Establishing a Swine Model to Study Whole Eye Transplant Dynamic Preservation and Transplantation

The very first human Whole Eye Transplant (WET) has sparked new hope for patients who have lost vision due to major ophthalmic injury, but significant challenges remain to be addressed before vision restoration through WET can become achievable. Among these, one of the most critical challenges is ex vivo preservation. The eyeball, particularly its neural components such as the retina and optic nerve, undergoes rapid and irreversible degeneration within minutes unless proper preservation is ensured. Static cold storage (SCS) remains the gold standard in vascularized composite allotransplantation (VCA) but is not suited to WET ex vivo preservation due to its inability to sufficiently suppress or support metabolism, leading to loss of graft viability and function. Subnormothermic machine perfusion (SNMP) has emerged as a promising alternative to SCS, offering the potential not only to preserve grafts but also to recondition them. Our group has successfully translated SNMP from solid organ transplantation to several VCA models, demonstrating its feasibility and advantages. Herein, we report the application of SNMP to preserve a WET in swine, detailing the anatomical model and preservation protocol. This approach represents a significant step forward in optimizing WET preservation and transplantation techniques.