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No long term transmission of PERV in fifty five patients receiving porcine skin xenografts

L. Scobie¹, C. Crossan¹, M. Matouskova², R. Hector¹, E. Cozzi³, M-C. Tallachini⁴, J-P. Soulillou⁵, J. Ribes⁶, Y. Takeuchi⁶, J. Hejnar¹, J. Blaha¹, P. Vesely¹

¹Department of Biological and Biomedical Sciences, Glasgow Caledonian University, Glasgow, United Kingdom; ²Department of Cellular and Viral Genetics, Institute of Molecular Genetics, Prague, Czech Republic; ³Direzione Sanitaria, Padua General Hospital, Padua, Italy; ⁴Facoltà di Giurisprudenza, Università Cattolica S.C, Piacenza, Italy; ⁵ITUN, Nantes, INSERM UMR643, Nantes, France; ⁶Infection and Immunity, UCL, London, United Kingdom

Introduction: Human cadaver skin is not always available and commercially available porcine skin has been shown to be effective in treating patients with severe burns. However, like other xenotransplantation practices, the use of porcine skin has raised issues about the viral safety of this technology. In addition, the long term safety monitoring of these practices is paramount to ensure that there is little or no risk of infection to the recipient.

Methods: This study examines 55 xenograft recipients with a post exposure to porcine skin grafts time up to 408 months (average 116.0 months ±SD74.3). All patients had 2nd and 3rd degree burns and were minimally immune-suppressed due to their condition. All samples were tested for PERV RNA, DNA, pig cell microchimerism and antibodies to PERV. Animals from the donor herd were also tested for the ability to transmit PERV in vitro.

Results: No evidence of persistent and/or productive PERV infection or antibody to PERV was seen in any of the patients examined when compared with controls (n=34). In addition, this is the first instance where the donor animals PERV transmission status has been documented.

Conclusion: It is clear that there is a risk for the transfer of pathogens via porcine skin xenografts, however, the evidence in vivo to date would suggest that the risk of PERV transmission is low even in severely burned recipients.