribution of N-Glycolylneuraminic Acid (Neu5Gc)-Terminated Glycans. Implications for Their Immunogenicity in Clinical Xenografting. Front. Mol. Biosci., 6.","DOI":"10.3389\/fmolb.2019.00057"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.actbio.2018.03.055","article-title":"Reducing immunoreactivity of porcine bioprosthetic heart valves by genetically-deleting three major glycan antigens, GGTA1\/beta4GalNT2\/CMAH","volume":"72","author":"Zhang","year":"2018","journal-title":"Acta Biomater."}],"container-title":["Bioengineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2306-5354\/13\/1\/53\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T05:13:16Z","timestamp":1767330796000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2306-5354\/13\/1\/53"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,31]]},"references-count":48,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["bioengineering13010053"],"URL":"https:\/\/doi.org\/10.3390\/bioengineering13010053","relation":{},"ISSN":["2306-5354"],"issn-type":[{"value":"2306-5354","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,31]]}}}