Supplementary Figure 1. Serial photographs of anterior segment in each recipient
after pig-to-rhesus lamellar corneal transplantation.
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In the Fresh group (n = 4), two recipients (Fresh 2 and 3) showed graft edema with
peripheral neovascularization (red arrows) around 4 weeks post-transplantation, resulting in
rejection at 112 days and 69 days post-transplantation, respectively. The other two
recipients showed no signs of rejection. In the Decell group (n = 5), all 5 recipients showed
a near-total epithelial defect (yellow arrows) on the day after transplantation, but these
defects were completely re-epithelialized by day 5-8 post-transplantation. Four recipients
(Decell 1-4) showed no signs of rejection during follow-up, but the remaining recipient
(Decell 5), which received decellularized posterior porcine stroma, showed a persistent
epithelial defect for more than 3 weeks, and eventually the graft was rejected with severe
edema and new vessels (red arrows).
The first images in each recipient were taken immediately after the operation (Op).
Numbers at the lower right corner in each image means post-operative days.
Fresh group; received untreated fresh porcine corneal lamellar grafts
Decell group; received hypertonic saline-treated porcine corneal lamellar grafts
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Supplementary Figure 2. Changes in memory T cell population in 3 recipients that
underwent chronic rejection.
As rejection progressed, effector memory CD8+ T cells (black solid lines) showed the most
prominent increase in number.
Fresh 2, rejection at 112 days post-transplantation; Fresh 3, rejection at 69 days posttransplantation; Decell 5, rejection at 49 days post-transplantation.
Fresh; received untreated fresh porcine corneal lamellar grafts
Decell; received hypertonic saline-treated porcine corneal lamellar grafts
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Supplementary Figure 3. Changes in aqueous and plasma C3a concentrations in 3
recipients that underwent chronic rejection.
Plasma C3a concentrations increased in the very early post-operative period (peak at 2-3
days post-transplantation), and aqueous C3a was maintained in high concentration even at
4 weeks post-transplantation.
All data represent the mean + S.D.
Fresh; received untreated fresh porcine corneal lamellar grafts
Decell; received hypertonic saline-treated porcine corneal lamellar grafts
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Supplementary Figure 4. Peak values in plasma anti-α-Gal antibody concentrations of
rhesus recipients under the terms of different porcine xenografts.
Group 1; received partial thickness porcine cornea in this study (n=7), Group 2; received full
thickness porcine cornea (n=1), Group 3; received porcine islet cells via portal vein (n=7,
from Xenotransplantation Research Center, Seoul National University Hospital). After
transplantation, group 3 showed much higher peak IgG and IgM concentrations than group
2 or group 3. Moreover, the result that group 2 showed higher peak IgG and IgM
concentrations than group 1 suggests lamellar corneal transplantation strategy is beneficial
to reduce a xenogeneic immunologic burden, which correlates with rejection of a xenograft.
All data represent the mean + S.D.
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